摘要
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。
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（×10^9/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 obvious
出处
《中国中西医结合急救杂志》
CAS
北大核心
2014年第2期104-107,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
系统性红斑狼疮
白芍总苷
白细胞减少
Systemic lupus erythematosus
Total glucosides of paeony
Low white blood cell
