针灸联合健脾滋肾汤治疗系统性红斑狼疮的效果评价

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• Title:针灸联合健脾滋肾汤治疗系统性红斑狼疮的效果评价

• 卷期:2024年22卷19期

• 作者:张淑香1  杨检生2

• 1.于都县中医院中医内科 江西于都342300；2.于都县人民医院普外科 江西于都 342300

• Author(s):Zhang Shuxiang

• Department of Traditional Chinese Medicine, Yudu Hospital of Traditional Chinese Medicine 342300

• 关键词针灸；健脾滋肾汤；系统性红斑狼疮；中医证候积分；免疫功能

• Keywords:acupuncture; Invigorating spleen and nourishing kidney soup; Systemic lupus erythematosus; TCM syndrome score; Immune function

• 摘要: 目的 探讨针灸联合健脾滋肾汤治疗系统性红斑狼疮的效果。方法 回顾性分析我院于2020年6月至2022年6月收治的66例系统性红斑狼疮患者，以治疗方案的不同作为分组依据，将32例采用常规西药（泼尼松+硫酸羟氯喹）治疗的患者纳入常规组，34例应用常规治疗+针灸联合健脾滋肾汤治疗的患者则归为研究组。治疗3个月后，比较两组C反应蛋白（CRP）、红细胞沉降率（ESR）以及补体C3、C4水平，同时对比其中医证候积分，对临床疗效开展评估。结果 治疗后，研究组CRP、ESR水平低于常规组，补体C3、C4则较常规组高（P＜0.05）；研究组高热面赤、斑疹鲜红、肌肉关节酸痛评分均较常规组低（P＜0.05）；研究组治疗总有效率较常规组高（P＜0.05）。结论 为系统性红斑狼疮患者应用针灸联合健脾滋肾汤的治疗方案可实现生化指标的改善，有助于缓解机体炎症状态，改善免疫功能，对中医证候积分的降低有重要意义，治疗效果确切。                                                                                                                                                                                

• Abstract To investigate the effect of acupuncture and moxibustion combined with Spleen-nourishing decoction on systemic lupus erythematosus. Methods 66 patients with systemic lupus erythematosus admitted to our hospital from June 2020 to June 2022 were retrospectively analyzed, and 32 patients treated with conventional western medicine (prednisone + hydrochloroquine sulfate) were included in the conventional group, and 34 patients treated with conventional therapy + acupuncture combined with spleen and kidney invigorating decoction were included in the study group. After 3 months of treatment, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and complement levels of C3 and C4 were compared between the two groups, and TCM syndrome scores were compared to evaluate the clinical efficacy. Results After treatment, the levels of CRP and ESR in the study group were lower than those in the conventional group, while the levels of C3 and C4 were higher than those in the conventional group (P < 0.05). The scores of hot face redness, macular bright redness and muscle and joint pain in the study group were lower than those in the conventional group (P < 0.05). The total effective rate of the study group was higher than that of the conventional group (P < 0.05). Conclusion: The application of acupuncture and moxibustion combined with spleen-invigorating decoction in patients with systemic lupus erythematosus can improve the biochemical indexes, help to relieve the inflammatory state of the body, improve the immune function, and have important significance for the reduction of TCM syndrome score, and the therapeutic effect is exact.

  系统性红斑狼疮作为一种累及多脏器、多系统的全身结缔组织炎症性疾病，与感染、激素、环境、遗传等因素有关，关节肿胀、疼痛、发热、乏力均为该疾病主要临床症状，可严重降低患者生活质量[1]。目前，针对系统性红斑狼疮，临床以泼尼松+硫酸羟氯喹的常规西药治疗方案为主，前者为糖皮质激素，可发挥免疫抑制、抗炎效果，后者属于免疫抑制剂，具有抗疟作用，但是长期使用西药治疗不良反应较多，且停药后容易复发，具有一定局限性[2]。中医认为[3]，系统性红斑狼疮属于“温毒发斑”、“阴阳毒”范畴，因此治疗应以凉血活血、填精滋阴、升阳营卫为主。针灸作为中医特色外治法，以经络学理论为基础，可根据患者实际情况进行辨证取穴，从而发挥疏通卫气，调和阴阳的作用。健脾滋肾汤由多种有效中药成分组成，可调节脏腑功能，对机体免疫功能的改善有重要意义。