通络润燥方治疗瘀血阻络型干燥综合征并小纤维神经病的疗效
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摘要
目的观察通络润燥方治疗瘀血阻络型原发性干燥综合征(pSS)合并小纤维神经病(SFN)的疗效。方法纳入2014年1月至2018年2月柳州市人民医院pSS合并SFN患者50例。采用随机对照研究,将合格受试者随机分为观察组及对照组各25例。两组均予硫酸羟氯喹、醋酸泼尼松片及甲钴胺分散片治疗,观察组加予通络润燥方,疗程12周。观察两组治疗前后干燥综合征疾病活动度指数、中医证候积分、临床疗效、交感神经皮肤反应及安全性反应。结果两组治疗前后干燥综合征疾病活动度指数、中医证候积分、交感神经皮肤反应差异有统计学意义(P <0.01),观察组改善优于对照组(P <0.05)。观察组总有效率(92%)高于对照组(78%,P <0.01)。结论通络润燥方可明显改善瘀血阻络型pSS合并SFN患者症状及小纤维损伤程度。
Objective Observation of the clinical efficacy of TongLuo RunZao compound on primary Sjogren's syndrome(pSS) with small fiber neuropathy(SFN) of blood stasis type. Methods 50 patients of pSS with SFN of blood stasis type were randomly divided into observation group(25 cases) and control group(25 cases).Both groups were treated with hydroxychloroquine sulfate, prednisone acetate tablets and mecobalamin dispersible tablets. The observation group took TongLuo RunZao compound for 12 weeks. The value of EULAR Sjogren's syndrome disease activity index(ESSDAI),TCM symptoms rating scale, skin sympathetic response(SSR) and adverse reactions were compared. Results The scores of ESSDAI, TCM symptoms rating scale and SSR in the two groups after treatment were better than those before treatment(P < 0.01). And the improvement in the observation group was better than that in the control group(P < 0.05). The total effective rate of the observation group was higher than that of the control group( P < 0.01). Conclusion TongLuo RunZao compound can improve the symptoms and decrease the degree of small fiber injury in patients of pSS with SFN.
Objective Observation of the clinical efficacy of TongLuo RunZao compound on primary Sjogren's syndrome(pSS) with small fiber neuropathy(SFN) of blood stasis type. Methods 50 patients of pSS with SFN of blood stasis type were randomly divided into observation group(25 cases) and control group(25 cases).Both groups were treated with hydroxychloroquine sulfate, prednisone acetate tablets and mecobalamin dispersible tablets. The observation group took TongLuo RunZao compound for 12 weeks. The value of EULAR Sjogren's syndrome disease activity index(ESSDAI),TCM symptoms rating scale, skin sympathetic response(SSR) and adverse reactions were compared. Results The scores of ESSDAI, TCM symptoms rating scale and SSR in the two groups after treatment were better than those before treatment(P < 0.01). And the improvement in the observation group was better than that in the control group(P < 0.05). The total effective rate of the observation group was higher than that of the control group( P < 0.01). Conclusion TongLuo RunZao compound can improve the symptoms and decrease the degree of small fiber injury in patients of pSS with SFN.
引文
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[13]韦尼,丁明辉,杨帆,等.毒瘀损络致干燥综合征小纤维神经病病机浅析[J].北京中医药,2017,36(1):64-66.
[14]王丹,薛鸾,胡建东,等.血瘀证在原发性干燥综合征中的临床特点分析[J].中华中医药学刊,2013,31(5):1108-1110.
[15]BIRNBAUM J,LALJI A,SAED A,et al.Biopsy-Proven SmallFiber Neuropathy in Primary Sj?gren′s Syndrome:Neuropathic Pain Characteristics,Autoantibody Findings,and Histopathological Features[J].Arthritis Care Res(Hoboken),2018,9:1-29.
[16]GORSON K C,HERRMANN D N,THIAGARAJAN R,et a1.Non-length dependent small fibre neuropathy/ganglionopathy[J].J Neurol Neurosurg Psychiatry,2008,79(2):163-169.
[17]MOROZURMI S,KAWAGASHIRA Y,LIJIMA M,et al.Intravenous immunoglobulin treatment for painful sensory neuropathy associated with Sjogren′s syndrome[J].J Neurol Sci,2009,279(1):57-61.
[2]孙博,黄旭升.小纤维神经病诊断研究进展[J].北京医学,2017,39(5):513-516.
[3]CARVAJAL A G,GUELLEC D,MARIETTE X,et al.Epidemiology of neurological manifestations in Sj?gren′s syndrome:data from the French ASSESS Cohort[J].Rmd Open,2016,2(1):e000179.
[4]FAUCHAIS A L,RICHARD L,GONDRAN G,et al.Small fibre neuropathy in primary Sj?gren syndrome[J].Revue De Medecine Interne,2011,32(3):142-148.
[5]LACOMIS D,GIULIANI M J,STEEN V,et al.Small fiber neuropathy and vasculitis[J].Arthritis Rheum,2014,40(6):1173-1177.
[6]BASTIAN I,GORDON T P,JACKSON M W.A novel cellbased assay for inhibitory anti-muscarinic type 3 receptor antibodies in primary Sj?gren′s syndrome[J].J Immunol Methods,2015,427:117-121.
[7]VITALI C.Classification criteria for Sjogren′s syndrome:a revised version of European criteria proposed by the America-European Consensus Group[J].Ann Rheum Dis,2002,61(6):554-558.
[8]LEFAUCHEUR J P,CREANGE A.Neurophysiological testing correlates with clinical examination according to fibre type involvement and severity in sensory neuropathy[J].J Neurol Neurosurg Psychiatry,2004,75(3):417-422.
[9]ZILLIOX L,RUSSELL J W.Treatment of diabetic sensory polyneuropathy[J].Curr Treat Options Neurol,2011,13(2):143-159.
[10]盛正和,翁映虹,刘溯章,等.温阳中药治疗干燥综合征并干眼症增效作用的临床观察[J].实用医学杂志,2017,33(10):1697-1700.
[11]崔丽英.简明肌电图学手册[M].北京:科学出版社,2006:183-211.
[12]国家中医药管理局医政司.22个专业95个病种中医临床诊疗方案(合订本)[M].2版.北京:中国中医药出版社,2012:280-284.
[13]韦尼,丁明辉,杨帆,等.毒瘀损络致干燥综合征小纤维神经病病机浅析[J].北京中医药,2017,36(1):64-66.
[14]王丹,薛鸾,胡建东,等.血瘀证在原发性干燥综合征中的临床特点分析[J].中华中医药学刊,2013,31(5):1108-1110.
[15]BIRNBAUM J,LALJI A,SAED A,et al.Biopsy-Proven SmallFiber Neuropathy in Primary Sj?gren′s Syndrome:Neuropathic Pain Characteristics,Autoantibody Findings,and Histopathological Features[J].Arthritis Care Res(Hoboken),2018,9:1-29.
[16]GORSON K C,HERRMANN D N,THIAGARAJAN R,et a1.Non-length dependent small fibre neuropathy/ganglionopathy[J].J Neurol Neurosurg Psychiatry,2008,79(2):163-169.
[17]MOROZURMI S,KAWAGASHIRA Y,LIJIMA M,et al.Intravenous immunoglobulin treatment for painful sensory neuropathy associated with Sjogren′s syndrome[J].J Neurol Sci,2009,279(1):57-61.