左归丸配合西药治疗狼疮性肾炎临床疗效观察

Clinical Observation of Zuogui Pills Combined with Western Medicine for Lupus Nephritis

目的:观察左归丸配合西药治疗狼疮性肾炎肝肾阴虚证患者的临床疗效。方法:将88例狼疮性肾炎肝肾阴虚证患者随机分为治疗组和对照组各44例。对照组予甲泼尼龙片、注射用环磷酰胺治疗,治疗组在对照组用药基础上以左归丸加减干预。2组连续治疗6月。比较2组的临床疗效,评定2组患者治疗前后的红斑狼疮活动度评分、肝肾阴虚证症状评分,并检测血清和尿液中的白细胞介素-17(IL-17)水平。结果:治疗组总有效率为97.73%,对照组总有效率为81.82%,2组比较,差异有统计学意义(P<0.05)。治疗3月和6月,2组红斑狼疮活动度评分、肝肾阴虚证各症状(浮肿、咽干口燥、脱发、耳鸣、五心烦热)评分均较治疗前减少(P<0.01),治疗组红斑狼疮活动度评分、各症状评分均低于对照组(P<0.01)。2组血清和尿液中IL-17水平均较治疗前降低(P<0.01),治疗组血清和尿液中IL-17水平均低于对照组(P<0.01)。结论:左归丸加减配合西药治疗狼疮性肾炎肝肾阴虚证患者可有助于控制病情,改善临床症状,提高临床疗效,其作用机制可能涉及下调炎症因子IL-17的表达,进而缓解机体的免疫性损伤。

Objective：To observe the clinical effect of Zuogui pills combined with western medicine for lupus nephritis with yin deficiency of liver and kidney syndrome. Methods：Divided 88 patients with hormone for lupus nephritis with yin deficiency of liver and kidney syndrome into the treatment group and the control group randomly,44 cases in each group.Both groups were treated with methylprednisolone tablets and cyclophosphamide for injection,while the treatment group was additionally given modified Zuogui pills. Both groups continuously received treatment for 6 months. Compared clinical effect of patients in both groups. Evaluated scores of lupus erythematosus activity and symptoms scores of yin deficiency of liver and kidney syndrome of patients in both groups before and after treatment. Detected levels of interleukin（IL）-17 in serum and urine of patients in both groups. Results：The total effective rate was 97.73% in the treatment group and 81.82% in the control group, the difference being significant（P〈0.05）. In the third and sixth month after treatment, scores of lupus erythematosus activity and symptoms scores of yin deficiency of liver and kidney syndrome such as dropsy,dry mouth and throat,hair loss,tinnitus and burning sensation of five feverish centers in both groups were decreased when compared with those before treatment（P〈0.01）. Scores of lupus erythematosus activity and all symptoms in the treatment group were lower than those in the control group（P〈0.01）. Levels of IL-17 in serum and urine in both groups were decreased when compared with those before treatment（P〈0.01）. Levels of IL-17 in serum and urine in the treatment group were lower than those in the control group（P〈0.01）. Conclusion：Modified Zuogui pills combined with western medicine for lupus nephritis with yin deficiency of liver and kidney syndrome can control disease, improve clinical symptoms and the clinical effect. The mechanism may be related to reducing the expression of inflammatory factor IL-17 so as to relieve immunologic injury of body.