本文選題：昆母湯　切入點：風(fēng)濕痹阻型　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察昆母湯治療風(fēng)濕痹阻型輕中度系統(tǒng)性紅斑狼瘡的短期治療效果及用藥的安全性,以充分利用中醫(yī)藥的優(yōu)勢,為系統(tǒng)性紅斑狼瘡患者提供更為便捷、可靠的治療方法。方法:納入2016年5月至2017年3月廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院風(fēng)濕病科門診及住院部符合標準的60名患者。以就診順序隨機編號,按完全隨機設(shè)計分為治療組和對照組各30例。治療組予口服醋酸潑尼松片10mg po qd+昆母湯,對照組予口服醋酸潑尼松片10mg po qd+硫酸羥氯喹片200mg po bid+甲氨蝶呤片10mg po qw,連續(xù)服藥8周,分別觀察及記錄治療前、治療后的實驗室指標、中醫(yī)癥狀及體征等,以評估昆母湯治療系統(tǒng)性紅斑狼瘡的臨床療效,采用SPSS22.0對數(shù)據(jù)進行統(tǒng)計學(xué)分析。結(jié)果:治療8周后,治療組總體效率為93.3%,對照組總體效率為80.0%,治療組療效更好(P0.05)。治療組中醫(yī)證候療效為93.3%,治療組中醫(yī)證候療效為66.7%%,治療組療效更有優(yōu)勢(P0.05)。治療組與對照組的中醫(yī)癥狀積分與SLEDAI評分較前均有降低,且治療組更明顯(P0.05)。在改善關(guān)節(jié)腫痛、顏面紅斑、口腔潰瘍、脫發(fā)、神疲乏力等中醫(yī)主要癥狀方面,治療組優(yōu)于對照組(P0.05)。治療組與對照組均能升高補體C3、補體C4值,兩組比較無差異(P0.05)。治療組和對照組均可降低ESR、CRP、抗ds-DNA水平,治療組更有效(P0.05)。治療組能降低尿蛋白定量、甘油三酯水平,兩組比較有差異(P0.05)。在用藥的安全性方面,治療組與對照組對白細胞、血紅蛋白、血小板的影響比較無差異(P0.05)。對照組可升高肝酶值,兩組比較有差異(P0.05)。治療組與對照組均出現(xiàn)肌酐的異常,兩組比較無差異(P0.05)。治療組與對照組對女性月經(jīng)情況的影響比較無差異(P0.05)。治療組對消化系統(tǒng)的影響更小,兩組比較有差異(P0.05)。結(jié)論:昆母湯聯(lián)合激素治療輕中度風(fēng)濕痹阻型系統(tǒng)性紅斑狼瘡患者,能有效改善臨床癥狀,降低疾病活動性指標,升高補體,降低尿蛋白水平,降低西藥副作用的發(fā)生率,鞏固療效,展示了昆母湯治療系統(tǒng)性紅斑狼瘡的獨特魅力,有助于提高患者的生活質(zhì)量。
[Abstract]:Objective: to observe the short-term therapeutic effect and safety of Kunmu decoction in the treatment of mild to moderate systemic lupus erythematosus with rheumatism obstruction, so as to make full use of the advantages of traditional Chinese medicine and to provide a more convenient and reliable treatment method for patients with systemic lupus erythematosus.Methods: from May 2016 to March 2017, 60 patients who met the criteria in the Department of Rheumatology, Department of Rheumatology, the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine were included.The patients were randomly divided into treatment group (n = 30) and control group (n = 30).The treatment group was treated with prednisone acetate 10mg po QD QD QD decoction, and the control group with prednisone acetate 10mg po QD hydroxychloroquine sulfate 200mg po bid methotrexate (10mg po QW) for 8 weeks.In order to evaluate the clinical efficacy of Kun Mu decoction in treating systemic lupus erythematosus (SLE), the laboratory indexes, symptoms and signs of TCM were evaluated, and the data were analyzed statistically by SPSS22.0.Results: after 8 weeks of treatment, the total efficiency of the treatment group was 93.3g, the total efficiency of the control group was 80.0. the curative effect of the treatment group was better than that of the control group (P 0.05).The curative effect of TCM syndromes in the treatment group was 93.3G, the curative effect of TCM syndrome in the treatment group was 66.7m, the curative effect of the treatment group was more superior than that of the control group (P 0.05).The scores of TCM symptom and SLEDAI in the treatment group and the control group were lower than before, and the treatment group was more obvious than the control group (P 0.05).The treatment group was superior to the control group in improving the main symptoms of traditional Chinese medicine, such as joint swelling and pain, facial erythema, oral ulcer, alopecia and fatigue.The value of complement C _ 3 and complement C _ 4 were increased in the treatment group and the control group, and there was no difference between the two groups (P 0.05).Both the treatment group and the control group could reduce the level of ds-DNA, and the treatment group was more effective than the control group.The treatment group can reduce the urine protein quantity and triglyceride level, there is a difference between the two groups (P 0.05).There was no difference in the effect of treatment group and control group on white blood cell, hemoglobin and platelet.The liver enzyme value in the control group was higher than that in the control group (P 0.05).There was no difference in creatinine between the treatment group and the control group (P 0.05).There was no difference between the treatment group and the control group on the menstrual status of women (P 0.05).The effect of the treatment group on digestive system was less, there was a difference between the two groups (P 0.05).Conclusion: the treatment of mild and moderate rheumatism obstruction systemic lupus erythematosus with Kunmu decoction combined with hormone can effectively improve clinical symptoms, reduce disease activity index, increase complement, reduce urinary protein level, and reduce the incidence of side effects of western medicine.Consolidate the curative effect, demonstrate the unique charm of Kun Mu decoction in the treatment of systemic lupus erythematosus, and help to improve the quality of life of the patients.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

