芪黄健脾滋肾颗粒对系统性红斑狼疮患者外周血中IL-10、TGF-β和补体水平的影响研究

Effects of Qihuang Jianpi Zishen Granule on Levels of IL-10,TGF-βand Complements in Peripheral Blood of Patients with SLE

目的:观察芪黄健脾滋肾颗粒对系统性红斑狼疮(SLE)患者治疗前后外周血中IL-10、TGF-β和补体水平的影响。方法:纳入安徽中医药大学第一附属医院2021年1月—2022年1月门诊及住院患者60例,随机分为对照组和治疗组,每组30例。对照组患者给予甲泼尼龙联合硫酸羟氯喹治疗,治疗组患者加用芪黄健脾滋肾颗粒口服治疗,分别于治疗前及治疗12周后比较两组患者血清补体C3、补体C4、抗C1q抗体、白介素-10(IL-10)、转化生长因子-β(TGF-β)、免疫球蛋白指标(IgG、IgA及IgM)、C-反应蛋白(CRP)、血沉(ESR)、肌酐(Scr)、24 h尿蛋白定量(PRO)、尿素氮(BUN),治疗前后中医症状积分、狼疮疾病活动指数评分(SLE-DAI)的变化情况及评价两组患者治疗后的中医临床疗效。结果:治疗组患者治疗后中医临床疗效优于对照组(P<0.05)。治疗后,两组SLE患者血清补体C3、C4、IL-10、TGF-β水平均高于本组治疗前(P<0.01),且与对照组治疗后相比,治疗组C3、IL-10、TGF-β显著高于对照组(P<0.05);两组SLE患者抗C1q水平、免疫球蛋白指标、肾功能指标、ESR、CRP、SLE-DAI评分、中医症状积分均低于治疗前(P<0.05),且与对照组治疗后相比,治疗组抗C1q水平、Ig G、CRP、Scr、SLE-DAI评分、中医症状积分改善更为突出(P<0.05)。结论:芪黄健脾滋肾颗粒能够在一定程度上调控SLE患者外周血中的IL-10、TGF-β及补体水平,改善中医症状积分、SLE-DAI评分,提高临床治疗效果,减轻SLE患者炎症反应、疾病活动度,改善免疫功能及肾功能,值得临床应用推广与研究。

Objective:To observe the effect of Qihuang Jianpi Zishen Granule on the levels of IL-10,TGF-βand complements in peripheral blood of the patients with systemic lupus erythematosus(SLE).Methods:A total of 60 patients with SLE were randomly divided into the treatment group and the control group,with 30 cases in each group.The control group was treated with Methylprednisolone in combination with Hydroxychloroquine Sulfate;on which basis,the treatment group was also treated with Qihuang Jianpi Zishen Granule.Complement 3(C3),complement 4(C4),antibody of C1q,interleukin-10(IL-10),transforming growth factor-beta(TGF-β),immunoglobulin indicators(IgG,IgA and IgM),C-reactive proteins(CRP),erythrocyte sedimentation rate(ESR),renal function index[creatinine(Scr),24-hour urinary protein quantification(PRO),blood urea nitrogen(BUN)],TCM symptoms score and lupus disease activity index(SLE-DAI)score were compared before and after 12 weeks of the treatment in the two groups.The clinical efficacy was also compared between the two groups.Results:The serum levels of C3,C4,IL-10 and TGF-βwere higher after the treatment than those before the treatment in the two groups(P<0.05);the levels of C3,IL-10 and TGF-βwere significantly higher in the treatment group than those in the control group after the treatment(P<0.05).Anti-C1q level,immunoglobulin indexes,renal function indexes,ESR,CRP,SLE-DAI score,and TCM symptoms scores were all lower after the treatment than those before the treatment in the two groups(P<0.05);compared with those in the control group,anti-C1q level,IgG,CRP,Scr,SLE-DAI score and TCM symptoms score improved more significantly in the treatment group after the treatment(P<0.05).The clinical efficacy was higher in the treatment group than that in the control group(P<0.05).Conclusion:Qihuang Jianpi Zishen Granule can regulate the levels of IL-10,TGF-βand complements in peripheral blood of SLE patients to a certain extent,it can improve TCM symptoms score and SLE-DAI score,improve clinical treatment effect,reduce inflammatory response in SLE patients and disease activity,as well as improve immune function and renal function.The therapy is worthy of clinical application and promotion.