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武汉市第一医院,武汉 430022
何浩,主治医师,从事中西医结合治疗红斑狼疮研究,E-mail:40359807@qq.com
纸质出版日期:2022-08-20,
网络出版日期:2022-03-22,
收稿日期:2022-02-09,
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何浩,邹荣,杨惠琴.犀角地黄汤结合针灸治疗系统性红斑狼疮热毒炽盛型临床疗效[J].中国实验方剂学杂志,2022,28(16):123-129.
HE Hao,ZOU Rong,YANG Huiqin.Clinical Effect of Xijiao Dihuangtang Combined with Acupuncture on Treatment of Systemic Lupus Erythematosus with Syndrome of Intense Heat Toxin[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(16):123-129.
何浩,邹荣,杨惠琴.犀角地黄汤结合针灸治疗系统性红斑狼疮热毒炽盛型临床疗效[J].中国实验方剂学杂志,2022,28(16):123-129. DOI: 10.13422/j.cnki.syfjx.20221695.
HE Hao,ZOU Rong,YANG Huiqin.Clinical Effect of Xijiao Dihuangtang Combined with Acupuncture on Treatment of Systemic Lupus Erythematosus with Syndrome of Intense Heat Toxin[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(16):123-129. DOI: 10.13422/j.cnki.syfjx.20221695.
目的
2
观察犀角地黄汤结合针灸治疗系统性红斑狼疮热毒炽盛型临床疗效。
方法
2
研究纳入2020年1月至2021年12月武汉市第一医院收治的102例系统性红斑狼疮热毒炽盛型患者,按随机数字表法分成对照组与观察组,每组各51例,对照组患者予西医常规治疗(硫酸羟氯喹+醋酸泼尼松龙片),观察组患者在对照组治疗基础上配合犀角地黄汤结合针灸治疗,观察两组患者临床疗效、患者起效时间、症状好转时间及皮损消退时间、住院时间、血常规指标变化、24 h尿蛋白水平及抗双链DNA抗体(抗ds-DNA抗体)指标变化、中医证候积分变化、血清细胞因子指标变化、血液流变学指标变化、T淋巴细胞亚群指标变化、系统性红斑狼疮疾病活动指数(SLEDAI)-2000及36条简明健康状况调查量表(SF-36)评分变化、不良反应发生情况等。
结果
2
观察组患者治疗总有效率为96.08%(49/51),对照组为84.31%(43/51),观察组治疗总有效率更高(
χ
2
=3.991,
P
<
0.05);观察组患者起效时间、症状好转时间及皮损消退时间、住院时间均短于对照组(
P
<
0.05,
P
<
0.01);治疗前,两组患者血常规指标[红细胞沉降率(ESR)及血小板计数(PLT)、血红蛋白(HGB)、白细胞计数(WBC)等]、24 h尿蛋白水平、抗ds-DNA抗体、中医证候积分、血清细胞因子指标[白细胞介素-4(IL-4)及白细胞介素-6(IL-6)、可溶性白介素-2受体(sIL-2R)]、血液流变学指标(纤维蛋白原、血浆黏度、全血黏度)、T淋巴细胞亚群指标(CD4
+
、CD8
+
、CD4
+
/CD8
+
)、SLEDAI-2000及SF-36评分比较,差异无统计学意义。治疗后,与本组治疗前比较,各组患者以上指标均,明显好转(
P
<
0.05),与对照组治疗后比较,观察组以上指标好转优于对照组(
P
<
0.05)。不良反应发生情况,观察组消化道反应1例,转氨酶升高1例,失眠1例;对照组消化道反应2例,感染1例,转氨酶升高1例;两组不良反应比较差异无统计学意义。
结论
2
犀角地黄汤结合针灸治疗系统性红斑狼疮热毒炽盛型临床效果好,且安全可靠,值得应用。
Objective
2
To observe the clinical effect of Xijiao Dihuangtang combined with acupuncture on the treatment of systemic lupus erythematosus (SLE) with syndrome of intense heat toxin.
Method
2
A total of 102 cases of SLE with syndrome of intense heat toxin (admitted from January 2020 to December 2021) were divided into a control group and an observation group by random number table method, with 51 cases in each group. Patients in the control group received conventional western medicine treatment (hydroxychloroquine sulfate + poonisone acetate tablets). Patients in the observation group were given Xijiao Dihuangtang combined with acupuncture based on the treatment of the control group. Clinical efficacy, onset time, symptom improvement time, skin lesion regression time, and hospital stays were recorded. Blood routine index change, 24 h urine protein levels, double-stranded DNA (ds-DNA) antibodies resistance index changes, traditional Chinese medicine (TCM) syndrome integral changes, and changes in serum cytokine indexes, blood rheology indexes, and T lymphocyte subsets indexes were observed. SLE changes in disease activity index (SLEDAI-2000), quality of life (SF-36) scores, and adverse reactions were explored.
Result
2
The total effective rate was 96.08% (49/51) in the observation group, higher than 84.31% (43/51) in the control group (
χ
2
=3.991,
P
<
0.05). The onset time, symptom improvement time, skin lesion regression time, and hospital stays in the observation group were shorter than those in the control group (
P
<
0.05,
P
<
0.01). Before treatment, erythrocyte sedimentation rate (ESR), platelet count (PLT), hemoglobin (HGB), white blood cell count (WBC), and other blood routine indexes, 24h urinary protein levels, anti-ds-DNA, TCM syndrome integral core, serum cytokine indexes including interleukin-4 (IL-4), IL-6, soluble interleukin-2 receptor (sIL-2R), blood rheology indexes (fibrinogen, plasma viscosity, and whole blood viscosity),T lymphocyte subsets indexes (CD4
+
, CD8
+
, and CD4
+
/CD8
+
), SLEDAI-2000, and SF-36 score comparison in both groups had no statistical significance
.
After treatment, the above indicators were improved in each group (
P
<
0.05), and the indicators in the observation group was better than that in the control group (
P
<
0.05). In terms of the adverse reactions, there was 1 case of digestive tract reaction, 1 case of elevated aminotransferase, and 1 case of insomnia in the observation group. There were 2 cases of digestive tract reaction,1 case of infection, and 1 case of elevated transaminase in the control group. The difference of the adverse reactions between the two groups had no statistical significance.
Conclusion
2
Xijiao Dihuangtang combined with acupuncture has good clinical effect on the treatment of SLE with syndrome of intense heat toxin, and the method is safe, reliable, and worthy of application.
系统性红斑狼疮热毒炽盛型犀角地黄汤针灸疗效不良反应
systemic lupus erythematosussyndrome of intense heat toxinXijiao Dihuangtangacupuncturecurative effectadverse reactions
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