中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2014年
2期
104-107
,共4页
系统性红斑狼疮%白芍总苷%白细胞减少
繫統性紅斑狼瘡%白芍總苷%白細胞減少
계통성홍반랑창%백작총감%백세포감소
Systemic lupus erythematosus%Total glucosides of paeony%Low white blood cell
目的：观察白芍总苷（TGP）治疗并发血白细胞（WBC）减少系统性红斑狼疮（SLE）患者的疗效及安全性。方法将符合1982年美国风湿病学会修订的SLE分类标准并发血WBC减少的62例SLE患者按随机原则分为对照组和试验组，每组31例。对照组按SLE诊疗方案在常规治疗基础上加用醋酸泼尼松0.5～1.0 mg?kg-1?d-1治疗；试验组在对照组治疗基础上加用TGP 0.6 g口服，每日3次，两组疗程均为12周。观察患者治疗前后血WBC、补体C3、红细胞沉降率（ESR）、C-反应蛋白（CRP）、肝肾功能等指标变化；评估两组患者的SLE疾病活动度指数（SLEDAI）评分、疗效及不良反应发生情况。结果治疗12周后，两组血WBC、补体C3均明显增高，ESR、CRP、SLEDAI均明显下降，以试验组改善更为明显〔WBC（×109/L）：5.38±1.32比4.16±1.39，补体C3（g/L）：1.28±0.32比0.86±0.26，ESR（mm/1 h）：22.36±5.26比28.85±8.56，CRP（g/L）：23.25±8.26比28.32±8.52，SLEDAI（分）：2.58±1.86比4.18±2.31，P＜0.05或P＜0.01〕，试验组总有效率高于对照组〔93.55%（29/31）比70.97%（22/31）〕，每日平均激素使用剂量及12周激素总用量试验组显著少于对照组〔泼尼松用量（mg/d）：16.26±9.85比25.32±9.68，泼尼松总用量（mg）：2016.5±125.6比2983.6±152.8，均P＜0.01〕，感染发生率明显低于对照组（9.68%比35.48%，P＜0.05），试验组和对照组不良反应发生率比较差异无统计学意义（12.90%比16.13%，P＞0.05）。结论 TGP用于治疗并发血WBC减少的SLE患者安全有效，可以明显减少SLE患者的糖皮质激素用量和感染发生率。
目的：觀察白芍總苷（TGP）治療併髮血白細胞（WBC）減少繫統性紅斑狼瘡（SLE）患者的療效及安全性。方法將符閤1982年美國風濕病學會脩訂的SLE分類標準併髮血WBC減少的62例SLE患者按隨機原則分為對照組和試驗組，每組31例。對照組按SLE診療方案在常規治療基礎上加用醋痠潑尼鬆0.5～1.0 mg?kg-1?d-1治療；試驗組在對照組治療基礎上加用TGP 0.6 g口服，每日3次，兩組療程均為12週。觀察患者治療前後血WBC、補體C3、紅細胞沉降率（ESR）、C-反應蛋白（CRP）、肝腎功能等指標變化；評估兩組患者的SLE疾病活動度指數（SLEDAI）評分、療效及不良反應髮生情況。結果治療12週後，兩組血WBC、補體C3均明顯增高，ESR、CRP、SLEDAI均明顯下降，以試驗組改善更為明顯〔WBC（×109/L）：5.38±1.32比4.16±1.39，補體C3（g/L）：1.28±0.32比0.86±0.26，ESR（mm/1 h）：22.36±5.26比28.85±8.56，CRP（g/L）：23.25±8.26比28.32±8.52，SLEDAI（分）：2.58±1.86比4.18±2.31，P＜0.05或P＜0.01〕，試驗組總有效率高于對照組〔93.55%（29/31）比70.97%（22/31）〕，每日平均激素使用劑量及12週激素總用量試驗組顯著少于對照組〔潑尼鬆用量（mg/d）：16.26±9.85比25.32±9.68，潑尼鬆總用量（mg）：2016.5±125.6比2983.6±152.8，均P＜0.01〕，感染髮生率明顯低于對照組（9.68%比35.48%，P＜0.05），試驗組和對照組不良反應髮生率比較差異無統計學意義（12.90%比16.13%，P＞0.05）。結論 TGP用于治療併髮血WBC減少的SLE患者安全有效，可以明顯減少SLE患者的糖皮質激素用量和感染髮生率。
목적：관찰백작총감（TGP）치료병발혈백세포（WBC）감소계통성홍반랑창（SLE）환자적료효급안전성。방법장부합1982년미국풍습병학회수정적SLE분류표준병발혈WBC감소적62례SLE환자안수궤원칙분위대조조화시험조，매조31례。대조조안SLE진료방안재상규치료기출상가용작산발니송0.5～1.0 mg?kg-1?d-1치료；시험조재대조조치료기출상가용TGP 0.6 g구복，매일3차，량조료정균위12주。관찰환자치료전후혈WBC、보체C3、홍세포침강솔（ESR）、C-반응단백（CRP）、간신공능등지표변화；평고량조환자적SLE질병활동도지수（SLEDAI）평분、료효급불량반응발생정황。결과치료12주후，량조혈WBC、보체C3균명현증고，ESR、CRP、SLEDAI균명현하강，이시험조개선경위명현〔WBC（×109/L）：5.38±1.32비4.16±1.39，보체C3（g/L）：1.28±0.32비0.86±0.26，ESR（mm/1 h）：22.36±5.26비28.85±8.56，CRP（g/L）：23.25±8.26비28.32±8.52，SLEDAI（분）：2.58±1.86비4.18±2.31，P＜0.05혹P＜0.01〕，시험조총유효솔고우대조조〔93.55%（29/31）비70.97%（22/31）〕，매일평균격소사용제량급12주격소총용량시험조현저소우대조조〔발니송용량（mg/d）：16.26±9.85비25.32±9.68，발니송총용량（mg）：2016.5±125.6비2983.6±152.8，균P＜0.01〕，감염발생솔명현저우대조조（9.68%비35.48%，P＜0.05），시험조화대조조불량반응발생솔비교차이무통계학의의（12.90%비16.13%，P＞0.05）。결론 TGP용우치료병발혈WBC감소적SLE환자안전유효，가이명현감소SLE환자적당피질격소용량화감염발생솔。
