生腺布液汤治疗热毒内结型原发性干燥综合征临床观察  

Clinical efficacy of ShengxianBuye Decoction on primary Sjogren's syndrome with heat toxin accumulation

作　　者：王可心 郜晨静 罗亚萍[2] 郝梦桃 马小栋 艾奕坤 张寒 张正国 WANG Kexin;GAO Chenjing;LUO Yaping;HAO Mengtao;MA Xiaodong;AI Yikun;ZHANG Han;ZHANG Zhengguo(North China University of Science and Technology,Tangshan,Hebei 063000;Department of Rheumatology,Hebei Province Hospital of TCM,Shijiazhuang,Hebei 050011;Department of Emergency,Xiqing District Traditional Chinese Medicine Hospital,Tianjin 300000;Hebei University of Chinese Medicine,Shijiazhuang,Hebei 050200)

机构地区：[1]华北理工大学,河北唐山063000 [2]河北省中医院风湿科,河北石家庄050011 [3]天津市西青区中医医院急诊科,天津300000 [4]河北中医药大学,河北石家庄050200

出　　处：《河北中医》2023年第11期1787-1791,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省重点研发计划项目:民生科技专项(编号:192777123D);2019年河北省老年病防治项目(编号:2019064577)。

摘　　要：目的 观察生腺布液汤治疗热毒内结型原发性干燥综合征(pSS)的临床疗效。方法 按照随机数字表法将60例pSS患者分为2组。对照组30例予硫酸羟氯喹片口服治疗,治疗组30例在对照组治疗基础上加生腺布液汤治疗,2组均治疗12周后统计疗效,比较2组治疗前后C反应蛋白(CRP)、红细胞沉降率(ESR)、免疫球蛋白G(IgG)水平,以及唾液流率、泪液分泌量、中医证候评分、SS疾病活动度(ESSDAI)评分、SS患者报告指数(ESSPRI)评分,并观察安全性。结果 治疗组总有效率为90.0%(27/30),对照组为76.7%(23/30),治疗组总有效率高于对照组(P<0.05)。治疗后,治疗组ESR、IgG水平均较本组治疗前降低(P<0.05),但CRP无明显变化(P>0.05)。对照组治疗后ESR水平较本组治疗前降低(P<0.05),但IgG、CRP水平无明显变化(P>0.05)。治疗后治疗组ESR、IgG水平均低于对照组(P<0.05)。治疗后,2组唾液流率、泪液分泌量均较本组治疗前增多(P<0.05),且治疗组均多于对照组(P<0.05)。治疗后,治疗组各项中医证候评分均较本组治疗前降低(P<0.05),而对照组仅双目干涩、口咽干燥、关节肿痛评分较本组治疗前降低(P<0.05)。治疗后治疗组皮肤干燥、腮腺肿大及周身乏力评分低于对照组(P<0.05)。治疗后,2组ESSDAI、ESSPRI评分均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。结论 联合生腺布液汤治疗pSS比单纯应用硫酸羟氯喹片治疗临床疗效更高,可明显改善患者临床症状,增加泪液和唾液量,降低血清ESR、IgG水平及中医证候、ESSDAI、ESSPRI评分。Objective To observe the clinical efficacy of ShengxianBuye Decoction on primary Sjogren's syndrome(pSS)with heat toxin accumulation.Methods Sixty pSS patients were randomly assigned into the treatment group(n=30)and the control group(n=30).All patients were managed by hydroxychloroquine sulfate tablets,and those in the treatment group were additionally treated with ShengxianBuye Decoction.Treated for 12 weeks,the aim was to compare C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),immunoglobulin G(IgG),salivary flow rate(SFR),tear secretion,traditional Chinese medicine(TCM)syndrome score,the European League Against Rheumatism(EULAR)Sjogren's syndrome disease activity index(ESSDAI),the EULAR SS Patient Reported Index(ESSPRI).The curative effect and safety were assessed.Results The overall effective rate in the treatment group was better than that in the control group(90.0%[27/30]vs 76.7%[23/30],[P<0.05],respectively).After treatment,ESR and IgG in the treatment groupdecreased significantly(P<0.05),while there was no significant difference CRP between before and after treatment(P>0.05).ESR in the control group were significantly decreased(all P<0.05).None of IgG and CRP in the control group differed significantly between before and after treatment(all P>0.05).After treatment,ESR and IgG in the treatment group were significantly lower than those in the control group(P<0.05).SFR and tear secretion in the both groups were significantly increased(P<0.05),which in the treatment group was more prevalent compared with the control group(P<0.05).After treatment,TCM symptom scores in the treatment group were significantly decreased(P<0.05),and the scores of binocular dryness,oropharyngeal dryness,joint swelling and pain in the control group were significantly decreased(P<0.05).The scores of dry skin,swollen parotid glands and general weakness in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the scores of ESSDAI and ESSPRI in the both groups were significantly

关 键 词：干燥综合征 火毒 热毒 中医药疗法 

分 类 号：R442.805.31[医药卫生—诊断学]