益肾固卫汤治疗慢性荨麻疹表虚证的疗效及对血清补体的影响

The Curative Effect of Yishen Guwei Decoction in Treating Chronic Urticaria of Superficial Deficiency Syndrome and Its Effect on Serum Complements

目的观察益肾固卫汤治疗慢性荨麻疹(CU)表虚证的疗效及安全性,并检测治疗前后血清补体(C)3、4水平变化,探讨益肾固卫汤对其免疫相关指标的影响及作用机制。方法将70例CU表虚证患者按随机数字表法分为治疗组35例和对照组35例。治疗组口服益肾固卫汤治疗,水煎服,每日服3次,每次150 mL;对照组口服枸地氯雷他定片和曲尼司特胶囊治疗。两组患者均以4周为1个疗程,共治疗2个疗程,观察两组患者的疗效、复发情况、不良反应及其治疗前后血清C3、C4水平的变化。结果治疗组总有效率87.88%(29/33);对照组总有效率84.38%(27/32),两组疗效比较,差异无统计学意义(Z=-0.685,P>0.05)。治疗后治疗组表虚证评分较治疗前显著降低(P<0.05),且治疗组较对照组降低明显(P<0.05)。治疗组治疗后血清C3水平较治疗前显著升高(P<0.05),与对照组治疗后比较,差异亦有统计学意义(P<0.05)。疗程结束后治疗组和对照组各有18、15例进行随访3个月,治疗组复发率为11.11%(2/18),显著低于对照组[53.33%(8/15)],两组比较,差异有统计学意义(χ^2=5.052,P<0.05)。两组均未出现严重不良反应。结论益肾固卫汤能明显改善CU表虚证患者的临床症状、升高C3水平,复发率低,且无明显不良反应,其作用机制可能与调整机体的免疫功能有关。

Objective To observe the efficacy and safety of Yishen Guwei Decoction(YSGWD) in the treatment of chronic urticaria(CU) patients with superficial deficiency syndrome(SDS), and to detect the changes of serum C3 and C4 levels before and after treatment, to study its effects on immunological indicators and its mechanism. Methods Totally 70 CU patients with SDS were assigned to the treatment group and the control group according to random number table, 35 in each group. Patients in the treatment group took YSGWD, decocted in water and taken 3 times per day, 150 mL each time. Patients in the control group took Dicloratadine Citrate Tablets and Tranilast Capsules. A total of 4 weeks consisted of one course of treatment, and a total of 2 courses of treatment were conducted to observe the efficacy, recurrence, adverse reactions and changes in serum C3 and C4 levels before and after treatment. Results The total effective rate was 87.88%(29/33) in the treatment group and 84.38%(27/32) in the control group, and there was no statistically significant difference in efficacy between the two groups(Z=-0.685, P>0.05). After treatment, the score of SDS in the treatment group was significantly lower than that before treatment(P<0.05), and the score in the treatment group was significantly lower than that in the control group(P<0.05). Serum C3 level in the treatment group was significantly higher after treatment than beforetreatment(P<0.05), with statistical difference as compared with post-treatment control group(P<0.05). At the 3 months follow-up after treatment the recurrence rate was 11.11%(2/18) in the treatment group, significantly lower than that of the control group [53.33%(8/15)], with statistical difference between the two groups(χ^2=5.052, P<0.05). No serious adverse reactions occurred in the two groups. ConclusionsYSGWD significantly improved clinical symptoms and C3 of CU patients with SDS, with low recurrence rate and no obvious adverse reactions. Its mechanism might be related to adjusting the immune function of the body.