清燥布津法治疗干燥综合征的临床及实验研究

发布时间：2018-06-12 21:42

本文选题：清燥布津法 + 干燥综合征　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:基于“燥毒学说”,阐明清燥布津法治疗干燥综合征(Sj?gren syndrome,SS)的理论依据,通过实验研究与临床研究相结合的方法,探讨清燥布津法治疗干燥综合征具有重要的理论与临床意义。方法:临床研究:将61例符合干燥综合征诊断标准患者采用随机数表法分组,随机分为清燥布津合剂试验组(QZBJ组)和硫酸羟氯喹对照组(HCQ组),QZBJ组31人,HCQ组30人。试验组给予清燥布津合剂治疗16周;对照组给予硫酸羟氯喹片口服治疗16周。比较试验组与对照组的临床疗效,并评价其安全性。实验研究:通过实验验证清燥布津合剂对干燥综合征BALB/c小鼠唾液分泌及相关细胞因子的影响。结果:临床研究:清燥布津合剂组显效5例,有效16例,改善6例,无效3例,总有效率为90%;羟氯喹组显效2例,有效8例,改善18例,无效7例,总有效率为76.67%。清燥布津合剂组效果优于羟氯喹组。清燥布津合剂组、羟氯喹组组内治疗前后在口干、眼干、皮肤干燥、大便干燥等症状评分、血沉、免疫球蛋白(IgG、IgM、IgA)、疾病活动度评价、患者主观评价均有不同程度的改善,组内治疗前后存在显著差异,结果具有统计学意义(P㩳0.05),说明清燥布津合剂与羟氯喹在治疗干燥综合征方面都有疗效;清燥布津合剂组与羟氯喹组组间治疗后在口干、眼干、皮肤干燥、大便干燥等症状评分、血沉、免疫球蛋白(IgG、IgM、IgA)、患者主观评价均有不同程度的改善,组间治疗后存在显著差异,结果具有统计学意义(P㩳0.05),说明清燥布津合剂组总体疗效优于羟氯喹组。实验研究:清燥布津合剂可以改善小鼠口干症状、唾液分泌量、对干燥综合征BALB/c小鼠模型Th平衡相关细胞因子具有调节作用。结论:临床研究显示清燥布津法治疗干燥综合征可以有效缓解患者口干、眼干等临床症状,并且治疗过程安全有效,是治疗干燥综合征的有效方法之一。实验研究显示能显著改善干燥综合征BALB/c模型小鼠病理状态,抑制干燥综合征相关炎性细胞因子,其机理可能是通过调节其免疫功能实现的。为清燥布津法治疗干燥综合征提供科学依据,有利于指导干燥综合征的临床实践。
[Abstract]:Objective: based on the theory of dryness and toxin, to clarify the theoretical basis for the treatment of Sjjgren syndrome SSs with the method of clearing dryness and Bujin, and to combine the experimental study with clinical research. It is of great theoretical and clinical significance to explore the treatment of Sjogren syndrome by clearing dryness and bujin. Methods: 61 patients with Sjogren's syndrome were randomly divided into QZBJ group (QZBJ group) and HCQ group (31 patients in HCQ group) and 30 patients in HCQ group. The experimental group was treated with Qingzao Bujin mixture for 16 weeks and the control group with hydroxychloroquine sulfate tablets for 16 weeks. To compare the clinical efficacy between the experimental group and the control group, and to evaluate its safety. Experimental study: the effects of Qingzao Bujin mixture on saliva secretion and related cytokines in BALB / P / c mice with Sjogren's syndrome were studied. Results: clinical study: in Qingzao Bujin mixture group, 5 cases were effective, 16 cases were effective, 6 cases were improved, 3 cases were ineffective, the total effective rate was 90 cases, in hydroxychloroquine group, there were 2 cases of remarkable effect, 8 cases of effective effect, 18 cases of improvement, 7 cases of ineffectiveness, and 76.67% of total effective rate. The effect of Qingzao Bujin mixture group was better than that of hydroxychloroquine group. The scores of dry mouth, dry eyes, dry skin, dry stool, erythrocyte sedimentation rate, immunoglobulin IgGG, IgM, disease activity, subjective evaluation of patients were improved in the treatment group of Qingzao Bujin mixture and hydroxychloroquine before and after treatment. There was significant difference between the two groups before and after treatment. The results showed that Qingzao Bujin mixture and hydroxychloroquine were effective in the treatment of Sjogren syndrome, and the dry mouth and eyes were dry after treatment between Qingzaobujin mixture group and hydroxychloroquine group. The scores of dry skin, dry stool and other symptoms, ESR, IgGG and IgMU IgA, the subjective evaluation of the patients were improved to some extent, and there were significant differences between the two groups after treatment. The results showed that the total curative effect of Qingzao Bujin mixture group was better than that of hydroxychloroquine group. Experimental study: Qingzao Bujin mixture can improve the dry mouth symptoms, saliva secretion, and regulate the Th balance of cytokines in Sjogren syndrome BALB- c mice model. Conclusion: the clinical study shows that the treatment of Sjogren's syndrome with Qingzao Bujin method can effectively relieve the clinical symptoms such as dry mouth and dry eye, and the treatment process is safe and effective. It is one of the effective methods for the treatment of Sjogren's syndrome. The experimental results showed that it could significantly improve the pathological state of BALB / c mice model of Sjogren's syndrome and inhibit the inflammatory cytokines associated with Sjogren's syndrome. The mechanism may be achieved by regulating the immune function of Sjogren's syndrome mice. It provides a scientific basis for the treatment of Sjogren syndrome with the method of clearing dryness and Bujin, and is helpful to guide the clinical practice of Sjogren syndrome.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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