摘要
目的探讨清化淤热法治疗系统性红斑狼疮的内皮功能变化以及中药干预机制。方法本次研究选取2014年3月-2015年3月在XX医院就诊的SLE患者60例作为研究对象,随机分为西医组、中西医组,每组30例。西医组使用正规糖皮质激素进行治疗,中医组在使用糖皮质激素进行治疗的基础上使用活血化瘀的典型方剂——红斑狼疮1号方。比较两组治疗前及治疗后4、8、12周记录SLEDAI及中医症状评分,记录强的松、环磷酰胺用量,复发例数、不良反应发生情况和内皮功能相关指标。结果三组患者治疗前的平一般资料比较无统计学意义,P>0.05。中西医组与西医组治疗前后各个时间点的SLEDAI、TCMSS、GCS的积分结果比较显示两种方法对SLE的治疗均有效,且中西医组的治疗效果优于西医组,P<0.05。中西医组与西医组的患者经过治疗后血管内皮生长因子(VEGF)、可溶性血栓调节蛋白(s TM)、血管假性血友病因子(v WF)、抗内皮细胞抗体(AECA)、血管内皮细胞蛋白C受体(EPCR)、循环内皮细胞(CEC)的指标均呈现出下降趋势,且中西医组下降优于对照组P<0.05;中西医组、西医组与健康组的指标仍旧存在差距,P<0.05;中西医组的复发病例数和不良反应数均低于西医组,P<0.05。结论中医与西医在治疗系统性红斑狼疮上的治疗均有效,从淤论治疗系统性红斑狼疮的效果要优于单纯使用激素治疗的西医,值得在临床上推广。
Objective To investigate the changes of endothelial function in patients with systemic lupus erythematosus and the mechanism of traditional Chinese medicine. Methods 60 SLE patients who were treated in XX hospital from March to March 2014 in were randomly divided into health group, western medicine group, and Western medicine group, 20 cases in eachgroup, cases in each group. Western medicine group using the regular glucocorticoid treatment, traditional Chinese medicine group in the use of glucocorticoid treatment on the basis of the use of thetypical formula of blood circulation to dissipate blood stasis- 1. Were compared between the two groups before treatment and after treatment for 4, 8, 12 weeks, record SLEDAI and TCM symptomscores, records of prednisone and cyclophosphamide dosage, cases of recurrence, adverse reactions occurred, and endothelial function related indicators. Results three groups of patients beforetreatment, the level of general information was not statistically significant, P > 0.05. The integration of SLEDAI, TCMSS and GCS of each time point before and after treatment in Western andtraditional Chinese medicine group and Western medicine group showed that the two approachs were effective in the treatment of SLE, and the therapeutic effect of the traditional Chinese andWestern medicine group was superior to that of Western medicine group, P < 0.05. Patients with integrated traditional Chinese and Western medicine group and Western medicine group aftertreatment of vascular endothelial growth factor(VEGF), soluble thrombomodulin(STM), von Willebrand factor(VWF), anti endothelial cell antibodies(AECA) and endothelial cell protein C receptor(EPCR) and circulating endothelial cells(CEC) index showed a downward trend, and the integrated Chinese and Western medicine group decreased compared with the control group P < 0.05; the gap still exists in traditional Chinese medicine and Western medicine group, western medicine group and the healthy group index, P < 0.05). The integrated Chinese and Western medicinegroup of recurrence number and number of adverse reactions were lower than western medicine group, P < 0.05). Conclusion TCM and Western medicine in the treatment of systemic lupuserythematosus are effective, and the effect of the treatment of systemic lupus erythematosus is better than the simple use of hormone therapy in western medicine, it is worth promoting in clinicalpractice.
引文
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