Objective To investigate the therapeutic efficacy and safety of using total glucosides of paeony (TGP)for treatment of patients with systemic lupus erythematosus(SLE)accompanied by low white blood cell(WBC) count. Methods According to the revised SLE Classification Standard of American College of Rheumatology in 1982,62 cases of SLE accompanied by low WBC consistent with the standard were randomly divided into experimental group(31 cases)and control group(31 cases). The conventional therapy plus prednisone of 0.5-1.0 mg?kg-1?d-1 was applied for treatment in both groups,and in the experimental group,additionally TGP(0.6 g orally each time,three times a day)was given. The therapeutic course in both groups was 12 weeks. The changes in following parameters of two groups were noted at baseline and after treatment:WBC,complement C3,erythrocyte sedimentation rate (ESR),C-reactive protein(CRP),liver and kidney function,etc;the SLE disease activity index(SLEDAI)score, the therapeutic effects and incidence of adverse reactions were evaluated in two groups. Results After 12 weeks of treatment,WBC and C3 were significantly increased,and ESR,CRP,SLEDAI were significantly decreased in the two groups,the improvement being more significant in the experimental group〔WBC(×109/L):5.38±1.32 vs. 4.16±1.39,complement C3(g/L):1.28±0.32 vs. 0.86±0.26,ESR(mm/1 h):22.36±5.26 vs. 28.85±8.56, CRP(g/L):23.25±8.26 vs. 28.32±8.52,SLEDAI(score):2.58±1.86 vs. 4.18±2.31,P<0.05 or P<0.01〕. Compared with the control group,the total effective rate was significantly higher in experimental group〔93.55%(29/31) vs. 70.97%(22/31)〕,the average daily dosage of prednisone and its total dosage in 12 weeks were significantly less in experimental group〔prednisone dosage(mg/d):16.26±9.85 vs. 25.32±9.68,the total dosage of prednisone (mg)2 016.5±125.6 vs. 2 983.6±152.8,both P<0.01〕. The incidence of infection in experimental group was obviously lower than that in the control group(9.68% vs. 35.48%,P<0.05),there was no significantly statistical difference in incidence of adverse reactions between experimental group and control group(12.90%vs. 16.13%,P>0.05). Conclusion TGP is a safe and effective treatment for patients with SLE accompanied by low WBC,and it also can significantly reduce the use of glucocorticoid dosage and the incidence of infection in such patients.
