基于津液代谢理论观察沙参麦冬汤联合白芍总苷胶囊治疗原发性干燥综合征

李增变; 周全; 张国胜; 张攀科

doi:10.13422/j.cnki.syfjx.20201972

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基于津液代谢理论观察沙参麦冬汤联合白芍总苷胶囊治疗原发性干燥综合征

临床 | 更新时间：2020-09-16

- 基于津液代谢理论观察沙参麦冬汤联合白芍总苷胶囊治疗原发性干燥综合征
- Clinical Efficacy of Shashen Maidongtang Plus Total Glucosides of Paeony Capsule in Treatment of Primary Sjogren's Syndrome with Based on Theory of Fluid Metabolism
- 中国实验方剂学杂志 2020年26卷第20期页码：100-104
- 作者机构：
  
  1.郑州市中医院，郑州 450007
  2.河南中医药大学第一附属医院，郑州 450000
- 作者简介：
  
  李增变，硕士，主治医师，从事中医药治疗风湿病研究，E-mail：doctor-zc@tom.com
  周全，博士，主任医师，教授，从事风湿疾病研究，E-mail：1718182818@qq.com
- 基金信息：
  
  河南省中医药学研究专项(2017ZY2022)
- DOI：10.13422/j.cnki.syfjx.20201972
  中图分类号： R22;R242;R2-031;R287
- 收稿日期：2020-02-17，
  
  网络出版日期：2020-07-23，
  
  纸质出版日期：2020-10-20
- 稿件说明：
移动端阅览
李增变,周全,张国胜等.基于津液代谢理论观察沙参麦冬汤联合白芍总苷胶囊治疗原发性干燥综合征[J].中国实验方剂学杂志,2020,26(20):100-104.

LI Zeng-bian,ZHOU Quan,ZHANG Guo-sheng,et al.Clinical Efficacy of Shashen Maidongtang Plus Total Glucosides of Paeony Capsule in Treatment of Primary Sjogren's Syndrome with Based on Theory of Fluid Metabolism[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(20):100-104.
李增变,周全,张国胜等.基于津液代谢理论观察沙参麦冬汤联合白芍总苷胶囊治疗原发性干燥综合征[J].中国实验方剂学杂志,2020,26(20):100-104. DOI： 10.13422/j.cnki.syfjx.20201972.

LI Zeng-bian,ZHOU Quan,ZHANG Guo-sheng,et al.Clinical Efficacy of Shashen Maidongtang Plus Total Glucosides of Paeony Capsule in Treatment of Primary Sjogren's Syndrome with Based on Theory of Fluid Metabolism[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(20):100-104. DOI： 10.13422/j.cnki.syfjx.20201972.

摘要

目的

基于津液代谢理论探讨沙参麦冬汤联合白芍总苷胶囊治疗原发性干燥综合征（pSS）的临床疗效，探讨其机制。

方法

选择郑州市中医院2018年1月至2019年1月收治的84例气阴两虚型pSS患者，使用随机数字表法分成观察组和对照组，每组42例。其中对照组口服白芍总苷胶囊加艾拉莫德片治疗，观察组口服白芍总苷胶囊联合沙参麦冬汤，所有对象连续治疗3个月。治疗前后对两组对象进行唾液流率和基础泪液分泌Ⅰ试验（SIt）测定，并按欧洲抗风湿病联盟干燥综合征患者报告指数及干燥综合征疾病活动指数（ESSPRI和ESSDAI）评分，使用魏氏法测定红细胞沉降率（ESR），此外分别选用免疫比浊法和速率散射比浊法检测血清类风湿因子（RF），免疫球蛋白（Ig）G含量。

结果

在总有效率上，观察组90.48%（38/42）较对照组69.05%（29/42）提高（

=5.974，

0.05）。两组治疗后唾液流率，SIt均较本组治疗前增加（

0.05）；治疗后观察组唾液流率及SIt均优于对照组同期（

0.05）。与本组治疗前比较，两组治疗后ESSPRI，ESSDAI评分均降低（

0.05）；且与对照组同期比较，观察组治疗后以上评分均降低（

0.05）。两组治疗后ESR及血清RF，IgG浓度均低于本组治疗前（

0.05）；且治疗后，观察组ESR及血清RF，IgG含量均较对照组同期更低（

0.05）。两组副反应均少而轻。

结论

沙参麦冬汤联合白芍总苷胶囊治疗气阴两虚型pSS的整体疗效良好，其在抑制患者体内过度炎症反应、抑制亢进的体液免疫及控制病情活动等方面的效果明显，这可能与沙参麦冬汤及其拆方具有纠正气阴两虚型pSS患者机体津液输布与代谢障碍的作用有关。

Abstract

Objective

To investigate the clinical efficacy of Shashen Maidongtang plus total glucosides of paeony capsule on primary Sjogren's syndrome (pSS) based on the theory of fluid metabolism.

Method

In this study

84 patients of Qi-Yin deficiency type pSS admitted in Zhengzhou Chinese Medicine Hospital from January 2018 to January 2019 were divided into observation group (42 cases) and control group (42 cases) on the basis of random number table. The control group was orally given total glucosides of paeony capsule and iguratimod tablet

while the observation group was orally given Shashen Maidongtang combined with glucosides of paeony capsule. After 3 months of continuous treatment to all subjects

the clinical efficacy was evaluated

and side effects were recorded. Before and after the treatment

the saliva flow rate and basal tear secretion Schirmer I test (SIt) value were measured

European League Against Rheumatism Sjogren's syndrome patient reported index and Sjogren's syndrome disease activity index (ESSPRI and ESSDAI) were scored

the erythrocyte sedimentation rate (ESR) was determined by Westergren

and the levels of serum rheumatoid factor (RF) and immunoglobulin (Ig) G were tested by immunoturbidimetry and rate scattering turbidimetry

respectively.

Result

The overall effective rate of the observation group was 90.48% (38/42)

which was much higher than 69.05% (29/42) of the control group (

=5.974，

0.05). After treatment

the saliva flow rates and SIt values of both groups got significantly increased compared with those before the treatment (

0.05)

but the saliva flow and SIt of the observation group were significantly better than those of the control group over the same period after treatment (

0.05). After treatment

both groups had a great decrease in ESSPRI and ESSDAI scores compared with those before the treatment (

0.05)

and the above scores of the observation group were dramatically lower than those of the control group over the same period (

0.05). After treatment

ESR

serum RF

and IgG levels of both groups were significantly lower than those before the treatment (

0.05)

and the observation group showed higher levels of ESR

serum RF and IgG than the control group over the same period after treatment (

0.05). Side effects were few and mild in both groups.

Conclusion

In treating patients of Qi-Yin deficiency type pSS

Shashen Maidongtang plus total glucosides of paeony capsule was proven to be effective generally. It could significantly inhibit excessive inflammation and hyperhumoral immunity in patients

and control their disease activity. This may be related to the effect of Shashen Maidong decoction and its decomposed recipes in correcting body fluid infusion and metabolic disorder in patients of Qi-Yin deficiency type pSS.

关键词

Keywords

references

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