| 甘露饮合升降散治疗原发性干燥综合征50例分析 |
| 投稿时间：2017-07-12 修订日期：2017-09-13 点此下载全文 |
| 引用本文：宣磊,王景,张昊泽,罗虹辉,董振华.甘露饮合升降散治疗原发性干燥综合征50例分析[J].医学研究杂志,2018,47(5):126-130 |
| DOI：
10.11969/j.issn.1673-548X.2018.05.031 |
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| 中文摘要:目的 观察中药局方甘露饮合升降散加减方治疗原发性干燥综合征（pSS）非系统受累患者的疗效，为中药复方治疗复杂证型疾病提供临床证据，体现中药对本病的治疗优势。方法 75例中医阴虚夹湿燥毒型pSS，随机2：1比例分为中药组50例，西药组25例。中药组口服甘露饮合升降散加减方，西药组口服硫酸羟氯喹（纷乐）0.1g每天两次，疗程3个月。分别记录两组患者西医疾病活动指数（ESSDAI）评分、中医症状积分、实验室指标、血清细胞因子水平以评价疗效。结果 治疗后两组ESSDAI评分、中医症状积分均明显降低，差异有统计学意义（P<0.05）；组间比较，中药组中医症状积分下降更显著，差异有统计学意义（P<0.05）。中药组可降低淋巴结肿大、腮腺肿痛、高免疫球蛋白血症的ESSDAI评分，同时降低血沉、高免疫球蛋白G、血清IL-17水平，差异具有统计学意义（P<0.05）；和西药组比较差异无统计学意义（P>0.05）。中药组疗后乏力、皮肤干裂、口眼黏腻、舌苔厚腻4项的中医积分下降比西药组更显著（P<0.05）。结论 局方甘露饮合升降散加减方有效改善非系统受累pSS患者的病情，减轻口眼干燥、乏力、腮腺肿大、关节疼痛等中医临床症状，并且降低血清IgG、IL-17水平。改善患者乏力、皮肤干裂、口眼黏腻、舌苔厚腻优于西药；本方治疗pSS阴虚夹湿燥毒这一复杂证型有临床优势。 |
| 中文关键词:原发性干燥综合征 阴虚夹湿燥毒证 中药治疗 细胞因子 |
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| Clinical Effect Analysis on 50 Cases of Primary Sjögren Syndrome Patients Treated by Ganlu Yin and Shengjiang Powder Modified Prescription |
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| Abstract:Objective To observe the curative effects by using traditional Chinese medicine (TCM) modified treatment of Ganlu yin and Shengjiang powder modified prescription to cure non-systemic involved primary Sjögren's syndrome (pSS) patients, provide clinical evidence for the treatment on complicated diseases by TCM, and demonstrate the treatment advantages of TCM on the disease.Methods Totally 75 case of Yin deficiency and dampness accompanied with accumulated toxin and dryness pSS were divided randomly into 50 cases of TCM group and 25 cases of Western medicine group (according to the proportion of 2:1). The TCM group took Ganlu yin and Shengjiang powder modified prescription orally, and the Western medicine group took 0.1g bid hydroxychloroquine sulfate tablets. The total course of treatment was three months. The TCM symptom scores, Western medicine disease activity index (ESSDAI) scores, laboratory indexes and serum cytokine levels of the patients of the two groups were recorded respectively to evaluate the curative effects.Results Before and after treatment, the two groups have reduced the ESSDAI scores and TCM syndrome scores. The results have statistical difference (P<0.05).Between the two groups, the TCM syndrome score of TCM group was significantly lower than that of Western medicine group. The results had statistical difference (P<0.05).The TCM can reduce the ESSDAI scores of lymphadenectasis, parotid gland swelling and hyperimmunoglobulinemia, and reduce the IL-17 levels,IgG and ESR, which has no statistical difference compared with Western medicine group (P>0.05). TCM group had a more remarkable performance in reducing TCM syndrome scores compared with Western medicine group, which had statistical difference (P<0.05). After treatment, TCM can significantly reduce the TCM syndrome scores of patients'syndrome, xerostomia,dry eyes, fatigue,chapped skin, sticky month and eyes, parotid gland swelling, joint pain,arthralgia and cleft tongueand greasy fur; of them, the reduction of the scores of fatigue,chapped skin, sticky month and eyes, and cleft tongue and greasy fur are more remarkable than Western medicine group (P<0.05).Conclusion TCM modified treatment of Ganlu yin and Shengjiang powder modified prescription could effectively improve the condition of non-systemic involved pSS, reduced the IL-17 level, and significantly alleviated the TCM clinical symptoms as pSS. In addition, TCM was more advantageous than Western medicine in improving fatigue,chapped skin, sticky month and eyes, and cleft tongue and greasy fur, and curing pSS Yin deficiency and dampness accompanied with accumulated toxin and dryness. |
| keywords:Primary Sjögren syndrome Yin deficiency and dampness accompanied with accumulated toxine and dryness Treatment of traditional Chinese medicine Cytokine |
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