滋阴降火汤防治活动性狼疮患者胰岛素抵抗的研究  

Impact of Ziyin Jianghuo Decoction on insulin resistance in patients with active systemic lupus erythematosus

作　　者：赵继军[1] 李美荣[2] 陆才生[1] 古洁若[1] 

机构地区：[1]中山大学附属第三医院风湿免疫科,广州中山510630 [2]中山大学附属第三医院皮肤科,广州中山510630

出　　处：《中国民族民间医药》2009年第15期114-115,118,共3页Chinese Journal of Ethnomedicine and Ethnopharmacy

基　　金：国家自然基金资助项目(30571736/C0302050301);广东省科技计划资助项目(No.2006B35601003)

摘　　要：目的:我们既往的研究发现滋阴降火汤配合糖皮质激素治疗系统性红斑狼疮(systemic lupus erythematosus,SLE)能显著减轻激素所致的医源性Cushing综合征且不影响疗效,本研究在此基础上继续探讨滋阴降火汤对活动性狼疮患者胰岛素抵抗的影响。方法:将符合入选标准的40例活动性SLE患者随机平均分为对照组及中药治疗组,对照组采用标准激素疗程,合并内脏损害者同时加用细胞毒药物;中药治疗组则在标准激素疗程基础上加用中药方剂滋阴降火汤。分别测定治疗前、治疗后8周对照组及中药治疗组胰岛素抵抗指数(homeostasis model assessment insulin resistance,HOMA-IR)和空腹血清可溶性细胞间黏附分子1(soluble ICAM-1,sICAM-1)及leptin水平。结果:中药治疗组与对照组间年龄、平均病程、治疗前狼疮活动程度、HOMA-IR和空腹血清sICAM-1及leptin水平无统计学差异(p>0.05)。治疗8周后,中药治疗组血清HOMA-IR显著低于单纯激素治疗组(p<0.05),中药治疗组空腹血清sICAM-1及leptin水平均低于对照组。结论:滋阴降火汤可能通过抑制血浆soluble ICAM-1(sICAM-1)及leptin水平防治SLE患者胰岛素抵抗。Objective： Our previous study suggest that Ziyin Jinaghuo Decoction can prevent iatrogenic Cushing syndrome in systemic lupus erythematosus （SLE） caused by corticosteroid therapy without affecting the efficacy and this study aimed at continuing to explore the role of Ziyin Jianghuo Decoction on on insulin resistance on this basis. Methods 40 patients with active SLE were divided randomly into the control group and the Traditional Chinese Medicine （TCM） group. The control group received the standard corticosteroid therapy, while the TCM group received Ziyin Jinaghuo Decoction on the basis of the standard corticosteroid therapy. Before and after treatment for 8 weeks, homeostasis model assessment insulin resistance （HOMA-IR） , soluble ICAM-1 （sICAM-1） and leptin levels were recorded for further analysis. Results： There was no statistical difference in the average age, disease duration, SLEDAI scores ,HOMA-IR, sICAM-1 and leptin between the TCM group and the control group at the initiation of treatment （p〉0.05） . After 8-week treatment, HOMA-IR in TCM group were significantly lower than that in control group （p〈0.01） . The serum sICAM-1 and leptin levels in the TCM group after treatment were decreased compared to those in control group （p〈0.01） . Conclusions： Ziyin Ji- naghuo Decoction may prevent the development of insulin resistance by regulating the serum slCAM-1 and leptin levels in active SLE.

关 键 词：滋阴降火汤:胰岛素抵抗 SICAM-1 LEPTIN 系统性红斑狼疮 

分 类 号：R593.241[医药卫生—内科学]