| 引用本文: |
张玉兰,李琴,王福祖,张文广,周春言,李积军.泻心汤联合小剂量沙利度胺对白塞病口腔黏膜病变患者的疗效及安全性分析[J].湖南中医药大学学报,2018,38(10):1179-1183[点击复制] |
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| 泻心汤联合小剂量沙利度胺对白塞病口腔黏膜病变患者的疗效及安全性分析 |
| 张玉兰,李琴,王福祖,张文广,周春言,李积军 |
| (青海省中医院风湿科, 青海 西宁 810000) |
| 摘要: |
| 目的 探讨泻心汤联合小剂量沙利度胺对白塞病口腔黏膜病变患者的疗效及安全性。方法 选择2014年1月至2017年12月本院接诊的白塞病口腔黏膜病变患者80例进行研究。采用随机数字表法将患者分为两组，每组各40例。对照组给予沙利度胺片4片/晚，待口腔溃疡愈合后降至1~2片/晚，观察组采用沙利度胺2片/晚基础上加以泻心汤加减，早晚各服1次，待溃疡痊愈后沙利度胺减至1片/晚，最终控制在1片/晚，3次/周。两组均以3个月为1个疗程。对比两组患者疗效、溃疡发作频次、溃疡总间歇时间、血清炎症因子、血沉、免疫功能、安全性指标。结果 观察组缓解率为95.0%，明显高于对照组的80.0%（P<0.05）。两组患者治疗后各炎症因子与免疫功能指标均明显下降（P<0.05），但除IgG两组差异无统计学意义（P>0.05），其他各炎症因子及免疫功能指标干预后观察组水平均明显低于对照组（P<0.05）。治疗后两组患者溃疡发生次数均明显下降（P<0.05），但两组差异无统计学意义（P>0.05）；治疗后两组患者溃疡总间歇时间明显延长（P<0.05），但观察组延长更为明显（P<0.05）。对照组不良反应发生率为20.0%，明显高于观察组的5.0%（P<0.05）。结论 泻心汤联合小剂量沙利度胺较单独使用沙利度胺治疗白塞病可明显提高疗效，延长溃疡总间歇时间，其机制可能与改善免疫、降低炎症因子水平有关，还可降低不良反应的发生率。 |
| 关键词: 白塞病 口腔黏膜 泻心汤 沙利度胺 |
| DOI：10.3969/j.issn.1674-070X.2018.10.020 |
| 投稿时间：2018-04-25 |
| 基金项目:青海省卫生和计划生育科研项目（2017-wjzdx-42）。 |
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| Analysis of Efficacy and Safety of Xiexin Decoction Combined with Low-Dose Thalidomide in Behcet's Disease Patients with Oral Mucosal Lesions |
| ZHANG Yulan,LI Qin,WANG Fuzu,ZHANG Wenguang,ZHOU Chunyan,LI Jijun |
| (Department of Rheumatism, Qinghai Provincial Hospital of Traditional Chinese Medicine, Xining, Qinghai 810000, China) |
| Abstract: |
| Objective To investigate the safety and efficacy of Xiexin Decoction combined with low-dose thalidomide in Behcet's disease patients with oral mucosal lesions. Methods A total of 80 patients with oral Behcet's disease admitted to our hospital from January 2014 to December 2017 were selected for study. Patients were divided into two groups using a random number table method, with 40 cases in each group. In the control group, thalidomide tablets were given 4 tablets every night. After the oral ulcers healed, they were taken 1-2 tablets every night. The patients in the observation group were additionally given Xiexin Decoction once every morning and evening on the basis of 2 tablets of thalidomide every night, and after recovery of ulcer, the dosage of thalidomide was reduced to one tablet every night, three times every week. The course of the two groups was for three months. The efficacy, the frequency of ulcers, total ulcer duration, serum inflammatory factors, ESR, immune function, and safety indicators of the two groups of patients were compared. Results The remission rate of the observation group was 95.00%, which was significantly higher than that in the control group (80.00%) (P<0.05). The inflammatory factors and immune function of the two groups decreased significantly after treatment (P<0.05), but there was no significant difference between the two groups except IgG intervention (P>0.05). The levels of other inflammatory factors and immune function after intervention in the observation group were significantly lower than those in the control group (P<0.05). The frequency of ulcers in both groups decreased significantly after treatment (P<0.05), but there was no significant difference between the two groups (P>0.05). After treatment, the total duration of ulceration was significantly prolonged (P<0.05). The incidence of adverse reactions in the control group was 20.00%, which was significantly higher than the 5.00% in the observation group (P<0.05). Conclusion The combination of Xiexin Decoction and low-dose thalidomide can significantly improve the efficacy of treatment of Behcet's disease and prolong the total intermittent time compared with thalidomide alone. Its mechanism may be related to the improvement of immunity and the reduction of inflammatory factors, and it can also reduce adverse reactions. |
| Key words: Behcet's disease oral mucosa Xiexin Decoction thalidomide |
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