自拟狼疮方联合环磷酰胺对系统性红斑狼疮患者血清IL-4、s IL-2R水平的影响观察
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摘要
目的:观察自拟狼疮方联合环磷酰胺对系统性红斑狼疮患者血清白细胞介素4 (IL-4)、可溶性白细胞介素-2受体(s IL-2R)水平的影响。方法:选取我院2015年3月至2017年3月84例系统性红斑狼疮患者为研究对象,将纳入患者按随机数表法分为中医组与对照组,每组42例。对照组在常规干预基础上给予泼尼松与环磷酰胺,中医组在对照组基础上加用自拟狼疮方,疗程均为3个月。检测患者血清细胞因子、T淋巴细胞亚群与血常规,评估中医证候疗效。结果:中医组治疗3个月后IL-4、IL-6、s IL-2R分别为(4. 43±0. 80) ng/L、(9. 02±1. 62) ng/L、(185. 22±33. 35) U/ml显著低于对照组的(5. 45±0. 97) ng/L、(10. 73±1. 93) ng/L、(217. 04±39. 08) U/ml (P<0. 05),CD4+、CD4+/CD8+分别为(43. 71±7. 88)%、(1. 10±0. 19)显著高于对照组的(39. 13±7. 04)%、(0. 99±0. 17)(P<0. 05)。中医组治疗3个月后白细胞计数(WBC)、血红蛋白(HGB)显著高于对照组(P<0. 05),红细胞沉降率(ESR)显著低于对照组(P<0. 05)。结论:自拟狼疮方可以调节IL-4、s IL-2R等多种细胞因子,配合环磷酰胺可以改善系统性红斑狼疮患者免疫紊乱情况,有利于减轻患者病情。
Objective To study the effect of Self-made Lupus Recipe combined with cyclophosphamide on serum interleukin 4(IL-4) and soluble interleukin-2receptor(s IL-2R) levels for patients with systemic lupus erythematosus(SLE). Methods:84patients with SLE who were admitted to the hospital from March 2015 to March 2017 were selected as the subjects. They were randomly divided into TCM group and controlled group,42 cases in each group. The controlled group was treated with prednisone and cyclophosphamide on the basis of routine intervention while the TCM group was treated with Self-made Lupus Recipe on the basis of the controlled group. The course of treatment was 3months. Serum cytokines,T lymphocyte subsets and blood routine were detected,and the curative effect on TCM syndrome was evaluated. Results: After 3months of treatment,levels of IL-4,IL-6and s IL-2R in the TCM group [(4. 43±0. 80) ng/L,(9. 02±1. 62) ng/L,(185. 22±33. 35) U/ml] were significantly lower than those in the controlled group [(5. 45±0. 97) ng/L,(10. 73±1. 93) ng/L,(217. 04±39. 08) U/ml](P< 0. 05)while CD4+and CD4+/CD8+[(43. 71±7. 88) %,(1. 10±0. 19) ]were significantly higher than those in the controlled group[(39. 13±7. 04) %,(0. 99±0. 17) ](P<0. 05). After 3months of treatment,the white blood cell count(WBC) and hemoglobin(HGB) in the TCM group were significantly higher than those in the controlled group(P< 0. 05),while the erythrocyte sedimentation rate(ESR) was significantly lower than that in the controlled group(P < 0. 05). Conclusion: Self-made Lupus Recipe can regulate various cytokines such as IL-4and s IL-2R. The combined use of cyclophosphamide can relieve immune disorders in patients with SLE,which is beneficial to alleviate the condition of patients.
Objective To study the effect of Self-made Lupus Recipe combined with cyclophosphamide on serum interleukin 4(IL-4) and soluble interleukin-2receptor(s IL-2R) levels for patients with systemic lupus erythematosus(SLE). Methods:84patients with SLE who were admitted to the hospital from March 2015 to March 2017 were selected as the subjects. They were randomly divided into TCM group and controlled group,42 cases in each group. The controlled group was treated with prednisone and cyclophosphamide on the basis of routine intervention while the TCM group was treated with Self-made Lupus Recipe on the basis of the controlled group. The course of treatment was 3months. Serum cytokines,T lymphocyte subsets and blood routine were detected,and the curative effect on TCM syndrome was evaluated. Results: After 3months of treatment,levels of IL-4,IL-6and s IL-2R in the TCM group [(4. 43±0. 80) ng/L,(9. 02±1. 62) ng/L,(185. 22±33. 35) U/ml] were significantly lower than those in the controlled group [(5. 45±0. 97) ng/L,(10. 73±1. 93) ng/L,(217. 04±39. 08) U/ml](P< 0. 05)while CD4+and CD4+/CD8+[(43. 71±7. 88) %,(1. 10±0. 19) ]were significantly higher than those in the controlled group[(39. 13±7. 04) %,(0. 99±0. 17) ](P<0. 05). After 3months of treatment,the white blood cell count(WBC) and hemoglobin(HGB) in the TCM group were significantly higher than those in the controlled group(P< 0. 05),while the erythrocyte sedimentation rate(ESR) was significantly lower than that in the controlled group(P < 0. 05). Conclusion: Self-made Lupus Recipe can regulate various cytokines such as IL-4and s IL-2R. The combined use of cyclophosphamide can relieve immune disorders in patients with SLE,which is beneficial to alleviate the condition of patients.
引文
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[2]胡丹.长期口服羟氯喹对系统性红斑狼疮患者血脂和左心室功能的影响[J].中国基层医药,2016,23(9):1333~1336
[3]中华医学会风湿病学分会.系统性红斑狼疮诊断及治疗指南[J].中华风湿病学杂志,2010,14(5):342~346
[4]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:111~114
[5]赵浩,王丹,薛鸾,等.滋阴清热法治疗阴虚内热型系统性红斑狼疮临床疗效观察[J].四川中医,2016,34(12):96~99
[6]张好元.浅论毒邪与系统性红斑狼疮的关系[J].四川中医,2017,35(4):51~52
[7]王志江,魏国栋,马思缇.地黄多糖的化学和药理作用研究进展[J].中国实验方剂学杂志,2015,21(16):231~235
[8]王凤霞,赵阳,钟赣生.从中医方剂研究石膏的临床应用规律[J].中国药房,2017,28(35):5003~5007
[9]王德青,马霞,赵玉丛,等.山药多糖组分对小鼠免疫功能的影响[J].畜牧与兽医,2015,47(6):99~101
[10]蔡小燕,陆宇,唐莼,等.白细胞介素-6启动子DNA甲基化在系统性红斑狼疮发病中的作用[J].中华医学杂志,2017,97(19):1491~1495
[11]王静,景晓娜,牛红青,等.白细胞介素-2对系统性红斑狼疮辅助性T细胞17及调节性T细胞影响的研究进展[J].中华风湿病学杂志,2017,21(8):572~574
[12]武延格,邱劲军,刘宏霞,等.负性调控因子IRAKM在系统性红斑狼疮免疫调节异常中的作用[J].中国免疫学杂志,2017,33(12):1858~1861