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青蒿鳖甲汤对阴虚内热型系统性红斑狼疮患者血清免疫球蛋白和补体C3、C4的影响

Effect of Qinghao Biejia Decoction on serum immunoglobulin and complement C3 and C4 in patients with systemic lupus erythematosus differentiated as internal heat and Yin deficiency

    摘要
  • 摘要:
      目的  探讨中药青蒿鳖甲汤治疗阴虚内热型系统性红斑狼疮(SLE)的疗效, 并观察其对血清免疫球蛋白和补体C3、C4水平的影响。
      方法  选取本院风湿免疫科收治的76例SLE患者，采用随机数表法分为对照组和观察组，各38例。对照组给予常规西医治疗，观察组给予常规西药联合中药青蒿鳖甲汤治疗，均持续治疗3个月。检测2组治疗前后血清免疫球蛋白(IgA、IgG、IgM), 补体C3、C4水平, SLE活动度评分(SLEDAI)和中医证候评分变化，并评估2组临床疗效。
      结果  2组治疗后血清IgA、IgG、IgM均较治疗前下降，补体C3、C4水平升高，差异有统计学意义(P < 0.05);与对照组比较，观察组治疗后血清IgA、IgG、IgM显著降低，补体C3、C4水平显著升高(P < 0.05); 2组治疗后SLEDAI评分均较治疗前显著下降(P < 0.05), 且观察组显著低于对照组(P < 0.05)。治疗后，对照组乏力、睡眠差、五心烦热、口干、脱发、月经不调、脉细数评分与治疗前相比，差异无统计学意义(P>0.05);治疗后，观察组各中医症候评分均较治疗前和对照组显著降低(P < 0.05)。观察组治疗总有效率显著高于对照组(P < 0.05)。
      结论  常规西医治疗基础上联合青蒿鳖甲汤能有效降低阴虚内热型SLE患者血清免疫球蛋白水平，提高补体C3、C4水平。

     

    Abstract:
      Objective  To investigate the therapeutic effect of Qinghao Biejia Decoction for patients with systemic lupus erythematosus (SLE) differentiated as internal heat and Yin deficiency, and to observe its impact on serum immunoglobulin, complement C3 and C4 levels.
      Methods  A total of 76 SLE patients in the Rheumatology and Immunology Department in our hospital were selected and divided into control group(n=38) and observation group(n=38) by random number table method. The control group was treated with routine western medicine, while the observation group was additionally treated by Qinghao Biejia Decoction, the treatments of two groups lasted for 6 months. The levels of serum IgA, IgG, IgM, complement C3 and C4, SLE activity score (SLEDAI) and TCM syndrome score were measured before and after treatment in both groups, and the clinical efficacy was evaluated.
      Results  After treatment, serum IgA, IgG and IgM decreased, complement C3 and C4 levels increased, and the differences were statistically significant (P < 0.05). Compared with the control group, the above indicators in the observation group changed more significantly(P < 0.05). The SLEDAI scores in two groups were significantly lower than treatment before (P < 0.05), and the observation group decreased more significantly compared with the control group (P < 0.05). After treatment, there were no significant differences in fatigue, poor sleep, fever in five centers, dry mouth, hair loss, irregular menstruation, and thin and rapid pulse scores compared with treatment before in the control group (P>0.05). After treatment, the TCM symptom scores of the observation group were significantly lower than treatment before and the control group(P < 0.05). The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05).
      Conclusion  Qinghao Biejia Decoction based on routine western medicine treatment can effectively reduce serum immunoglobulin level and increase complement C3 and C4 levels in SLE patients differentiated as internal heat and Yin deficiency.

     

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