健脾滋肾法对系统性红斑狼疮的疗效及患者生活质量的影响

Effects of spleen-fortifying and kidney-replenishing therapy on manifestation and quality of life in patients with systemic lupus erythematosus disease

目的探讨健脾滋肾法治疗系统性红斑狼疮(SLE)的疗效及对患者生活质量的改善作用。方法将50例SLE患者随机分为治疗组25例和对照组25例,对照组给予泼尼松片联合硫酸羟氯喹治疗,治疗组在此基础上,加用中药健脾滋肾汤。比较2组治疗前后的临床疗效,系统性红斑狼疮活动性标准(SLEDAI)积分变化,生活质量积分变化,抑郁(SDS)、焦虑(SAS)量表积分变化,中医症状积分变化,实验室指标变化。结果治疗组临床缓解4例,显效10例,有效8例,无效3例,总有效率为88.0%;对照组临床缓解2例,显效6例,有效10例,无效7例,总有效率为72.0%。经Ridit分析,U=2.771,P<0.05,说明治疗组疗效优于对照组。2组间治疗前后SLEDAI积分差值无显著性差异(P>0.05);治疗组治疗前后生活质量各维度积分和SAS、SDS积分差值与对照组比较均有统计学意义(P<0.01);治疗组治疗前后各项中医症状积分差值与对照组比较均有统计学意义(P<0.05);治疗组治疗前后实验室指标免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)、补体C4(C4)、超敏C反应蛋白(CRP)、白细胞(WBC)、红细胞(RBC)与对照组比较均有统计学意义(P<0.05)。结论健脾滋肾法治疗SLE取得了较好的临床疗效,对疾病活动度,生活质量积分、中医症状积分及抑郁焦虑量表积分等方面具有显著的改善作用,且安全性高,适合在临床推广使用。

Objective To explore the effects of spleen-fortifying and kidney-replenishing therapy on manifestation and quality of life in patients with systemic lupus erythematosus disease（ SLE）. Methods 50 SLE patients were randomly divided into treatment group and control group. Both groups were given prednisone tablets combined with hydroxychloroquine sulfate while the treatment group also took the Spleenfortifying and Kidney-replenishing Decoction（ Jianpi Yishen Tang）. Changes of clinical manifestations and laboratory parameters before and after treatment were used to evaluate the efficacy and effects on the quality of life. Results Total effective rate of 88. 0% with 4 cases of clinical response,10 cases of remarkable effect,8 cases of effect and 3 cases of non-respond in the treatment group,was significantly higher than 72. 0% of the control group（ clinical response 2 cases,remarkable effect 6 cases,effect 10 cases and non-response 7 cases）（ P 0. 05）. There was no significant difference between the two groups in SLEDAI scores. The treatment group was significantly superior to the control group（ P 0. 01） in improving patients＇ quality of life and scores of SDS and SAS. TCM symptom scores in the treatment group were significantly lower than those in the control group（ P 0. 05）. Ig G,CRP and other laboratory parameters in the treatment group were also significantly lower than that of the control group（ P 0. 05）.Levels of Ig M,C4,WBC,and RBC in the treatment group were significantly higher than those in the control group（ P 0. 05）. Conclusion Spleen-fortifying and kidney-replenishing therapy could significantly attenuate clinical manifestations,disease activity,TCM symptom scores and relieve anxiety and depression in SLE patients. The efficiency and safety had been proved to improve the quality of patents＇ life.