增液布津汤治疗原发性干燥综合征气阴两虚、燥热血瘀证疗效观察及对唾液乙酰胆碱酯酶活性的影响

摘要

目的 观察增液布津汤治疗原发性干燥综合征(pSS)气阴两虚、燥热血瘀证的临床疗效及对唾液乙酰胆碱酯酶活性的影响.方法 将45例pSS气阴两虚、燥热血瘀证患者随机分为2组,治疗组25例予增液布津汤加减治疗,对照组20例予硫酸羟氯喹口服治疗.比较2组患者治疗前后干燥症状自我评分、欧洲风湿病联盟干燥综合征疾病活动指数(ESSDAI)及实验室相关指标[包括红细胞沉降率(ESR)、C反应蛋白(CRP)、抗核抗体(ANA)滴度、免疫球蛋白G(IgG)定量、唾液流率、泪流量]、唾液乙酰胆碱酯酶活性变化.同时纳入30例健康者为健康对照组,检测唾液乙酰胆碱酯酶活性,并与治疗前45例pSS患者进行比较.结果 2组患者治疗后干燥症状自我评分、ESSDAI、IgG、CRP、ESR均较本组治疗前明显降低,泪流量、唾液流率增加,比较差异均有统计学意义(P<0.01,P<0.05),且治疗组干燥症状自我评分低于对照组(P<0.05);2组干燥症状自我评分、泪流量、唾液流率治疗前后差值比较差异有统计学意义(P<0.05,P<0.01),治疗组大于对照组;2组治疗前后ANA滴度比较差异无统计学意义(P>0.05).与健康对照组相比,pSS患者唾液乙酰胆碱酯酶活性显著增高(P<0.01).2组pSS患者治疗后唾液乙酰胆碱酯酶活性均较较本组治疗前降低(P<0.05),但2组间比较及治疗前后差值比较差异均无统计学意义(P>0.05).结论 增液布津汤治疗pSS能有效改善患者症状,但在降低唾液乙酰胆碱酯酶活性方面无明显优势,有待进一步研究.%Objective To observe the effects of Zengye-bujin decoction on the treatment of primary Sjogren's syndrome(pSS)patients with Qi-yin deficiency type and dryness heat-blood stasis type and its effect on saliary cholinesterase activity. Methods 45 pSS patients with Qi-yin deficiency type and dryness heat-blood stasis type were randomly divided into two groups. 25 patients in treatment group were treated by modified Zengye -bujin decoction. 20 patients in control group were treated by hydroxychloroquine sulfate for oral. The self scores of symptoms of dry ,the changes of the European Union for rheumatism disease activity index of sjogren's syndrome (ES-SDAI),laboratory related indexes [including Erythrocyte sedimentation rate (ESR),C-reactive protein (CRP), ANA titer,IgG quantitative,salivary flow rate and tear flow rate]and saliary cholinesterase activity were observed before and after treatment in two groups. Another 30 healthy cases were taken as normal control,saliary cholinester-ase activity were tested and compared with 45 pSS patients before treatment. Results The self scores of symptoms of dry,ESSDAI,IgG,CRP and ESR after treatment were obviously decreased in two groups,tear flow rate and salivary flow rate were increased after treatment in two groups,with statistically significant (P < 0. 01,P < 0. 05 ). The self scores of symptoms of dry,ESSDAI in treatment group were inferior to those in control group (P < 0. 05). There were sta-tistical differences on the self scores of symptoms of dry,sal-ivary flow rate and tear flow rate before and after treatment,the treatment group was greater than control group(P < 0. 05,P < 0. 01). There were no statistical differences on titer before and after treatment in two groups (P > 0. 05). As compared with normal control,the saliary cholinesterase ac-tivity was significantly increased in pSS group(P < 0. 01). The saliary cholinesterase activity after treatment were de-creased in two groups (P < 0. 05),but there were no statistical differences (P > 0. 05). Conclusion The Zengye- bujin decoction can effectively improve the clinical symptoms on the treatment of pSS,but there were no obvious advantages on reducing saliary cholinesterase activity,which should be studied further.