解毒祛瘀滋阴方对系统性红斑狼疮狼疮活动的影响作用及机制探讨

Effect and Mechanism of Jiedu Quyu Ziyin Prescription(解毒祛瘀滋阴方)on Lupus Activity in Patients with Systemic Lupus Erythematosus

目的观察解毒祛瘀滋阴方对系统性红斑狼疮狼疮活动的影响作用及机制探讨。方法选择2018年6月—2019年12月医院收治的系统性红斑狼疮患者168例。应用随机数字表法,将其分为对照组和观察组,每组84例。对照组口服醋酸泼尼松和硫酸羟氯喹片治疗,待病情稳定后,酌情减量。观察组在对照组治疗的基础上,口服解毒祛瘀滋阴方治疗。两组均持续治疗12周。比较两组治疗前后中医证候积分和治疗疗效,比较两组治疗前后SLEDAI评分,比较两组治疗前后外周血中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)水平,比较两组治疗过程中不良反应发生情况。结果观察组治疗后总有效率92.86%(78/84)高于对照组82.14%(69/84)(P<0.05);观察组治疗后皮肤红斑、关节疼痛、乏力和发热等中医证候积分低于对照组(P<0.05);观察组治疗后SLEDAI评分低于对照组(P<0.05);观察组治疗后NLR和PLR水平低于对照组(P<0.05);两组治疗后不良反应比较差异无统计学意义(P>0.05)。结论解毒祛瘀滋阴方联合西药治疗系统性红斑狼疮疗效确切,可有效的改善临床症状及体征,降低系统性红斑狼疮的活动性,控制病情,安全性高,而该方案对炎性指标的调节作用可能是其疗效优势形成重要原因。

Objective To observe the effect and mechanism of Jiedu Quyu Ziyin Prescription(解毒祛瘀滋阴方,JQZP)on lupus activity in patients with systemic lupus erythematosus.Methods A total of 168 patients with systemic lupus erythematosus admitted to our hospital from June 2018 to December 2019 were selected.They were divided into control group and observation group by random number table method,84 cases in each group.In the control group,prednisone acetate and hydroxychloroquine sulfate tablets were taken orally.The observation group added JQZP on the basis of control group treatment.Both groups continued treatment for 12 weeks.The TCM syndrome score and therapeutic effect before and after treatment in the two groups were compared.SLEDAI scores before and after treatment in the two groups were compared.The levels of neutrophils/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in the peripheral blood of the two groups before and after treatment were compared,and the occurrences of adverse reactions in the two groups during treatment were compared.Results The total effective rate of the observation group after treatment was 92.86%(78/84),higher than that of the control group 82.14%(69/84)(P<0.05).After treatment,the scores of TCM symptoms such as skin erythema,joint pain,fatigue and fever in the observation group were lower than those in the control group(P<0.05).SLEDAI score in the observation group was lower than that in the control group(P<0.05).Levels of NLR and PLR in the observation group were lower than those in the control group(P<0.05).There was no significant difference in adverse reactions between the two groups after treatment(P>0.05).Conclusion JQZP combined with western medicine in the treatment of systemic lupus erythematosus is effective and can effectively improve the clinical symptoms and signs,reduce the activity of systemic lupus erythematosus and control the disease,with high safety.The regulation of inflammatory indicators of the program may be an important reason for the formation of its therapeutic advantage.