摘要
目的探讨滋阴清热解毒法联合激素、甲氨蝶呤治疗系统性红斑狼疮的疗效及对患者补体和免疫功能的影响。方法选择杭州市第三人民医院2017年3月至2019年3月收治的系统性红斑狼疮患者62例,采用随机数字表法分为观察组31例与对照组31例。对照组采用激素联合甲氨蝶呤治疗,观察组在对照组基础上结合滋阴清热解毒法治疗。两组疗程均为3个月。比较两组的疗效,治疗前后补体水平和免疫球蛋白(Ig)水平的变化。结果治疗后观察组总有效率为96.77%(30/31),对照组为74.19%(23/31),两组总有效率比较差异有统计学意义(χ^2=6.369,P<0.05)。两组治疗前补体C3和C4水平比较差异无统计学意义(P>0.05);两组治疗后补体C3和C4水平均较治疗前升高,差异有统计学意义(P<0.05);观察组治疗后补体C3和C4水平高于对照组[(1.08±0.15)g/L比(0.81±0.13)g/L、(0.24±0.05)g/L比(0.18±0.03)g/L],差异有统计学意义(t=7.574、5.729,P<0.05)。两组治疗前CD3^+、CD4^+和CD4^+/CD8^+水平比较差异无统计学意义(P>0.05);两组治疗后CD3^+、CD4^+和CD4^+/CD8^+水平均较治疗前升高,差异有统计学意义(P<0.05);观察组治疗后CD3^+、CD4^+和CD4^+/CD8^+水平高于对照组[(65.72±5.62)%比(58.93±4.25)%、(41.03±1.75)%比(38.21±1.43)%、1.65±0.09比1.41±0.12],差异有统计学意义(t=5.365、6.948、8.908,P<0.05)。两组治疗前IgA、IgG、IgM水平比较差异无统计学意义(P>0.05);两组治疗后IgA和IgG水平均较治疗前降低,IgM水平较治疗前升高,差异有统计学意义(P<0.05);观察组治疗后IgA和IgG水平低于对照组[(1.85±0.38)g/L比(2.54±0.42)g/L、(12.19±1.63)g/L比(14.53±1.37)g/L],差异有统计学意义(t=6.783、6.119,P<0.05)。结论滋阴清热解毒法联合甲氨蝶呤治疗系统性红斑狼疮患者疗效良好,可有效提高补体C3和C4水平,改善免疫功能。
Objective To investigate the therapeutic effect of nourishing Yin,clearing heat and detoxifying method combined with hormone and methotrexate on systemic lupus erythematosus(SLE)patients and its immune function.Methods Sixty-two patients with systemic lupus erythematosus admitted to Third People′s Hospital of Hangzhou from March 2017 to March 2019 were randomly divided into observation group(31 cases)and control group(31 cases)by random number table.The patients in the control group were treated with prednisone and methotrexate,while the patients in the observation group were treated with nourishing Yin,clearing heat and detoxifying method combined with hormone and methotrexate on the basis of the control group.Both groups were treated for 3 months.The therapeutic effects of the two groups were compared,and the changes of complement C3 and C4,immune function before and after treatment were compared.Results The total effective rate of the observation group was higher than that of the control group[96.77%(30/31)vs.74.19%(23/31)],and there was significant difference(χ^2=6.369,P<0.05).The levels of complement C3 and C4 in two groups before treatment had no significant differences(P>0.05);after treatment,the levels of complement C3 and C4 in two groups were significantly increased(P<0.05),and the levels of complement C3 and C4 in observation group were significantly higher than those in control group[(1.08±0.15)g/L vs.(0.81±0.13)g/L,(0.24±0.05)g/L vs.(0.18±0.03)g/L],and there were significant differences(t=7.574,5.729,P<0.05).The levels of CD3^+,CD4^+and CD4^+/CD8^+in two groups before treatment had no significant differences(P>0.05);after treatment,the levels of CD3^+,CD4^+and CD4^+/CD8^+in two groups were significantly increased(P<0.05),and the levels of CD3^+,CD4^+and CD4^+/CD8^+in observation group were significantly higher than those in control group[(65.72±5.62)%vs.(58.93±4.25)%,(41.03±1.75)%vs.(38.21±1.43)%,1.65±0.09 vs.1.41±0.12],and there were significant differences(t=5.365,6.948,8.908,P<0.05).The levels of IgA,IgG and IgM in two groups before treatment had no significant differences(P>0.05);after treatment,the levels of IgA,IgG in two groups were increased,the level of IgM in two groups was decreased,and there were significant differences(P<0.05).The levels of IgA,IgG in observation group were significantly higher than those in control group[(1.85±0.38)g/L vs.(2.54±0.42)g/L,(12.19±1.63)g/L vs.(14.53±1.37)g/L],and there were significant differences(t=6.783,6.119,P<0.05).Conclusions Nourishing Yin,clearing heat and detoxifying method combined with hormone and methotrexate in treating SLE is effective,which can effectively improve the levels of complement C3 and C4 and immune function.
作者
张彦
徐琼
陈梦露
Zhang Yan;Xu Qiong;Chen Menglu(Department of Endocrinology and Hematology,Third People′s Hospital of Hangzhou,Hangzhou 310009,China)
出处
《中国医师进修杂志》
2020年第6期509-512,共4页
Chinese Journal of Postgraduates of Medicine
关键词
红斑狼疮
系统性
泼尼松
甲氨蝶呤
滋阴清热解毒法
Lupus erythematosus,systemic
Prednisone
Methotrexate
Nourishing Yin,clearing heat and detoxifying method
