益气养阴活血方治疗系统性红斑狼疮的探讨

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目的探讨益气养阴活血方对系统性红斑狼疮患者治疗的免疫学基础和临床变化。方法利用实时荧光定量PCR技术检测SLE患者治疗前后外周血单核细胞(PBMC)中Foxp3 mRNA的表达;用酶联免疫吸附试验(ELISA)检测SLE患者治疗前后血清中IL-10和TGF-β水平变化;观察SLE患者治疗前后临床症状和实验室指标的改善情况。治疗组应用糖皮质激素加用益气养阴活血方;对照组应用糖皮质激素。结果治疗组治疗后Foxp3 mRNA和TGF-β表达较对照组上升明显,差异有统计学意义(P均<0.05),IL-10表达较对照组下降明显,差异有统计学意义(P<0.05)。治疗组治疗后患者皮损、关节痛、乏力的症状较对照组改善明显,差异有统计学意义(P均<0.05);而光敏感和脱发两组间差异无统计学意义。治疗组治疗后ESR较对照组降低明显,差异有统计学意义(P<0.05);Hb,WBC两组治疗后均上升,差异有统计学意义,但组间比较无差别;补体C3两组治疗前后均无明显变化。患者激素的用量及复发率治疗组均较对照组明显减少,差异有统计学意义(P<0.05和P<0.01)。结论加用益气养阴活血方可通过调节SLE相关的转录因子及细胞因子的分泌,调动了机体免疫系统,发挥其临床治疗效应。 Objective To investigate the immunological basis and clinical changes of the treatment of patients with systemic lupus erythematosus with Yiqi Yangyin Huoxue prescription. Methods The expression of Foxp3 mRNA in peripheral blood mononuclear cells (PBMC) of patients with SLE before and after treatment was detected by real-time fluorescence quantitative PCR. Changes; observed SLE patients before and after treatment of clinical symptoms and laboratory indicators of improvement. The treatment group was treated with glucocorticoid plus nourishing yin and invigorating the yin and invigorating blood; while the control group was given glucocorticoid. Results The expression of Foxp3 mRNA and TGF-β in the treatment group increased significantly compared with that in the control group (P <0.05). The expression of IL-10 in the treatment group decreased significantly compared with the control group (P <0.05) . After treatment, the symptoms of skin lesions, joint pain and fatigue in treatment group were significantly improved compared with those in control group (all P <0.05). There was no significant difference between the two groups in light sensitivity and hair loss. The ESR of the treatment group was significantly lower than that of the control group (P <0.05). The levels of Hb and WBC in both groups increased after treatment, but there was no significant difference between the two groups Before and after no significant changes. The dosage and recurrence rate of patients with hormone therapy group were significantly reduced compared with the control group, the difference was statistically significant (P <0.05 and P <0.01). Conclusion Supplementing Qi, Nourishing Yin and Promoting Blood Circulation can mobilize the body’s immune system and exert its clinical therapeutic effect by regulating the secretion of SLE-related transcription factors and cytokines.
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