辨证论治配合激素治疗系统性红斑狼疮的疗效及对自身抗体水平的影响

Effect of Syndrome Differentiation combined with Hormone on Systemic Lupus Erythematosus

目的:探讨辨证论治结合激素治疗系统性红斑狼疮(SLE)的疗效及对自身抗体的影响。方法:将145例SLE患者随机分为治疗组和对照组,治疗组85例采用辨证论治配合激素治疗;对照组采用激素和免疫抑制剂治疗,观察两组患者的治疗效果;及治疗组各证型患者治疗前后自身抗体表达的变化情况。结果:治疗组总有效率为90.6%,显著高于对照组的76.7%(P<0.05)。治疗组抗ds DNA抗体、抗核小体抗体(Anu A)和抗U1RNP抗体总阳性率均较治疗前明显减低,差异有统计学意义(P<0.05)。治疗组中风湿热痹证患者治疗后抗ds DNA抗体阳性率明显降低,脾肾阳虚证患者治疗后Anu A阳性率明显降低,实证(风湿热痹证和瘀热痹阻证)患者治疗后抗U1RNP抗体阳性率明显降低,差异均有统计学意义(P<0.05)。结论:辨证施治结合激素治疗能有效改善SLE患者的病情,随着患者证的缓解,与其有关的自身抗体表达下降。

Objective： To explore the effect of syndrome differentiation combined with hormone on systemic lupus erythematosus （SLE）, and the changes of auto-antibodies. Methods： The 145 SLE patients were randomly divided into treatment group and control group. Treatment group of 85 patients were given syndrome differentiation combined with hormone; the control group of 60 cases were treated with hormone and immunosuppressive drugs. Then the therapeutic effect was observed in both groups. Changes were observed in patients with the syndrome before and after treatment of autoantibody treatment group expressed. Results： The effective rate of treatment group was 90.6%, significantly higher than the control group of 76.7% （P〈0.05）. The total positive rate of anti-dsDNA antibody, anti-nucleosome antibodies （AnuA） and anti U1RNP antibody in treatment group was significantly lower than pre-treatment, the difference was statistically significant （P〈0.05）. The positive rate of anti-dsDNA antibody was significantly lower in patients with wind-damp-heat arthralgia after treatment, the positive rate of AnuA significantly decreased in patients with spleen deficiency syndrome after treatment, the antiantibody positive rate U1RNP positive group （wind-damp-heat arthralgia and stasis heat blockage syndrome） patients after treatment was significantly lower, the difference was statistically significant （P〈0.05）. Conclusion： Syndrome differentiation combined with hormone can effectively improve the patient＇s condition. With the remission of the patient＇s syndrome, the expression of its own antibody decreased.