中药治疗原发性干燥综合征阴虚夹湿燥毒证的临床研究  

Clinical study on the treatment of primary Sjgren's syndrome with Yin deficiency combined with dampness dryness and toxicity by Chinese herbal medicine

作　　者：宣磊[1] 王景[1] 张昊泽[1] 陈霞[1] 董振华[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院中医科,北京100730

出　　处：《北京中医药》2017年第10期882-886,共5页Beijing Journal of Traditional Chinese Medicine

摘　　要：目的观察和分析中药治疗原发性干燥综合征(pSS)阴虚夹湿燥毒证的临床疗效。方法将96例pSS阴虚夹湿燥毒证患者随机分为治疗组和对照组各48例,治疗组口服甘露饮合柴芩升降散汤剂,对照组服硫酸羟氯喹片(纷乐),疗程为6个月。治疗3个月、6个月时观察2组临床总有效率、欧洲风湿病联盟干燥综合征疾病活动指数(ESSDAI)评分、中医症状积分及临床症状改善情况。结果治疗3个月、6个月时治疗组总有效率分别为51.1%、75.6%,对照组为35.6%、82.2%,2组疗效差异无统计学意义(P>0.05)。2组ESSDAI评分和中医症状积分均在治疗3个月、6个月时下降(P<0.05),3个月时治疗组中医症状积分下降更显著(P<0.05)。治疗3个月时治疗组口咽干燥、舌苔厚腻、皮肤干燥、口眼黏腻、腮腺肿痛、关节肿痛、两目干涩、舌干燥裂症状积分均较治疗前明显下降(P<0.05),且口眼黏腻、舌苔厚腻症状积分较对照组下降显著(P<0.05)。治疗6个月时上述症状积分均较治疗前进一步下降,且五心烦热积分降低(P<0.05),皮肤干燥、舌苔厚腻症状积分较对照组明显下降(P<0.05),关节肿痛积分较对照组显著升高(P<0.05)。3个月时2组IgG水平均较治疗前显著下降(P<0.05),6个月时ESR、IgG水平均较治疗前显著下降(P<0.05),各实验室指标2组间比较差异无统计学意义(P>0.05)。结论中药甘露饮合柴芩升降散汤剂治疗pSS阴虚夹湿燥毒证疗效较好,与硫酸羟氯喹片疗效无差异;可减轻pSS患者口眼和皮肤干燥、口眼黏腻、腮腺肿痛、舌干苔厚腻等症状,且作用持续,治疗半年效果最佳;改善口眼黏腻、舌苔厚腻、皮肤干燥症状,起效快于西药硫酸羟氯喹片。Objective To observe and analyze the clinical effects of using Chinese herbal medicine to treat primary Sjogren＇ s syndrome （ pSS ） with Yin deficiency combined with dampness dryness and toxicity. Methods 96 pSS cases of patients with Yin deficiency combined with dampness dryness and toxicity were grouped randomly into a treatment group and a control group of 48 cases each. The treatment group took Ganluying together with Chaiqin Shengjiang San Decoction. And the control group took hydroxychloroquine sulfate tablets. The treatment courses were three months and six months. The total clinical effective rates, ESSDAI scores, TCM symptom integrals, and clinical symptom improvement were observed. Results When two groups had been treated for three months and six months, the total effective rates of the treatment group were 51.1% and 75.6% , and that of the control group were 35.6% and 82.2%, the difference of two groups had no statistical significance （ P 〉 0. 05 ）. The ESSDAI scores and TCM symptom integrals of both groups were dropped at both two treatment courses of three months and six months （ P 〈 0. 05 ）. After three months of treatment, TCM symptom integrals of the treatment group dropped even more remarkably （ P 〈 0. 05 ）. TCM symptoms of dry mouth and eyes, dry skin, sticky mouth and eyes, parotid gland swelling and pain, arthralgia, and dry tongue with thick and greasy coating were significantly improved. After 6 months of treatment, the scores of these symptoms were decreased further （ P 〈 0. 05 ） , and the scores of dysphoria in chest palms-soles were decreased significantly （P 〈 0. 05）. After 3 months of treatment, the scores of sticky mouth and eyes and tongue with thick and greasy coating in the treatment group were significantly lower than those in the control group （ P 〈 0.05 ） ; after 6 months of treatment, the scores of dry skin and tongue with thick and greasy coating were significantly lower than those in the control group （ P 〈 0. 05 ）. After 3 month

关 键 词：干燥综合征 阴虚夹湿燥毒证 中医药疗法 

分 类 号：R259[医药卫生—中西医结合]