中药组方治疗阴虚内热型系统性红斑狼疮及对Th相关细胞因子影响的研究

Research on the Treatment of Yin Deficiency and Interior Heat type SLE with TCM Formula and the Influence of Th-related Cytokines

目的:验证中药组方对阴虚内热型系统性红斑狼疮的疗效及对Th1/Th2平衡的调节作用。方法:将90例系统性红斑狼疮患者随机分为中医组、西医组和中西医结合组,每组30例。中西医结合组给予中药组方和激素;中医组给予为中药组方;西医组给予激素。中药组方药用生地、黄芩、积雪草、川芎、猫爪草、丹参。激素使用醋酸泼尼松龙每天1mg·kg-1治疗。三组均使用硫酸羟氯喹作为基本药物。治疗6个月,观察三组治疗前后临床症状及对血清中细胞因子(IL-2、IFN-γ、IL-4、IL-l0)水平的影响,并进行统计分析。结果:中西医结合组治疗后与治疗前相比,血清IL-2、IL-4水平有显著改善(P﹤0.01),IL-10水平有改善(P﹤0.05)。中西医结合组改善IL-4水平明显优于西医组(P<0.01),优于中医组(P﹤0.05)。在改善IL-2、IL-10水平上,三组治疗后比较,差异无统计学意义(P>0.05)。中西医结合组、西医组和中医组的总有效率分别为76.70%,46.70%和33.30%。中西医结合组有效率明显优于中医组(P﹤0.01),优于西医组(P﹤0.05)。中西医结合组对疾病活动评分积分的改善明显优于中医组(P﹤0.01),优于西医组(P﹤0.05)。中西医结合组改善中医证候积分优于中医组和西医组(P<0.05)。结论:中药组方治疗阴虚内热型系统性红斑狼疮作用机制之一,可能是改善了Th1和Th2之间细胞因子,从而调节了Th1/Th2平衡。

Objective： To test the therapeutic effect of traditional Chinese medicine formula （TCM formula） in the treatment of patients with systemic lupus erythematosus （SLE） and the formula＇s balance adjustment to Thl / Th2. Methods： 90 SLE cases were divided into the traditional Chinese medicine group treated with TCM formula, the western medicine group treated with hormonal （1 mg·kg-1 precortisyl） and the integrative medicine group treated with TCM formula and hormonal. The TCM formula was composed of Shengdi （Rehmannia Dride Rhizome）, Huangqin （Radix Scutellariae Baicalensis）, Jixuecao （Herba Centellae Asiaticae）, Chuanxiong （Rhizoma Chanxiong）, Maozhuacao （Radix Ranunculi Termati）, and Danshen （Radix Salviae Miltiorrhizae）. Hydroxychloroquine Sulfate was taken as the basic drug. All the patients were treated 6 months as a course. The clinical symptoms and levels of cytokines （IL-2, IFN-γ, IL-4, IL-10） before and after the treatment of the three groups were observed, and the statistical analysis was made. Results： Compared the integrative group before and after treatment, the serum levels oflL-2, IL-4 were significantly improved （P 〈 0.01 ） and serum level of IL- l0 was also improved （ P 〈 0.05 ） . The IL-4 level of the integrative group was obviously better than that of the western medicine group （ P 〈 0.01 ） and the Chinese medicine group （ P 〈 0.05 ） . In improving the IL-2, IL-10 levels, there was no statistical difference （ P 〉 0.05 ） between the three groups before and after the treatment. In respect of disease effectiveness assessment, total effectiveness rate of the integrative medicine group and the traditional Chinese medicine group were respectively 76 medicine group, the western .70%, 46.70% and 33.30%. The effectiveness rate of the integrative group was obviously superior to that of the traditional Chinese medicine group （P 〈 0.01 ） and the western medicine group （P 〈 0.05 ） . The improvement of the SLEDAI score of the integrative group was obviously superior to that of the traditional Chinese medicine group （ P 〈 0.01 ） and the western medicine group （ P 〈 0.05 ） . The improvement of the TCM symptom integral of the integrative group was superior to that of the Chinese medicine group and the western medicine group （ P 〈 0.05 ） . Conclusion： One of the mechanisms of the TCM formula in the treatment of yin-deficiency-and-interior-heat-type SLE might improve cytokines between Th 1 and Th2, thus regulating the balance of Th 1 / Th2.