清温解毒方治疗重症系统性红斑狼疮

Qingwen Jiedu Decoction in Treatment of Severe Lupus Erythematosus

目的:观察清温解毒方治疗重症系统性红斑狼疮的临床疗效。方法:75例重症红斑狼疮患者随机分为中西医结合组36例,单用西药组39例。中西医结合组给予清温解毒方伍用免疫抑制剂,单用西药组给予免疫抑制剂。比较两组患者中医证候积分、BILAG-2004积分、SLEDAI-2000积分、抗双链DNA抗体及不良反应。结果:中西医结合组有效率为88.89%,高于单用西药组的69.23%(P<0.05)。两组患者治疗后BILAG-2004积分及SLEDAI-2000积分显著低于治疗前(P<0.05),中西医结合组中医证候积分、BILAG-2004积分低于单用西药组(P<0.05)。两组患者治疗后IgG水平显著低于治疗前(P<0.05)。两组患者治疗后补体C3水平显著高于治疗前(P<0.05),且中西医结合组以上指标高于单用西药组(P<0.05)。中西医结合组抗双链DNA抗体转阴率(50.00%)高于单用西药组(35.71%)。中西医结合组感染率(36.11%)、骨髓抑制率(13.89%)显著低于单用西药组(58.97%、33.33%),差异均有统计学意义(P<0.05)。结论:清温解毒方治疗重症系统性红斑狼疮疗效显著,可显著降低患者中医证候积分、BILAG-2004积分及SLEDAI-2000积分,升高补体C3水平、抗双链DNA抗体转阴率,降低感染率、骨髓抑制率。

Objective:To observe the clinical efficacy of Qingwen Jiedu Decoction in treatment of severe lupus erythematosus.Methods:Seventy-five patients with severe lupus erythematosus were randomly divided into the TCM group(n=36)and the western medicine group(n=39).The combination of TCM and Western medicine was used to treat the immunosuppressive agents of Qingwen Jiedu decoction,and the western medicine group was used to give immune-suppressants.TCM syndrome scores,BILAG-2004 scores,SLEDAI-2000 scores,anti-double-stranded DNA antibodies,and adverse reactions were compared between the two groups.Results:The effective rate of the combination of traditional Chinese medicine and western medicine was 88.89%,which was significantly higher than that(69.23%)of the western medicine group(P<0.05).The BILAG-2004 scores and SLEDAI-2000 scores in the two groups were significantly lower than those before treatment(P<0.05).The scores of TCM sgndromes,BILA-2004 scores in the integrated Chinese and Western medicine group were significantly lower than those in the western medicine group(P<0.05).The IgG levels in the two groups were significantly lower than those before treatment(P<0.05).The levels of complement C3 in the two groups were significantly higher than those before treatment(P<0.05),and the above indexes in the integrated Chinese and Western medicine group were higher than those in the western medicine group(P<0.05).The anti-double-stranded DNA antibody conversion rate in the integrated Chinese and Western medicine group(50.00%)was higher than that in the western medicine group(35.71%).The infection rate(36.11%)and bone marrow suppression rate(13.89%)in the integrated Chinese and Western medicine group were significantly lower than those in the western medicine group(58.97%,33.33%).The difference was statistically significant(P<0.05).Conclusion:Qingwen Jiedu Decoction has significant curative effect on severe lupus erythematosus,which can significantly reduce TCM syndrome score,BILAG-2004 score and SLEDAI-2000 score,increase complement C3 level,anti-double-strand DNA antibody negative rate,and reduce infection rate,bone marrow suppression rate.