清养透解合剂联合西药对系统性红斑狼疮患者血管损伤的影响

Effects of Qingyang Toujie Mixture Combined With Western Medicine on Vascular Injury in Patients With Systemic Lupus Erythematosus

目的观察清养透解合剂联合西药治疗系统性红斑狼疮(SLE)患者的临床疗效及其对血管损伤的影响。方法采用前瞻性单盲随机对照的方法,将42例SLE阴虚证患者随机分为治疗组22例和对照组20例,并设健康体检者12名作为健康组。治疗组在西医基础治疗同时加用清养透解合剂,每天1剂;对照组在西医基础治疗同时加用安慰剂,每天1剂,两组均治疗6个月。观察两组治疗前后狼疮活动性评分(SLEDAI)、中医证候积分、泼尼松用量及不良反应;并与健康组比较人可溶性血栓调节蛋白(sTM)、血管假性血友病因子(vWF)的表达。结果与本组治疗前比较,两组治疗后SLEDAI评分、中医证候积分、泼尼松片用量均明显降低(P<0.01);治疗后治疗组SLEDAI评分、中医证候积分、泼尼松片用量均明显低于对照组(P<0.01或P<0.05)。治疗前治疗组及对照组与健康组比较血清vWF、sTM水平均明显升高(P<0.01);治疗组治疗后较治疗前血清vWF、sTM水平明显降低(P<0.01)。治疗组不良反应例数明显少于对照组(P<0.01)。结论清养透解合剂联合西药能改善SLE阴虚证患者临床症状,减少激素用量,明显降低血管损伤因子vWF、sTM的表达,从而减轻血管损伤。

Objective To observe the therapeutic effect of Qingyang Toujie Mixture combined with western medi-cine and its effects on vascular injury in patients with systemic lupus erythematosus （SLE）. Methods A prospective single - blind randomized controlled method was used. Totally 42 SLE patients with yin deficiency syndrome were randomized into the treatment group with 22 patients and control group with 20 patients. Twelve healthy persons wereselected as the healthy group. Both the treatment and control groups were given western medicine. The treatment group was added with Qingyang Toujie Mixture one dose daily. The control group was added with placebo one dose daily. Both groups were treated for 6 months. The Systemic Lupus Erythematosus Disease Activity Index （SLEDAI）,TCM syndrome score, prednisone dosage and adverse reactions were observed before and after treatment. The expressions of soluble thrombomodulin （sTM） and yon Willebrand factor （vWF） were observed and compared with the healthy group. Results The SLEDAI scores, TCM syndrome scores and prednisone dosage were significantly decreased in the treatment group and control group after treatment （ P 〈 0. 01 ）, especially in the treatment group （ P 〈 O. 01 ）. Comparing with the healthy group, the levels of vWF and sTM were significantly higher in the treatment group and control group before treatment （P 〈0. 01 ）. The levels of vWF and sTM were significantly decreased in the treat-ment group after treatment （P 〈 O. O1 ）. The cases of adverse reactions in the treatment group were significantly fewer than those in the control group （P 〈 0. 01 ）. Conclusion The combo therapy of Qingyang Toujie Mixture and western medicine can relieve the clinical symptoms, reduce the hormone dosage, decrease vWF and sTM expression, and alleviate vascular injury in SLE patients with yin deficiency syndrome.