犀角地黄汤联合来氟米特对系统性红斑狼疮的改善作用

Effect of Xijiao Dihuang Decoction combined with leflunomide on systemic lupus erythematosus

目的观察犀角地黄汤联合来氟米特对系统性红斑狼疮(systemic lupus erythema,SLE)的改善及对Th1/Th2失衡的影响。方法选取123例急性活动期热毒炽盛证SLE患者,用随机数字表法分为对照组(n=61)和试验组(n=62)。对照组采用醋酸泼尼松片联合来氟米特治疗,试验组在对照组治疗的基础上用犀角地黄汤治疗。比较治疗前、治疗后1个月和治疗后3个月2组疾病活动度评分、中医证候评分、补体C3水平和Th1/Th2值;比较2组抗ds-DNA抗体阳性率、临床疗效和不良反应。结果治疗前2组SLE疾病活动度评分(SLE disease activity score,SLEDAI)、中医证候评分、补体C3水平和Th1/Th2值比较,差异无统计学意义;治疗后1、3个月试验组SLEDAI评分、中医证候评分、Th1/Th2值和抗ds-DNA抗体阳性率均明显低于对照组,补体C3水平和临床总有效率均明显高于对照组(P<0.05);试验组不良反应发生率明显低于对照组(P<0.05)。结论犀角地黄汤可改善急性活动期热毒炽盛证SLE患者疾病活动度及中医证候、实验室指标,提升临床疗效,减少糖皮质激素及免疫抑制剂所致的不良反应。

Objective To observe the efficacy of Xijiao Dihuang Decoction combined with leflunomide on systemic lupus erythematosus(SLE)and the effect on Th1/Th2 imbalance.Methods A total of 123 patients with SLE with acute active heat-toxin flaring syndrome who were admitted to our hospital were selected and divided into control group and experimental group by random number table method,with 61 cases and 62 cases respectively.The control group was treated with Prednisone Acetate Tablets combined with leflunomide,and the experimental group was treated with Xijiao Dihuang Decoction on the basis of the control group.The disease activity score,the traditional Chinese medicine(TCM)syndrome score,the complement C3 level,and the Th1/Th2 ratio were compared between the 2 groups before treatment,1 and 3 months after treatment.The anti-ds-DNA antibody positive rate,clinical efficacy and adverse reactions were also compared.Results There was no significant difference in SLE disease activity score(SLEDAI),TCM syndrome score,complement C3 level,and Th1/Th2 ratio between the 2 groups before treatment(P>0.05).The SLEDAI score,TCM syndrome score,and Th1/Th2 ratio in the experimental group were significantly lower than those in the control group,and the levels of complement C3 were significantly higher than those in the control group 1 and 3 months after treatment(P<0.05).The positive rate of anti-ds-DNA antibody in the experimental group was lower than that in the control group 1 and 3 months after treatment(P<0.05).The clinical total effective rate in the experimental group was significantly higher than that in the control group(P<0.05).The incidence of adverse reactions in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion Xijiao Dihuang Decoction can decrease the disease activity,TCM syndromes and laboratory indicators of SLE patients with acute active heat-toxicity syndrome,improve clinical efficacy,and reduce adverse reactions caused by glucocorticoids and immunosuppressants.