1.北京中医药大学研究生院 北京 100029
2.中日友好医院中医风湿病科
3.免疫炎性疾病北京市重点实验室
陈嘉琪,女,在读博士生
# 罗静,女,博士,主治医师,主要研究方向:风湿免疫病中西医临床和基础研究,E-mail: luojinggg@sina.com
纸质出版日期:2023-11-30,
网络出版日期:2023-10-27,
收稿日期:2023-04-26,
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陈嘉琪, 杨建英, 张燕, 等. 补肾清热润燥汤治疗原发性干燥综合征阴虚燥热证的随机对照研究[J]. 北京中医药大学学报, 2023,46(11):1490-1498.
CHEN Jiaqi, YANG Jianying, ZHANG Yan, et al. A randomized controlled trial on the treatment of primary Sjögren syndrome with yin deficiency and dryness-heat pattern with
陈嘉琪, 杨建英, 张燕, 等. 补肾清热润燥汤治疗原发性干燥综合征阴虚燥热证的随机对照研究[J]. 北京中医药大学学报, 2023,46(11):1490-1498. DOI: 10.3969/j.issn.1006-2157.2023.11.002.
CHEN Jiaqi, YANG Jianying, ZHANG Yan, et al. A randomized controlled trial on the treatment of primary Sjögren syndrome with yin deficiency and dryness-heat pattern with
目的
2
评价补肾清热润燥汤(生地黄、麦冬、石斛、牡丹皮、淡竹叶、连翘、桑叶、砂仁)治疗原发性干燥综合征(PSS)阴虚燥热证患者的有效性和安全性。
方法
2
采用随机对照试验的方法,纳入2020年9月—2023年1月于中日友好医院中医风湿病科就诊的PSS阴虚燥热证患者,按照随机数字表法1∶1分为试验组和对照组。试验组予以补肾清热润燥汤治疗,对照组予以硫酸羟氯喹片治疗,疗程12周。比较2组患者口干、眼干、疲乏、肢体疼痛、整体干燥症状视觉模拟评分法(VAS)评分,欧洲抗风湿病联盟干燥综合征患者报告指数(ESSPRI)、疾病活动指数(ESSDAI),唾液流率,Schirmer试验,免疫炎症指标[血清免疫球蛋白(IgG、IgA、IgM),补体(C3、C4),红细胞沉降率及C-反应蛋白]及健康调查简表(SF-36)各项评分的差异,并观察不良反应。
结果
2
共纳入96例PSS患者,每组48例。治疗12周后,试验组口干VAS评分、眼干VAS评分、整体干燥症状VAS评分均低于对照组(均
P
<
0.05)。试验组治疗12周后,口干VAS评分、眼干VAS评分、ESSPRI、整体干燥症状VAS评分较治疗前降低(均
P
<
0.05),且Schirmer试验结果、SF-36中健康变化评分较治疗前升高(均
P
<
0.01)。对照组治疗12周后,疲乏VAS评分较治疗前降低(
P
<
0.01),血清IgA、C3、C4、SF-36中健康变化评分较治疗前升高(均
P
<
0.05)。试验组仅见1例腹泻及1例稀便,对照组见1例皮疹及1例皮肤颜色变黑。2组均未见严重不良反应。
结论
2
补肾清热润燥汤能够有效改善PSS阴虚燥热证患者的口、眼干燥等症状,增加泪液分泌量,且安全性高。
Objective
2
This study aimed to evaluate the efficacy and safety of
Bushen Qingre Runzao
Decoction (rehmanniae radix
ophiopogonis radix
dendrobii caulis
moutan cortex
lophatheri herba
forsythiae fructus
mori folium
and amomi fructus) in treating primary Sjögren syndrome (PSS) with yin deficiency and dryness-heat pattern.
Methods
2
A randomized controlled trial was conducted. PSS patients with yin deficiency and dryness-heat pattern who were admitted to TCM Department of Rheumatism of China-Japan Friendship Hospital from September 2020 to January 2023
were enrolled. Patients were randomized 1∶1 into the treatment and control groups. The treatment group was treated with
Bushen Qingre Runzao
Decoction
and the control group was administered hydroxychloroquine sulfate tablets. The duration of intervention in both groups was 12 weeks. The differences in Vision Analog Scale (VAS) scores of dry mouth
dry eyes
fatigue
body pain
overall dry symptoms
and European League Against Rheumatism (EULAR) Sjögren Syndrome Patient-Reported Index (ESSPRI)
Sjögren Syndrome Disease Activity Index (ESSDAI)
salivary flow rate
Schirmer’s test
and immune inflammation index [serum immunoglobulins (IgG
IgA
IgM)
complements(C3
C4)
erythrocyte sedimentation rate
C-reactive protein] between the two groups were compared
and adverse reactions were observed.
Results
2
A total of 96 patients were included
with 48 cases per group. After 12 weeks of intervention
the VAS scores of dry mouth
dry eyes
and overall dryness symptoms were lower in the treatment group than those in the control group (all
P
<
0.05). In the treatment group
after 12 weeks of intervention
the VAS scores of dry mouth
dry eyes
and overall dryness symptoms and ESSPRI were significantly lower than those before treatment (all
P
<
0.05)
and the Schirmer’s test result and health change scores of SF-36 were significantly higher than those before treatment (both
P
<
0.01). In the control group
after 12 weeks of intervention
the VAS score of fatigue(
P
<
0.01) was lower than that before treatment
and serum levels of IgA
C3
C4
and health change score of SF-36 were higher than those before treatment(all
P
<
0.05). There was only one case of diarrhea and one case of loose stool in the experimental group
and one case of rash and one case of skin color darkening in the control group. No serious adverse reactions were observed in both groups.
Conclusion
2
Bushen Qingre Runzao
Decoction has a high safety profile and can effectively improve dryness symptoms such as dry mouth and eyes and increase tear secretion in PSS patients with yin deficiency and dryness-heat pattern.
原发性干燥综合征阴虚燥热证补肾清热润燥汤硫酸羟氯喹随机对照试验
primary Sjögren syndromeyin deficiency and dryness-heat patternBushen Qingre Runzao Decoctionhydroxychloroquine sulfaterandomized controlled trial
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