清热活血方联合甲泼尼龙治疗系统性红斑狼疮瘀热痹阻证的效果  

Effect of QingRe Huoxue Decoction Combined with Methylprednisolone in the Treatment of Systemic Lupus Erythematosus with Stasis and Heat Obstruction Syndrome

作　　者：郭乃亮 张晟 张乾坤 GUO Nailiang;ZHANG Sheng;ZHANG Qiankun(Department of Traditional Chinese Medicine,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]信阳市中心医院中医科,河南信阳464000

出　　处：《河南医学研究》2025年第6期1093-1097,共5页Henan Medical Research

摘　　要：目的探讨清热活血方联合甲泼尼龙治疗系统性红斑狼疮(SLE)瘀热痹阻证的效果。方法按随机数字表法将信阳市中心医院收治的140例SLE瘀热痹阻证患者分入两组。对照组70例接受硫酸羟氯片联合甲泼尼龙治疗,治疗组70例在对照组基础上联合清热活血方治疗。对比两组治疗前后中医症状评分、肾功能及免疫功能指标变化,分析其疗效与不良反应。结果与对照组比较,治疗组总有效率更高(92.86%比80.00%)(χ^(2)=4.933,P=0.026);治疗后两组瘀热痹阻证候各评分均降低,治疗组治疗后双手红斑、口疮、烦躁易怒、肌肉疼痛评分低于对照组(P<0.05);治疗后两组24 h尿蛋白、血肌酐(SCr)水平均下降,血浆白蛋白上升,且治疗组治疗后24 h尿蛋白、SCr水平低于对照组,血浆白蛋白高于对照组(P<0.05);治疗后两组IgA、IgG、IgM水平降低,补体C3、C4升高,且相比对照组,治疗组治疗后IgA、IgG、IgM水平更低,补体C3、C4更高(P<0.05);治疗组不良反应发生率(4.29%)低于对照组(20.00%)(χ^(2)=8.101,P=0.004)。结论清热活血方联合甲泼尼龙治疗SLE瘀热痹阻证能获得较佳的临床效果,不但能改善患者临床症状、调节免疫功能和肾功能,还能减少不良反应、安全性高,值得推广。Objective To explore the effect of Qingre Huoxue Decoction combined with methylprednisolone in the treatment of systemic lupus erythematosus(SLE)with stasis and heat obstruction syndrome.Methods By the random number table method,140 SLE patients with stasis and heat obstruction were divided into two groups.The control group(70 cases)was treated with hydroxyl chloride sulfate tablets combined with methylprednisolone,and the treatment group(70 cases)was treated with Qingre Huoxue Decoction on the basis of the control group.The TCM symptom scores,renal function and immune function indexes before and after treatment were compared in two groups,and the efficacy and side reactions were analyzed.Results The effective rate in treatment group was higher compared with control group(92.86%vs 80.00%)(χ^(2)=4.933,P=0.026).After treatment,the scores of stasis and heat obstruction syndrome in the two groups were decreased,and the scores of erythema on both hands,aphtha,irritability and muscle pain in the treatment group were lower compared with control group(P<0.05).After treatment,the levels of 24 hours urinary protein and serum creatinine(SCr)in the two groups decreased,the level of albumin increased,and the levels of 24 hours urinary protein and SCr in the treatment group were lower compared with control group,and the level of albumin was higher compared with control group(P<0.05).After treatment,the levels of IgA,IgG and IgM in the two groups decreased,C3,C4 increased,and the levels of IgA,IgG and IgM in the treatment group were lower compared with control group,and the C3,C4 were higher(P<0.05).The incidence of side reactions in the treatment group was 4.29%,which was lower than 20.00%in the control group(χ^(2)=8.101,P=0.004).Conclusion Qingre Huoxue Decoction combined with methylprednisolone in the treatment of SLE with stasis and heat obstruction syndrome can achieve better clinical efficacy,which can not only improve the clinical symptoms of patients,regulate immune function,but also regulate renal function,reduce adv

关 键 词：系统性红斑狼疮 瘀热痹阻证 清热活血方 甲泼尼龙 

分 类 号：R593.24[医药卫生—内科学]