摘要
目的探究参苓白术散加减治疗肺脾气虚津亏干燥综合征的疗效及对血清Toll样受体4(TLR4)和核因子-κB(NF-κB)水平的影响。方法选取2019年3月—2022年3月收治的107例干燥综合征患者为研究对象,采用信封法从密封箱子抽取带有数字的纸团,大于等于54的号码为观察组,小于54的号码为对照组。观察组54例,对照组53例。对照组给予硫酸羟氯喹片、甲泼尼龙片治疗,观察组在此基础上联合使用参苓白术散加减治疗。观察两组患者治疗前后中医证候评分、疾病活动指数(ESSDAI)和自我报告指数(ESSPRI)评分、γ-干扰素(IFN-γ)、白介素-17(IL-17)、免疫功能(CD_(8)^(+)、CD_(4)^(+)和CD^(+)_(4/)CD_(8)^(+))、血清TLR4和NF-κB水平。观察两组患者临床疗效。结果治疗前两组患者两目干涩、关节疼痛、口燥咽干、皮肤干燥、体倦乏力和唾液腺肿评分差异无统计学意义(P>0.05)。治疗后观察组两目干涩、关节疼痛、口燥咽干、皮肤干燥、体倦乏力和唾液腺肿评分显著低于对照组(P<0.05)。治疗前两组患者ESSDAI和ES⁃SPRI评分差异无统计学意义(P>0.05)。治疗后观察组ESSDAI和ESSPRI评分显著低于对照组(P<0.05)。治疗前两组患者IFN-γ、IL-17水平差异无统计学意义(P>0.05)。治疗后观察组IFN-γ、IL-17水平显著低于对照组(P<0.05)。两组患者治疗前CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD^(+)8水平差异无统计学意义(P>0.05)。治疗后观察组的CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平较对照组显著升高,而CD^(+)8水平较对照组显著降低(P<0.05)。两组患者治疗前TLR4/NF-κB水平差异无统计学意义(P>0.05)。治疗后观察组TLR4/NF-κB水平较对照组显著降低(P<0.05)。观察组总有效率为96.30%(52/54),显著高于对照组的84.91%(45/53)(χ^(2)=4.096,P=0.043)。结论参苓白术散加减能有效提高干燥综合征患者临床疗效、降低ESSDAI和ESSPRI评分、改善TLR4/NF-κB的水平,有利于提高患者免疫力。
Objective To explore the clinical efficacy of Modified Shenling Baizhu Powder(参苓白术散加减)in the treatment of Sjögren syndrome of lung and spleen Qi deficiency type and its effect on toll-like receptor 4/nuclear factor kappa B(TLR4/NF-κB)levels.Methods One hundred and seven patients with Sjögren syndrome in the hospital from March 2019 to March 2022 were enrolled,and classified into two groups by using sealed opaque envelopes.The patients with the numbers greater than or equal to 54 were included in the observation group(54 cases)and those with the numbers less than 54 were included in the control group(53 cases).The control group was given hydroxychloroquine sulphate tablets and methylprednisolone tablets for treatment.Based on this,the observation group was treated with Modified Shenling Baizhu Powder.Then the TCM syndrome scores,EULAR Sjögren's Syndrome Disease Activity Index(ESSDAI),EULAR Sjögren's Syndrome Patient Reported Index(ES⁃SPRI),inflammatory factors,immune function and serum TLR4/NF-κB levels were observed before and after treatment in both groups.Then the clinical efficacy was compared between two groups.Results The scores of TCM syndromes including ocular dry⁃ness,joint pain,dry mouth and throat,dry skin,fatigue and salivary gland swelling yielded no statistical difference between two groups before treatment(P>0.05),while the above TCM syndrome scores of the observation group were lower than those of the control group(P<0.05).ESSDAI and ESSPRI scores showed no statistical difference between two groups before treatment(P>0.05),while the observation group scored lower on ESSDAI and ESSPRI than those of the control group after treatment(P<0.05).The serum levels of interferon-γ(IFN-γ)and interleukin-17(IL-17)denoted no statistical difference between two groups(P>0.05),while the two inflammation factors were lower in the observation group than those in the control group after treatment(P<0.05).The values of CD_(4)^(+),CD_(8)^(+)and CD_(4)^(+)/CD_(8)^(+)demonstrated no statistical difference between two groups before treatment(P>0.05).After treatment,an increase in CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)along with a decrease in CD8^(+)were observed in both groups.Furthermore,the two changes were both more remarkable in the observation group than those in the control group(P<0.05).TLR4/NF-κB levels demonstrated no statistical difference between two groups before treatment,while the TLR4/NF-κB level of the observation group was lower than that of the control group(P<0.05).The clinical efficacy rate was 96.30%in the observation group,which was higher than 84.91%in the control group,with statistical difference(χ^(2)=4.096,P=0.043).Conclusion Application of Modified Shenling Baizhu Powder in the treatment of Sjögren syndrome can effectively reduce ESSDAI and ESSPRI scores,improve TLR4/NF-κB and immune function in patients.
作者
宋亚丽
马艳苗
胡桂芬
来晓炜
SONG Yali;MA Yanmiao;HU Guifen;LAI Xiaowei(Heping Hospital Alliliated to Changzhi Medical College,Changzhi 046000,Shanxi,China;College of Basic Medicine,Shanxi University of Traditional Chinese Medicine,Taiyuan 030000,Shanxi,China)
出处
《中华中医药学刊》
CAS
北大核心
2024年第5期186-190,共5页
Chinese Archives of Traditional Chinese Medicine
基金
山西省卫生健康委员会项目(2020093)。
关键词
参苓白术散
肺脾气虚
津亏
干燥综合征
TLR4
NF-κB
临床疗效
Shenling Baizhu Powder(参苓白术散)
lung and spleen Qi deficiency
body fluid deficiency
Sjögren syndrome
TLR4
NF-κB
clinical efficacy
