昆母汤联合激素治疗风湿痹阻型系统性红斑狼疮的临床观察

发布时间：2018-04-03 18:52

本文选题：昆母汤　切入点：风湿痹阻型　出处：《广州中医药大学》2017年硕士论文

【摘要】：目的:观察昆母汤治疗风湿痹阻型轻中度系统性红斑狼疮的短期治疗效果及用药的安全性,以充分利用中医药的优势,为系统性红斑狼疮患者提供更为便捷、可靠的治疗方法。方法:纳入2016年5月至2017年3月广州中医药大学第一附属医院风湿病科门诊及住院部符合标准的60名患者。以就诊顺序随机编号,按完全随机设计分为治疗组和对照组各30例。治疗组予口服醋酸泼尼松片10mg po qd+昆母汤,对照组予口服醋酸泼尼松片10mg po qd+硫酸羟氯喹片200mg po bid+甲氨蝶呤片10mg po qw,连续服药8周,分别观察及记录治疗前、治疗后的实验室指标、中医症状及体征等,以评估昆母汤治疗系统性红斑狼疮的临床疗效,采用SPSS22.0对数据进行统计学分析。结果:治疗8周后,治疗组总体效率为93.3%,对照组总体效率为80.0%,治疗组疗效更好(P0.05)。治疗组中医证候疗效为93.3%,治疗组中医证候疗效为66.7%%,治疗组疗效更有优势(P0.05)。治疗组与对照组的中医症状积分与SLEDAI评分较前均有降低,且治疗组更明显(P0.05)。在改善关节肿痛、颜面红斑、口腔溃疡、脱发、神疲乏力等中医主要症状方面,治疗组优于对照组(P0.05)。治疗组与对照组均能升高补体C3、补体C4值,两组比较无差异(P0.05)。治疗组和对照组均可降低ESR、CRP、抗ds-DNA水平,治疗组更有效(P0.05)。治疗组能降低尿蛋白定量、甘油三酯水平,两组比较有差异(P0.05)。在用药的安全性方面,治疗组与对照组对白细胞、血红蛋白、血小板的影响比较无差异(P0.05)。对照组可升高肝酶值,两组比较有差异(P0.05)。治疗组与对照组均出现肌酐的异常,两组比较无差异(P0.05)。治疗组与对照组对女性月经情况的影响比较无差异(P0.05)。治疗组对消化系统的影响更小,两组比较有差异(P0.05)。结论:昆母汤联合激素治疗轻中度风湿痹阻型系统性红斑狼疮患者,能有效改善临床症状,降低疾病活动性指标,升高补体,降低尿蛋白水平,降低西药副作用的发生率,巩固疗效,展示了昆母汤治疗系统性红斑狼疮的独特魅力,有助于提高患者的生活质量。
[Abstract]:Objective: to observe the short-term therapeutic effect and safety of Kunmu decoction in the treatment of mild to moderate systemic lupus erythematosus with rheumatism obstruction, so as to make full use of the advantages of traditional Chinese medicine and to provide a more convenient and reliable treatment method for patients with systemic lupus erythematosus.Methods: from May 2016 to March 2017, 60 patients who met the criteria in the Department of Rheumatology, Department of Rheumatology, the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine were included.The patients were randomly divided into treatment group (n = 30) and control group (n = 30).The treatment group was treated with prednisone acetate 10mg po QD QD QD decoction, and the control group with prednisone acetate 10mg po QD hydroxychloroquine sulfate 200mg po bid methotrexate (10mg po QW) for 8 weeks.In order to evaluate the clinical efficacy of Kun Mu decoction in treating systemic lupus erythematosus (SLE), the laboratory indexes, symptoms and signs of TCM were evaluated, and the data were analyzed statistically by SPSS22.0.Results: after 8 weeks of treatment, the total efficiency of the treatment group was 93.3g, the total efficiency of the control group was 80.0. the curative effect of the treatment group was better than that of the control group (P 0.05).The curative effect of TCM syndromes in the treatment group was 93.3G, the curative effect of TCM syndrome in the treatment group was 66.7m, the curative effect of the treatment group was more superior than that of the control group (P 0.05).The scores of TCM symptom and SLEDAI in the treatment group and the control group were lower than before, and the treatment group was more obvious than the control group (P 0.05).The treatment group was superior to the control group in improving the main symptoms of traditional Chinese medicine, such as joint swelling and pain, facial erythema, oral ulcer, alopecia and fatigue.The value of complement C _ 3 and complement C _ 4 were increased in the treatment group and the control group, and there was no difference between the two groups (P 0.05).Both the treatment group and the control group could reduce the level of ds-DNA, and the treatment group was more effective than the control group.The treatment group can reduce the urine protein quantity and triglyceride level, there is a difference between the two groups (P 0.05).There was no difference in the effect of treatment group and control group on white blood cell, hemoglobin and platelet.The liver enzyme value in the control group was higher than that in the control group (P 0.05).There was no difference in creatinine between the treatment group and the control group (P 0.05).There was no difference between the treatment group and the control group on the menstrual status of women (P 0.05).The effect of the treatment group on digestive system was less, there was a difference between the two groups (P 0.05).Conclusion: the treatment of mild and moderate rheumatism obstruction systemic lupus erythematosus with Kunmu decoction combined with hormone can effectively improve clinical symptoms, reduce disease activity index, increase complement, reduce urinary protein level, and reduce the incidence of side effects of western medicine.Consolidate the curative effect, demonstrate the unique charm of Kun Mu decoction in the treatment of systemic lupus erythematosus, and help to improve the quality of life of the patients.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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