附桂润燥汤加减联合西药治疗对干燥综合征患者唾液腺、泪腺分泌功能及血清红细胞沉降率、免疫球蛋白的影响

Effect of Modified Fugui Runzao Decoction Combined with Western Medicine on the Secretion of Salivary Gland and Lacrimal Gland and Serum ESR and IgG in Patients with Sjogren′s Syndrome

目的观察附桂润燥汤加减联合西药治疗对干燥综合征(Sjogren syndrome,SS)患者唾液腺、泪腺分泌功能及血清红细胞沉降率(Erythrocyte sedimentation rate,ESR)、免疫球蛋白G(Immunoglobulin,IgG)的影响。方法选取2018年2月—2020年7月期间在廊坊市人民医院住院治疗的200例阴虚津亏证SS患者,按随机数字表法分为对照组和实验组,每组各100例。对照组患者采用硫酸羟氯喹治疗,实验组患者在对照组基础上加服附桂润燥汤加减治疗。两组均接受治疗3个月后,观察比较两组患者临床疗效、治疗前后临床证候积分、唾液流率(Saliva flow rate,SFR)、Schirmer试验、血清ESR、血清IgG以及不良反应情况。结果治疗后实验组总有效率为95%(95/100)明显高于对照组83%(83/100),差异有统计学意义(P<0.05)。治疗后两组患者临床证候积分较治疗前有明显下降,差异有统计学意义(P<0.05);且实验组下降幅度优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者糖化时间较治疗前缩短,Schirmer试验结果较治疗前明显上升,差异有统计学意义(P<0.05);且实验组糖化时间、Schirmer试验结果优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清ESR、IgG水平均较治疗前下降,差异有统计学意义(P<0.05);且实验组血清ESR、IgG水平较对照组明显降低,差异有统计学意义(P<0.05)。治疗期间,实验组不良反应发生率为6%(6/100),对照组不良反应发生率为15%(15/100),两组比较差异有统计学意义(P<0.05)。结论附桂润燥汤加减联合西药治疗SS疗效确切,可明显改善患者临床症状和唾液、泪腺分泌功能,降低ESR、IgG水平,且不良反应较少,安全性高。

Objective To observe the effect of modified Fugui Runzao Decoction combined with western medicine on the secretion of salivary gland and lacrimal gland and serum erythrocyte sedimentation rate(ESR)and immunoglobulin G(IgG)in patients with Sjogren′s syndrome(SS).Methods A total of 200 patients with SS of yin deficiency and fluid inadequacy syndrome who were admitted to our hospital from February 2018 to July 2020 were selected and classified into control group(n=100)and experimental group(n=100)with the random table number method.The control group was treated with hydroxychloroquine sulfate,and the experimental group with modified Fugui Runzao Decoction and hydroxychloroquine sulfate.The administration lasted 3 months for both groups.The clinical efficacy,traditional Chinese medicine(TCM)syndrome score before and after treatment,saliva flow rate(SFR),Schirmer test result,serum ESR,serum IgG,and adverse reactions were compared between the two groups.Results The total effective rate in the experimental group was higher than that in the control group[95.00%vs.83.00%,P<0.05].After treatment,the TCM syndrome scores in the two groups were lower than those before treatment(P<0.05),and the decrease was larger in the experimental group than in the control group(P<0.05).After treatment,the glycation time was significantly shortened and the Schirmer test result was significantly improved in the two groups(P<0.05),particularly the experimental group which showed significant difference from the control group(P<0.05).The serum levels of ESR and IgG decreased in both groups after treatment(P<0.05),especially the experimental group which demonstrated significant difference from the control group(P<0.05).The incidence of adverse reactions in the experimental group was lower than that in the control group(6.00%vs.15.00%,P<0.05).Conclusions Fugui Runzao Decoction combined with western medicine has definite effect in the treatment of SS,which can significantly improve the clinical symptoms and secretion of saliva and lacrimal glands and reduce serum levels of ESR and IgG,with little adverse reactions and low safety risk.