| 张旭峰,蔡妍,刘苏仪,等.益气养阴祛瘀方改善原发性干燥综合征疲劳的回顾性研究[J].浙江中医药大学学报,2023,47(1):19-24. |
| 益气养阴祛瘀方改善原发性干燥综合征疲劳的回顾性研究 |
| Retrospective Study on the Mechanism of Yiqi Yangyin Quyu Decoction in the Treatment of Primary Sjogren‘s Syndrome with Fatigue |
| DOI：10.16466/j.issn1005-5509.2023.01.004 |
| 中文关键词: 原发性干燥综合征 疲劳 益气养阴祛瘀方 回顾性研究 多巴胺 肿瘤坏死因子-α |
| 英文关键词: primary Sjogren‘s syndrome fatigue Yiqi Yangyin Quyu Decoction retrospective study dopamine tumor necrosis factor-α |
| 基金项目:国家自然科学基金面上项目(82074341、81473646) |
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| 中文摘要: |
| [目的] 评价益气养阴祛瘀方改善原发性干燥综合征(primary Sj?觟gren‘s syndrome，pSS)患者疲劳症状的临床疗效并探讨其作用机制。[方法] 纳入56例有不同程度疲劳症状的pSS患者，所有患者均连续接受治疗，根据治疗方案分为中药组28例和对照组28例，其中对照组服用常规西药治疗，中药组在常规西药治疗的基础上加用益气养阴祛瘀方治疗。以疲劳自评量表(fatigue severity scale，FSS)、多维疲劳量表(multi-dimensional fatigue inventory，MFI-20)评分观察两组患者治疗前后疲劳症状的变化，通过血沉(erythrocyte sedimentation rate，ESR)、C反应蛋白(C reactive protein，CRP)、中医证候积分、干燥综合征疾病活动度指数(Sj?觟gren‘s syndrome disease activity index，SSDAI)、干燥综合征患者报告指数(EULAR Sj?觟gren‘s syndrome patient reported index，ESSPRI)观察患者疾病活动度变化，同时检测两组患者治疗前后血清多巴胺(dopamine，DA)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)、四氢生物蝶呤(tetrahydrobiopterin，BH4)等指标变化。 [结果] 治疗后中药组FSS评分、中医证候积分下降(P＜0.05)，且FSS评分低于对照组(P＜0.05)；治疗后中药组血清TNF-α水平显著下降(P＜0.01)，血清BH4、DA水平显著升高(P＜0.01)，且高于对照组(P＜0.01)；中药组血清DA水平与FSS评分呈负相关(P＜0.05)；两组治疗前后其余指标差异无统计学意义(P＞0.05)；治疗安全性评价良好。[结论] 益气养阴祛瘀方能够显著改善pSS患者的疲劳症状，其作用机制可能与通过调控血清TNF-α水平，提高DA水平相关。 |
| 英文摘要: |
| [Objective] To evaluate the clinical efficacy of Yiqi Yangyin Quyu Decoction in the treatment of primary Sjogren‘s syndrome(pSS) with fatigue symptoms and explore its mechanism. [Methods] Fifty-six patients with primary stage of pSS with varying degrees of fatigue were reviewed into two groups: traditional Chinese medicine group(28 cases) and control group(28 cases). The control group was treated with conventional medicine， and traditional Chinese medicine group was treated with Yiqi Yangyin Quyu Decoction on the basis of conventional western medicine. The changes of fatigue symptoms in the two groups were observed by the scores of fatigue severity scale(FSS) and multi-dimensional fatigue inventory(MFI-20) before and after treatment. The changes of disease activity were observed by erythrocyte sedimentation rate(ESR)， C reactive protein(CRP)， traditional Chinese medicine syndrome score， Sj?觟gren‘s syndrome disease activity index(SSDAI) and EULAR Sj?觟gren‘s syndrome patient reported index(ESSPRI). Serum dopamine(DA)， tumor necrosis factor-α(TNF-α)， serum tetrahydrobiopterin(BH4) and other indexes were detected and analyzed in the two groups before and after treatment. [Results] The scores of FSS and traditional Chinese medicine syndrome of the traditional Chinese medicine group decreased after treatment(P＜0.05)， and the scores of FSS of the traditional Chinese medicine group were lower than those of the control group(P＜0.05). After treatment， the level of serum TNF-α of the traditional Chinese medicine group decreased significantly(P＜0.01)， while the levels of serum BH4 and DA increased significantly and were higher than those of the control group(P＜0.01). There was a negative correlation between the serum DA level and FSS score of the traditional Chinese medicine group(P＜0.05)， meanwhile there was no significant correlation among the other indexes of the two groups before and after treatment(P＞0.05). The evaluation of treatment safety was good. [Conclusion] Yiqi Yangyin Quyu Decoction has a significant clinical effect in the treatment of pSS with fatigue， and its mechanism may be related to regulating serum TNF-α level to increase the level of DA. |
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