滋阴降火法治疗系统性红斑狼疮的疗效评价及其对细胞因子IL-10、IL-18的影响

发布时间：2018-03-04 14:26

本文选题：系统性红斑狼疮　切入点：阴虚内热　出处：《浙江中医药大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的研究阴虚内热型系统性红斑狼疮患者外周血中细胞因子IL-10和IL-18与病情活动的关系,以及滋阴降火方联合糖皮质激素和羟氯喹片治疗对IL-10和IL-18的影响,并分析中药联合西药治疗后的临床疗效以及对疾病活动性和中医症候的改善情况,探究SLE患者免疫学发病机制和临床疗效,为中西医结合综合治疗系统性红斑狼疮的优势提供实验室依据。方法随机选择40例系统性红斑狼疮患者,分为中西医结合组和西药组,收集临床资料,观察临床疗效及治疗前后疾病活动性和中医症候的变化,并采用酶联免疫吸附(ELISA)实验检测中西医结合组西药组两组血清细胞因子IL-10和IL-18表达水平的变化。结果1.SLEDAI积分改善情况和中医症候疗效改善情况,中西医结合组显著高于西药组,具有统计学意义(P0.05)。2.中西医结合组、西药组IL-10和IL-18与SLEDAI积分呈正相关,具有统计学意义(P0.05)。3.与西药组比较,糖皮质激素和羟氯喹片联合滋阴降火方治疗SLE后,IL-10和IL-18的表达量下降更明显,两组间差异具有统计学意义(P0.05)。结论1.第一、中西医结合组西药组改善明显,滋阴降火方能明显改善阴虚内热型SLE的病情和中医症候。2.第二、SLE患者中西医结合组西药组IL-10和IL-18与SLEDAI积分呈正相关,提示IL-10和IL-18水平可以反映SLE的疾病活动程度。3.第三、糖皮质激素和羟氯喹片联合“滋阴降火”方比单纯使用糖皮质激素和羟氯喹片能更有效降低阴虚内热型SLE患者细胞因子IL-10和IL-18水平。
[Abstract]:Objective to study the relationship between cytokines IL-10 and IL-18 in peripheral blood of patients with systemic lupus erythematosus with yin deficiency and internal heat, and the effect of Ziyin Jianghuo recipe combined with glucocorticoid and hydroxychloroquine on IL-10 and IL-18. The clinical curative effect, the improvement of disease activity and TCM symptom after the treatment of traditional Chinese medicine and western medicine were analyzed, and the pathogenesis and clinical efficacy of immunology in patients with SLE were explored. Methods 40 patients with systemic lupus erythematosus were randomly selected and divided into two groups. To observe the clinical curative effect and the changes of disease activity and TCM symptoms before and after treatment. Enzyme linked immunosorbent assay (Elisa) was used to detect the changes of serum cytokines IL-10 and IL-18 expression in the western medicine group and the western medicine group. 1. The improvement of SLEDAI score and the improvement of the curative effect of traditional Chinese medicine syndrome were significantly higher in the integrated Chinese and western medicine group than in the western medicine group. There was a positive correlation between IL-10 and IL-18 and SLEDAI score in the group of integrated Chinese and western medicine, and there was significant difference between the scores of IL-10 and IL-18 in the group of western medicine and the group of western medicine. Glucocorticoid and hydroxychloroquine tablets combined with Ziyin Jianghuo recipe can decrease the expression of IL-10 and IL-18 in patients with SLE, and the difference between the two groups is statistically significant (P 0.05). Conclusion 1.First, the combination of traditional Chinese and Western medicine can improve the expression of IL-10 and IL-18 significantly. ZYJF can obviously improve the condition and TCM symptom of SLE with Yin deficiency and Internal Heat. The IL-10, IL-18 and SLEDAI score in the group of TCM and western medicine combined with western medicine are positively correlated with that of SLEDAI, suggesting that the levels of IL-10 and IL-18 can reflect the degree of disease activity of SLE. Third, there is a positive correlation between the level of IL-10 and IL-18 and the degree of disease activity of SLE. Glucocorticoid and hydroxychloroquine tablets combined with "Ziyin Jianghuo" recipe can effectively reduce the levels of cytokine IL-10 and IL-18 in patients with SLE with Yin deficiency and internal heat than those with glucocorticoid and hydroxychloroquine alone.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R593.241

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