灯盏花素联合双冲击疗法治疗狼疮脑病的临床观察

Clinical Observation of Breviscapine Combined with Double Shock in the Treatment of Lupus Encephalopathy

目的:观察灯盏花素联合双冲击疗法治疗狼疮脑病的疗效和安全性。方法:70例狼疮脑病患者随机均分为对照组和观察组。对照组患者给予注射用甲泼尼龙琥珀酸钠500 mg,静脉滴注,每日1次,连用3 d,第4天给予注射用环磷酰胺1.0 g,静脉滴注,第5天给予注射用甲泼尼龙琥珀酸钠80 mg进行维持治疗,每日1次,连用15 d;观察组患者在对照组治疗的基础上给予注射用灯盏花素50 mg静脉滴注,每日1次,连用20 d。观察两组患者治疗前后系统性红斑狼疮活动性(SLEDAI)评分、白细胞介素(IL)1β、IL-6、IL-8、干扰素(IFN)γ,记录神经症状和精神症状的发生例数、病死率及不良反应发生情况。结果:治疗后,两组患者SLEDAI评分、IL-1β、IL-6、IL-8、IFN-γ均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05);两组患者神经症状(除无菌性脑膜炎外)和精神症状(除幻听外)的发生例数均少于对照组,差异均有统计学意义(P<0.05)。两组患者病死率、不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:灯盏花素联合双冲击疗法治疗狼疮脑病疗效和安全性均较好,可降低SLEDAI评分,改善神经症状、精神症状。

OBJECTIVE ： To observe the efficacy and safety of breviscapine combined with double shock in the treatment of lu- pus encephalopathy. METHODS： 70 patients with lupus encephalopathy were randomly divided into control group and observation group. Control group was treated with Methylprednisolone sodium succinate for injection 500 mg for continuous 3 d, iv, once a day, Cyclophosphamide for injection 1.0 g in the 4th day, iv, and Methylprednisolone sodium succinate for injection 80 mg was used for maintaining treatment in the 5th day for continuous 15 d, once a day. Observation group was treated with Breviscapine for injection 50 mg for continuous 20 d based on the treatment of control group, iv, once a day. The SLE activity（SLEDAI） score, IL-113, IL-6, IL-8 and IFN-7 were observed, cases of neurological and psychological symptoms, the fatality rate and incidence of adverse reactions were recorded. RESULTS： After treatment, the SLEDAI, IL-1D, IL-6, IL-8 and IFN-y in 2 groups were signifi- cantly lower than before, and observation group was lower than control group（P〈0.05） ; the cases of neurological symptoms （ex- cept for aseptic meningitis） and psychological symptoms （except for auditory hallucinations） were significantly less than control group （P〈0.05）. There was no significant difference in the mortality rate and incidence of adverse reactions（P〉0.05）. CONCLU- SIONS ： Breviscapine combined with double shock has good efficacy and safety in the treatment of lupus encephalopathy, it can re- duce the SLEDAI score, improve neurological and psychological symptoms.