雷公藤双层片联合甲泼尼龙脉冲治疗系统性红斑狼疮的临床研究

Clinical study of Tripterygium wilfordii double-layer tablets combined with methylprednisolone pulse in the treatment of systemic lupus erythematosus

目的观察雷公藤双层片联合甲泼尼龙脉冲治疗系统性红斑狼疮(SLE)的临床疗效并分析其治疗机制。方法将2017年1月至2018年1月该院收治的173例SLE患者按入院先后顺序采用随机对照原则分为对照组(85例)和观察组(88例)。对照组采用甲泼尼龙脉冲治疗,观察组采用雷公藤双层片联合甲泼尼龙脉冲治疗。比较两组患者外周血单核细胞趋化蛋白-4、血清白细胞介素-2(IL-2)、IL-4,以及外周血T淋巴细胞亚群CD3^+、CD4^+、CD8^+、CD4^+/CD8^+变化情况;采用酶联免疫吸附试验检测两组患者细胞间黏附分子-1、血管黏附分子-1表达,并采用SLE专属生活质量量表评价两组患者生活质量及疗效。结果观察组患者治疗后CD8^+、外周血单核细胞趋化蛋白-4、IL-2、IL-4、细胞间黏附分子-1、血管黏附分子-1均明显降低,CD4^+、CD4^+/CD8^+明显升高,与对照组比较,差异均有统计学意义(P<0.05)。观察组患者SLE专属生活质量量表总分及6个维度中症状、治疗方面、心情和自我形象评分均明显低于对照组,有效率明显高于对照组,差异均有统计学意义(P<0.05)。结论雷公藤双层片可增强甲泼尼龙脉冲治疗SLE的临床疗效,在改善SLE临床症状方面优于单用甲泼尼龙脉冲疗法。

Objective To observe the clinical efficacy of Tripterygium wilfordii double-layer tablets combined with methylprednisolone pulse therapy in the treatment of systemic lupus erythematosus (SLE) and analyze the therapeutic mechanism. Methods 173 cases of SLE from January 2017 to January 2018 were divided into the control group ( n =85) and the observation group ( n =88) according to the random control principle.The control group was treated with methylprednisolone pulse therapy and the observation group was added with Tripterygium wilfordii double-layer tablets.Peripheral blood monocyte chemoattractant protein-4 (MCP-4),interleukin -2 (IL-2),IL-4,and changes of CD3^+,CD4^+,CD8^+ and CD4^+/CD8^+ ratios in peripheral blood T lymphocyte subsets were compared.ELISA method was used to detect the intercellular adhesion molecule-1 (ICAM-1) and the Vascular adhesion molecule- 1.SLE-specific quality of life scale was used to evaluate the quality of life and efficacy of two groups. Results The percentage of CD8^+,MCP-4,IL-2,IL-4,ICAM-1 and VCAM-1 decreased and the percentage of CD4^+ and CD4^+/CD8^+ increased significantly in the observation group compared with the control group,and the difference was statistically significant( P <0.05).The overall score of SLE-specific quality of life scale symptoms,self-image and mood scores 6 dimensions of observation group were lower than those of control group and the effective rate was higher than that in control group,and the difference was statistically significant( P <0.05). Conclusion Tripterygium wilfordii double-layer tablets can enhance the clinical efficacy of methylprednisolone pulse therapy for SLE,and is better than single methylprednisolone pulse therapy improve the clinical symptoms of SLE.