【參考文獻】

相關(guān)期刊論文 前10條

1 郗建雄;鄒延峰;;糖皮質(zhì)激素治療系統(tǒng)性紅斑狼瘡致血脂異常的研究進展[J];安徽醫(yī)藥;2016年02期

2 母傳賢;劉國玲;;昆明山海棠對膠原性關(guān)節(jié)炎大鼠免疫功能的干預(yù)作用及其機制[J];吉林大學(xué)學(xué)報(醫(yī)學(xué)版);2016年01期

3 王志華;王永福;;系統(tǒng)性紅斑狼瘡免疫機制研究進展[J];包頭醫(yī)學(xué)院學(xué)報;2015年12期

4 朱震;張世勤;汪悅;;從瘀熱論治系統(tǒng)性紅斑狼瘡[J];南京中醫(yī)藥大學(xué)學(xué)報;2015年06期

5 冉昕;鄧丹琪;;系統(tǒng)性紅斑狼瘡與地理環(huán)境因素的研究進展[J];中國皮膚性病學(xué)雜志;2015年10期

6 徐莉;唐雪梅;;調(diào)節(jié)性B細胞在系統(tǒng)性紅斑狼瘡發(fā)病機制中的作用[J];兒科藥學(xué)雜志;2015年10期

7 鄭少燕;陳慶奇;;益母草多糖對免疫抑制小鼠免疫功能的影響作用研究[J];輕工科技;2015年09期

8 陳秀敏;林昌松;劉清平;徐強;關(guān)彤;陳紀藩;劉風(fēng)震;吳瑩;;昆母湯對類風(fēng)濕關(guān)節(jié)炎滑膜細胞增殖及凋亡的影響[J];實用醫(yī)學(xué)雜志;2015年17期

9 陳鈿鑫;;廣東潮州系統(tǒng)性紅斑狼瘡發(fā)病因素調(diào)查分析[J];深圳中西醫(yī)結(jié)合雜志;2015年14期

10 謝晨瓊;周萍;李祥;陳建偉;;昆明山海棠化學(xué)成分及藥理作用和臨床應(yīng)用研究進展[J];中草藥;2015年13期

相關(guān)博士學(xué)位論文 前1條

1 陳樹蘭;汪履秋教授治療痹證的學(xué)術(shù)思想探討[D];南京中醫(yī)藥大學(xué);2007年

相關(guān)碩士學(xué)位論文 前1條

1 劉真;經(jīng)方治療系統(tǒng)性紅斑狼瘡的臨床研究[D];湖北中醫(yī)學(xué)院;2008年

，

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