中西医结合治疗系统性红斑狼疮疗效观察

作者	单位
刘书珍	浙江省杭州市下沙医院
刘广西	浙江省杭州市下沙医院
刘三运	山东省济宁市中医院
王福兰	山东省济宁市第一人民医院
闫平	山东省济宁市第一人民医院

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中文摘要:

目的观察中西医结合治疗系统性红斑狼疮的疗效。方法110例系统性红斑狼疮患者随机分为两组,对照组(50例)口服泼尼松,治疗组(60例)在对照组治疗的基础上,按中医辨证分3型(3期)施治,疗程6个月。观察两组治疗前后临床症状、免疫学指标、血象、血沉(ESR)、C反应蛋白(CRP)、血肌酐(SCr)及24h尿蛋白定量(u-TP/24h)的变化。结果治疗组临床缓解29例,显效18例,有效9例,无效4例,总有效率93.3%(56/60);对照组临床缓解11例,显效10例,有效19例,无效10例,总有效率80.0%(40/50),两组总有效率比较,差异有统计学意义(χ2=4.36,P<0.05)。治疗组临床症状中发热、关节痛、脱发改善优于对照组(P<0.05,P<0.01,P<0.05);治疗组抗核抗体(ANA)转阴率51.3%(20/39)、抗双链脱氧核糖核酸抗体(抗ds-DNA)转阴率53.6%(15/28)、抗核糖核蛋白抗体(抗RNP)转阴率63.2%(12/19)、循环免疫复合物(CIC)转阴率63.2%(12/19),对照组分别依次为28.1%(9/32)、26.1%(6/23)、29.4%(5/17)、29.4%(5/17),治疗组皆优于对照组(P<0.05);两组免疫球蛋白(IgG、IgM)治疗后均下降,且治疗组优于对照组(P<0.05,P<0.01);两组血象、ESR、CRP、SCr及u-TP/24h均改善,且治疗组优于对照组(P<0.05,P<0.01)。结论中西医结合治疗系统性红斑狼疮疗效显著。

英文摘要:

Objective To observe the curative effect of integrative medicine for treatment of systematic lupus erythematosus(SLE).Methods Totally 110 cases of SLE were randomized into two groups,50 in the control group and 60 in the treated group,both were treated with prednisone,but to the treated group,integrative medical treatment was given additionally according to syndrome differentiation.The course for both groups was 6 months.Clinical symptoms,immunological indexes,peripheral blood figure,erythrocyte sedimentation rate(ESR),levels of C-reactive protein(CRP)and creatinine(Cr)in blood,and 24 h urinary total protein(u-TP/24 h)were observed before and after treatment.Results Of the 60 patients in the treated group,the treatment on 29 was evaluated as clinical remission,18 as remarkably effective,9 as effective,and 4 as ineffective,the total effective rate being 93.33%(56/60),while that in the control group was clinical remission in 11,remarkably effective in 10,effective in 19,ineffective in 10 respectively,and the total effective rate 80%(40/50),the difference on total effective rate between the two groups was significant(χ2 =4.36,P<0.05).Besides,the improvement in the treated group was superior to that in the control group in terms of clinical symptoms such as fever,arthralgia and baldness(P<0.05,P<0.01);the negative reversion rate of anti-nuclear antibody(ANA,51.3% vs 28.1%),anti-double-stranded DNA(ds-DNA,53.6% vs 26.1%),anti-ribonucleoprotein(RNP,63.2% vs 29.4%)and circulating immnue complexes(CIC,63.2% vs 29.4%,all P<0.05);lowering of immunoglobulin(for IgG,P<0.05;IgA,P<0.01;IgM,P<0.01);as well as bettering in peripheral blood figure,ESR,CRP,Cr and u-TP/24 h(P<0.05 or P<0.01).Conclusion Integrative medical treatment is obviously effective for SLE patients.

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