养阴清热活血中药结合西药调节阴虚内热型系统性红斑狼疮Th1/Th2平衡的临床研究

Combination of herbal medicine and western medicine in regulating Th1 /Th2 of systemic lupus erythematosus of yin deficiency and internal heat pattern

目的观察养阴清热活血中药对阴虚内热型系统性红斑狼疮Th1/Th2相关细胞因子的干预作用,从调节Th1/Th2平衡的角度阐明其可能的作用机制。方法采用前瞻、随机、对照研究设计方案,将60例患者随机分为治疗组30例和对照组30例;两组均给予西医基础治疗,治疗组同时加用养阴清热活血中药。治疗6个月后,比较两组血清IL-2、IFN-γ、IL-4、IL-10水平,中医证候积分、SLE-DAI积分的变化情况。结果治疗组总有效率为83.3%,对照组总有效率为56.7%,组间临床疗效差异有统计学意义(P<0.05)。治疗后两组中医证候积分、SLE-DAI积分均明显降低(P<0.01),血清IL-2水平升高(P<0.01),治疗组在降低中医证候积分方面具有优势(P<0.01)。结论养阴清热活血中药治疗阴虚内热型系统性红斑狼疮总体疗效良好,可能通过提高血清IL-2水平,进而调节Th1/Th2平衡,发挥治疗作用。

Objective To explore the intervention effect of herbal medicine in treating systemic lupus erythematosus （SLE） and its mechanism of regulating the balance of Thl/Th2. Methods Sixty SLE cases were randomized into treatment group and control group by prospective randomized and controlled trial. Thirty cases in treatment group were treated by conventional western medicine and herbal medicine, and 30 cases in control group were treated by conventional western medicine. Six months after treatment, the levels of serum IL-2, IFN-~/, IL-4 and IL-10, and TCM syndrome score, SLE-DAI score were compared between the two groups. Results The total effective rate was 83.3% in the treatment group and 56.7%. The TCM syndrome score, SLE-DAI score and IL-2 level were improved significantly between before and after treatment in each group （P 〈 0. 001 ）. There was significant difference in improving the TCM syndrome score between the control group and treatment group （P 〈 0. 001 ）. Conclusion herbal medicine can regulate the Th1/Th2 balance by improving IL-2 level.