青蒿鳖甲汤加减对阴虚内热证狼疮性肾炎的疗效

Curative effect of modified Qinghao Biejia Decoction on lupus nephritis of Yin-deficiency intrinsic heat syndrome

目的 探析青蒿鳖甲汤加减对阴虚内热证狼疮性肾炎(lupus nephritis, LN)的疗效。方法 将70例阴虚内热证LN患者分为对照组和观察组,每组35例。对照组采取复方环磷酰胺联合醋酸泼尼松片治疗,观察组在对照组治疗的基础上辨证服用青蒿鳖甲汤加减治疗,2组治疗周期均为3个月。治疗后比较2组患者的疾病活动指数、临床疗效、中医证候疗效、中医症候积分、相关生化指标及不良反应情况。结果 治疗后,观察组临床疗效总有效率(94.12%)显著高于对照组(76.47%)(P<0.05),中医症候疗效有效率(88.24%)显著高于对照组(67.65%);2组病例盗汗、五心烦热、咽痛和斑疹症候积分均较本组治疗前显著下降,且观察组各指标下降更显著(P<0.05);2组血肌酐(serum creatinine, Scr)、尿素氮(blood urea nitrogen, BUN)、24 h尿蛋白、系统性红斑狼疮疾病活动指数(systemic lupus erythematosus disease activity index, SLEDAI)、红细胞沉降率(erythrocyte sedimentation rate, ESR)和C-反应蛋白(C-reactive protein, CRP)与本组治疗前比较均显著下降(P<0.05),且观察组治疗后各指标下降更显著(P<0.05);治疗期间观察组不良反应发生率(8.82%)与对照组(14.71%)比较差异无统计学意义。结论 青蒿鳖甲汤加减联合治疗可显著降低阴虚内热证LN病例的中医症候积分和疾病活动指数,提升中医症候疗效,改善患者肾功能。

Objective To explore the curative effect of modified Qinghao Biejia Decoction on lupus nephritis(LN) of Yin-deficiency intrinsic heat syndrome.Methods A total of 70 patients with LN of Yin-deficiency intrinsic heat syndrome were divided into control group and observation group, 35 cases in each group. The control group were treated with compound cyclophosphamide and Prednisone Acetate Tablets, while the observation group were treated with modified Qinghao Biejia Decoction on the basis of control group. All were treated for 3 months. After treatment, the disease activity index, clinical curative effect, curative effect on traditional Chinese medicine(TCM), TCM syndromes scores, related biochemical indexes and adverse reactions were compared between the 2 groups.Results After treatment, the total response rate of clinical curative effect in observation group was significantly higher than that in control group(94.12% vs. 76.47%)(P<0.05), and the response rate of TCM symptoms was significantly higher than that in control group(88.24% vs. 67.65%). After treatment, the scores of night sweats, dysphoria in chest palms-soles, sore throat and macula syndromes in both groups were significantly decreased, which were significantly lower in observation group than in control group(P<0.05). After treatment, the serum creatinine(Scr), blood urea nitrogen(BUN), 24 hours’ urine protein, systemic lupus erythematosus disease activity index(SLEDAI), erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) in both groups were significantly decreased, which were significantly lower in observation group than in control group(P<0.05). The difference in the incidence of adverse reactions between the 2 groups was not statistically significant during treatment(8.82% vs. 14.71%)(P>0.05).Conclusion The modified Qinghao Biejia Decoction can significantly reduce the scores of TCM syndromes and disease activity index in patients with LN of Yin-deficiency intrinsic heat syndrome, and improve the curative effect on TCM syndromes and renal function.