本文選題：清燥布津法 + 干燥綜合征��； 參考：《山東中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:基于“燥毒學(xué)說”,闡明清燥布津法治療干燥綜合征(Sj?gren syndrome,SS)的理論依據(jù),通過實驗研究與臨床研究相結(jié)合的方法,探討清燥布津法治療干燥綜合征具有重要的理論與臨床意義。方法:臨床研究:將61例符合干燥綜合征診斷標(biāo)準(zhǔn)患者采用隨機數(shù)表法分組,隨機分為清燥布津合劑試驗組(QZBJ組)和硫酸羥氯喹對照組(HCQ組),QZBJ組31人,HCQ組30人。試驗組給予清燥布津合劑治療16周;對照組給予硫酸羥氯喹片口服治療16周。比較試驗組與對照組的臨床療效,并評價其安全性。實驗研究:通過實驗驗證清燥布津合劑對干燥綜合征BALB/c小鼠唾液分泌及相關(guān)細胞因子的影響。結(jié)果:臨床研究:清燥布津合劑組顯效5例,有效16例,改善6例,無效3例,總有效率為90%;羥氯喹組顯效2例,有效8例,改善18例,無效7例,總有效率為76.67%。清燥布津合劑組效果優(yōu)于羥氯喹組。清燥布津合劑組、羥氯喹組組內(nèi)治療前后在口干、眼干、皮膚干燥、大便干燥等癥狀評分、血沉、免疫球蛋白(IgG、IgM、IgA)、疾病活動度評價、患者主觀評價均有不同程度的改善,組內(nèi)治療前后存在顯著差異,結(jié)果具有統(tǒng)計學(xué)意義(P㩳0.05),說明清燥布津合劑與羥氯喹在治療干燥綜合征方面都有療效;清燥布津合劑組與羥氯喹組組間治療后在口干、眼干、皮膚干燥、大便干燥等癥狀評分、血沉、免疫球蛋白(IgG、IgM、IgA)、患者主觀評價均有不同程度的改善,組間治療后存在顯著差異,結(jié)果具有統(tǒng)計學(xué)意義(P㩳0.05),說明清燥布津合劑組總體療效優(yōu)于羥氯喹組。實驗研究:清燥布津合劑可以改善小鼠口干癥狀、唾液分泌量、對干燥綜合征BALB/c小鼠模型Th平衡相關(guān)細胞因子具有調(diào)節(jié)作用。結(jié)論:臨床研究顯示清燥布津法治療干燥綜合征可以有效緩解患者口干、眼干等臨床癥狀,并且治療過程安全有效,是治療干燥綜合征的有效方法之一。實驗研究顯示能顯著改善干燥綜合征BALB/c模型小鼠病理狀態(tài),抑制干燥綜合征相關(guān)炎性細胞因子,其機理可能是通過調(diào)節(jié)其免疫功能實現(xiàn)的。為清燥布津法治療干燥綜合征提供科學(xué)依據(jù),有利于指導(dǎo)干燥綜合征的臨床實踐。
[Abstract]:Objective: based on the theory of dryness and toxin, to clarify the theoretical basis for the treatment of Sjjgren syndrome SSs with the method of clearing dryness and Bujin, and to combine the experimental study with clinical research. It is of great theoretical and clinical significance to explore the treatment of Sjogren syndrome by clearing dryness and bujin. Methods: 61 patients with Sjogren's syndrome were randomly divided into QZBJ group (QZBJ group) and HCQ group (31 patients in HCQ group) and 30 patients in HCQ group. The experimental group was treated with Qingzao Bujin mixture for 16 weeks and the control group with hydroxychloroquine sulfate tablets for 16 weeks. To compare the clinical efficacy between the experimental group and the control group, and to evaluate its safety. Experimental study: the effects of Qingzao Bujin mixture on saliva secretion and related cytokines in BALB / P / c mice with Sjogren's syndrome were studied. Results: clinical study: in Qingzao Bujin mixture group, 5 cases were effective, 16 cases were effective, 6 cases were improved, 3 cases were ineffective, the total effective rate was 90 cases, in hydroxychloroquine group, there were 2 cases of remarkable effect, 8 cases of effective effect, 18 cases of improvement, 7 cases of ineffectiveness, and 76.67% of total effective rate. The effect of Qingzao Bujin mixture group was better than that of hydroxychloroquine group. The scores of dry mouth, dry eyes, dry skin, dry stool, erythrocyte sedimentation rate, immunoglobulin IgGG, IgM, disease activity, subjective evaluation of patients were improved in the treatment group of Qingzao Bujin mixture and hydroxychloroquine before and after treatment. There was significant difference between the two groups before and after treatment. The results showed that Qingzao Bujin mixture and hydroxychloroquine were effective in the treatment of Sjogren syndrome, and the dry mouth and eyes were dry after treatment between Qingzaobujin mixture group and hydroxychloroquine group. The scores of dry skin, dry stool and other symptoms, ESR, IgGG and IgMU IgA, the subjective evaluation of the patients were improved to some extent, and there were significant differences between the two groups after treatment. The results showed that the total curative effect of Qingzao Bujin mixture group was better than that of hydroxychloroquine group. Experimental study: Qingzao Bujin mixture can improve the dry mouth symptoms, saliva secretion, and regulate the Th balance of cytokines in Sjogren syndrome BALB- c mice model. Conclusion: the clinical study shows that the treatment of Sjogren's syndrome with Qingzao Bujin method can effectively relieve the clinical symptoms such as dry mouth and dry eye, and the treatment process is safe and effective. It is one of the effective methods for the treatment of Sjogren's syndrome. The experimental results showed that it could significantly improve the pathological state of BALB / c mice model of Sjogren's syndrome and inhibit the inflammatory cytokines associated with Sjogren's syndrome. The mechanism may be achieved by regulating the immune function of Sjogren's syndrome mice. It provides a scientific basis for the treatment of Sjogren syndrome with the method of clearing dryness and Bujin, and is helpful to guide the clinical practice of Sjogren syndrome.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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