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C<sub>3</sub>、C<sub>4</sub>的影响

白琳; 赵君

doi:10.7619/jcmp.201919014

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

白琳¹,
赵君^2, ,

1.
陕西省西安市第五医院, 风湿八科, 陕西西安, 710082
2.
陕西省西安市第五医院, 风湿科七病区, 陕西西安, 710082

详细信息

通讯作者:
赵君, E-mail: 195475292@qq.com

中图分类号: R593.24
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出版历程
- 收稿日期: 2019-06-02
- 录用日期: 2019-08-10
- 网络出版日期: 2021-02-28
- 发布日期: 2019-10-14

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

BAI Lin¹,
ZHAO Jun^2, ,

1.
Eighth Department of Rheumatology, Xi′an Fifth Hospital, Xi′an, Shaanxi, 710082
2.
The Seventh Ward of Rheumatology, Xi′an Fifth Hospital, Xi′an, Shaanxi, 710082

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。
- 系统性红斑狼疮 /
- 青蒿鳖甲汤 /
- 阴虚内热型 /
- 免疫球蛋白 /
- 补体C₃ /
- 补体C₄
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.
- systemic lupus erythematosus /
- Qinghao Biejia Decoction /
- internal heat and Yin deficiency /
- immunoglobulin /
- complement C₃ /
- complement C₄

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表 1 2组治疗前后血清免疫球蛋白和补体C₃、C₄水平变化(x±s)

组别	时点	免疫球蛋白/(g/L)			补体/(mg/L)
组别	时点	IgA	IgG	IgM	C₃	C₄
对照组	治疗前	3.51±0.55	19.05±2.47	2.50±0.38	0.42±0.08	0.11±0.03
	治疗后	3.05±0.37^*	14.30±2.13^*	2.09±0.30^*	0.68±0.13^*	0.24±0.07^*
观察组	治疗前	3.48±0.52	18.97±2.51	2.51±0.42	0.40±0.09	0.12±0.04
	治疗后	2.38±0.32^*#	12.24±2.05^*#	1.72±0.24^*#	0.90±0.17^*#	0.30±0.09^*#
与治疗前比较, *P < 0.05;与对照组比较, #P < 0.05。

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表 2 2组SLEDAI评分、中医症候评分比较(x±s) 分

项目		对照组		观察组
项目		治疗前	治疗后	治疗前	治疗后
SLEDAI评分		8.17±1.74	5.27±1.02^*	8.20±1.81	4.25±0.78^*#
中医证候评分	低热	2.35±0.67	1.63±0.41^*	2.38±0.62	1.10±0.34^*#
	乏力	2.61±0.72	2.45±0.59	2.64±0.70	1.21±0.24^*#
	睡眠差	2.33±0.74	2.41±0.68	2.39±0.71	1.34±0.47^*#
	五心烦热	2.29±0.64	2.43±0.66	2.31±0.62	1.14±0.13^*#
	口干	2.59±0.57	2.48±0.51	2.57±0.60	1.34±0.29^*#
	脱发	2.21±0.44	2.26±0.35	2.20±0.42	1.06±0.24^*#
	眼干	2.14±0.52	1.67±0.41^*	2.11±0.50	1.15±0.26^*#
	月经不调	2.36±0.47	2.15±0.42	2.38±0.40	1.03±0.15^*#
	面部红斑	2.51±0.62	1.87±0.43^*	2.53±0.59	1.15±0.24^*#
	关节疼痛	2.48±0.35	1.82±0.27^*	2.44±0.36	1.14±0.16^*#
	双手红斑	2.46±0.42	1.79±0.30^*	2.45±0.41	1.21±0.33^*#
	脉细数	1.32±0.24	0.93±0.15	1.30±0.22	0.29±0.08^*#
SLEDAI:系统性红斑狼疮活动度。治疗前比较, *P < 0.05;与对照组比较, #P < 0.05。

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