【作者】 李小兰；

【导师】 汪悦；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2009， 硕士

【摘要】 目的:1、探讨运用凉血化瘀法治疗系统性红斑狼疮瘀热痹阻证的临床疗效;2、评价该治疗方法是否对单纯运用强的松+环磷酰胺有减毒增效作用;3、为临床治疗系统性红斑狼疮瘀热痹阻证提供依据。方法:搜集符合要求的病例40例,按照随机对照的原则,将40例患者分为治疗组和对照组。两组病人均符合系统性红斑狼疮的诊断标准。治疗组在常规西医治疗的基础上,配合运用具有凉血化瘀作用的中药治疗,对照组使用常规西药治疗,观察两组病例中患者入院治疗前及治疗3个月后临床症状,体征及相关实验室检查如:血白细胞、血小板、血红蛋白,尿蛋白,抗ds-DNA,抗SSA抗体、抗SSB抗体、抗Sm抗体,补体C3、C4,24h尿蛋白定量,ESR,C反应蛋白,肝。肾功能等。资料均采用SPSS14.0软件进行统计分析。结果:1.治疗组的疾病疗效评定总有效率高于对照组,但差异无统计学意义(p＞0.05);2.治疗组对照组SLEDAI评分和中医证候积分在治疗后较治疗前均有明显改善(P＜0.01),并且治疗组降低较对照组明显,有统计学差异(P＜0.05);3.治疗后两组补体C3、C4均较治疗前上升,具有统计学差异(P均＜0.01),治疗组补体C3较对照组升高明显(P＜0.05);治疗后两组CRP、ESR较治疗前降低,但治疗组CRP较对照组降低明显,具有统计学差异(P均＜0.05),治疗组IgG治疗后较对照组治疗后降低较为明显,具有统计学差异(P＜0.05);4.治疗组治疗前后24小时尿蛋白定量明显低于对照组,但无显著性差异(P＞0.05);5.两组治疗后抗ds-DNA抗体的阳性例数均较治疗前有减少(P均＜0.05),但两组治疗后无差异(P均＞0.05);各组抗SSA抗体、抗SSB抗体、抗Sm抗体治疗前后均无显著差异(P均＞0.05)。结论:常规西医治疗的同时,结合中医凉血化瘀法辨证论治SLE瘀热痹阻证能提高疗效,改善临床症状,控制SLE活动,降低蛋白尿及减少副作用。中西医结合治疗组疗效更好,本研究为临床治疗瘀热痹阻证SLE提供了一定的参考依据。更多还原

【Abstract】 Objective: 1.To explored in the method of cooling blood and promoting blood flow of drugs in the treatment of stagnated heat and blockage card of systemic lupus erythematosus; 2.The evaluation of the treatment methods used for simple MP + cyclophosphamide are attenuated synergies; 3.For the treatment of stagnated heat and blockage card of systemic lupus erythematosus provide the basis for stasis.Methods: Collected to meet the requirements of a total of 40 cases of cases,in accordance with the principle of stochastic control,40 cases were divided into treatment and control groups. Patient groups are in line with the diagnostic criteria for stagnated heat and blockage card of systemic lupus erythematosus. In the conventional treatment group on the basis of traditional Chinese and western medicine treatment with the use of cooling blood and promoting blood flow role of the traditional Chinese medicine treatment, the control group using conventional western medicine treatment,patients were observed in patients hospitalized for treatment before and three months after the clinical symptoms and signs and the related laboratory tests such as: white blood cell, platelet, hemoglobin, urine protein, anti-ds-DNA, anti-SSA antibody, anti-SSB antibodies, anti-Sm antibodies, complement C3, C4, 24h urinary protein, ESR, C-reactive protein, liver and kidney function. Information SPSS14.0 software used for statistical analysis. Results: 1. The treatment group effect of the disease have assessed the overall efficiency of the control group, but the difference was not statistically significant (p> 0.05); 2. The treatment group and control group SLEDAI score and traditional Chinese medicine symptoms score before treatment than after treatment are significantly improved (P <0.01), and the treatment group significantly lower than the control group, there is significant difference (P <0.05); 3. Treated the two groups complement C3, C4 were increased before treatment, with significant difference (P all <0.01), the treatment group’s C3 complement increased significantly than the control group’s (P <0.05); after treatment the two groups CRP, ESR lower than before treatment, but treatment group’s CRP significantly lower than the control group, with significant difference (P all < 0.05). After treatment treatment group’s IgG reduce the more obvious than the control group, with significant difference (P <0.05); 4. The 24-hour urinary protein of the treatment group was significantly lower than the control group before and after the treatment, but no significant difference (P> 0.05 ); 5. After treatment the number of positive cases of two groups of anti-ds-DNA antibodies has reduced than pre-treatment (P all <0.05), however, no difference in the two groups after treatment (P all> 0.05); the group of anti-SSA antibody, anti-SSB antibodies, anti-Sm antibodies before and after treatment there was no significant difference (P all> 0.05).Conclusion: Western medicine treatment combined with cooling blood and promoting blood flow of drugs in the treatment of stagnated heat and blockage card of systemic lupus erythematosus can improve the clinical symptoms, control SLE activity, reduce proteinuria and reduce side effects. The effect of Traditional Chinese combined with western medicine was better, and this study for clinical treatment of stagnated heat and blockage card of systemic lupus erythematosus provides a frame of reference.更多还原