| ObjectiveSystemic Lupus Erythematosus (SLE) is a kind of autoimmunity chronic inflammational connective tissue disease and the course of SLE is still uncovered. It is a very complicated process and might be influenced by multiple factors, such as genetics, environment, medicine, infection, immune reaction and so on. Its morbidity is increasing year by year, and the state is complex, the range of the pathological changes is comprehensive, the course of disease is lasting, and influenced the life quality and living quality of SLE patients. Glucocorticoid(GC) is the main medicine that cures SLE at present, but the long-term use of GC brought a great deal of secondary acting, such as osteoporosis, avascular necrosis of the femoral head, diabetes induced by drug, hypertension and Cushing's syndrome etc, and this caused a great anguish to the SLE patients. Along with the development of Chinese medicine, it may play an important role in the clinical treatment of the disease, and could raise the curative effect and reduce the side effect of GC. And the Chinese medicine could improve the general condition, symptom and quality of life. To evaluate the clinical efficacy of treating SLE with Zhibai Yangyin Decoction in combination with Glucocorticoid, and to observe the regulatory effects of the side effects of glucocorticoid by Zhibai Yangyin Decoction from clinical and experimental research.Methods This paper includes two parts:clinical observation and animal experiment research.(1) Clinical research:Choose 60 cases according with the diagnostic standard of SLE(which was revised by American College of Rheumatology in 1997), and traditional Chinese medicine dialectical to Yin Deficiency Inner Heat (2002 clinical research guideline of traditional Chinese medicine and new medicine). They were divided into treatment group and control group at random, the treatment group were treated with Zhibai Yangyin Decoction and glucocorticoid, and the control group were treated with glucocorticoid (lmg/(kg·d)). The whole study is to observe clinic effect, and the influences in systematic lupus erythematosus disease activity index, the body score, BMI, WHR, CST, and detect the blood glucose (BG), serum lipids, C-reactive protein(CRP), serum complement(C3, C4, CH50), and et al.(2) Experiment research:Thirty SD rats were randomly divided into 3 groups:normal group, model group and TCM treatment group (each n=10).The Yin deficient model was induced by glucocorticosteroid. The black group and the model control group were perfused distilled water 10ml/(kg·d) into stomach for 2 days, and the TCM treatment group was perfused Zhibai Yangyin Decoction. Until 3rd day the black group was perfused physiological saline, the model control group and the TCM treatment group were perfused Hydroconisone(50mg/(kg·d)) into stomach continuously 5 days. After the experiment, test and compare the concentrations of total cholesterol (CHOL), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), blood glucose(BG) and CRP.Results(1) Clinical research:①Symptoms:Before the treatment, there were no significant differences in the body score, BMI, WHR and CST between two groups(P>0.05). After treatment, the above indexes of two groups were all increased, but the body score, WHR and CST of treatment group were lower than that in the control group(P<0.05).②Activity of disease:The SLEDAI indexes were reduced distinctively in treatment group, and have statistics meaning between the two groups(P<0.05).③In evaluation of curative effect, the curative efficiency and TCM symptoms of treatment group were all superior to simple glucocorticoid control group(P<0.05).④In index of laboratory, before treating, there was no obvious difference in BG, serum lipids, CRP and serum complement. After treating, BG and lipids were improved in the control group, especially the serum lipids(P<0.05). This indicated that the glucocorticoid affected the metabolism of glucose and lipids of SLE. After used the Zhibai Yangyin Decoction in the treatment group, the CHOL and TG were no significant increase, the BG, LDL-C and CRP were obviously lower than the control group (P<0.05). The complement C3, C4, CH50 were all higher than before (P<0.05). This indicated that the traditional Chinese medicine can increase the complement of SLE.(2) Experiment research:Compared with the normal control group, the concentration of BG, TG, CHOL, HDL-C were higher in the other groups(P<0.05). Compared with the model group, the concentration of BG,CHOL,TG,HDL-C,LDL-C were decreased in the TCM group while BG,CHOL were more significantly decreased(P<0.05). This indicated that the Zhibai Yangyin Decoction could improve the glucose and lipid metabolism. The hs-CRP that in model group and TCM treatment group were increased, the TCM group was lower than the model group, but the difference was not significant(P>0.05).ConclutionTreatment with Zhibai Yangyin Decoction cooperate with glucocorticoid group has better clinical curative effect in treating SLE patients of Yin Deficiency Inner Heat, and could decrease the disease active index and could help glucocorticoid to reduce the side effects. There were some degree disorder of glucose and lipid metabolism and the immune parameters on the rats with Yin-deficiency induced by glucocorticosteroid. Zhibai Yangyin Decoction could improve the symptoms of Yin-deficiency, and could lower the hs-CRP and the glucose and lipid metabolism of rats with Yin-deficiency caused by glucocorticosteroid. The results suggest that the treatment of SLE with combination of Chinese and western medicine could raise curative effect, reduced the side effects, which is worthy to attention and promotion. |
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