论文部分内容阅读
目的:观察滋肾化毒饮联合间断性环磷酰胺(CTX)静脉冲击疗法对活动期狼疮性肾炎(LN)患者外周血淋巴细胞(PBL)凋亡调控因子及临床指标的影响。方法:将活动性LN患者40例,随机分为治疗组和对照组,每组各20例。治疗组予滋肾化毒饮联合间断性CTX静脉冲击疗法,对照组予间断性CTX静脉冲击疗法。观察治疗3个月前后的PBL的Fas、FasL、Bcl-2表达及临床指标变化,Fas、FasL、Bcl-2用免疫组化法测定。结果:治疗后两组Fas、FasL及治疗组Bcl-2表达下调(P<0.05),而Fas、FasL表达下调幅度大于对照组(P<0.05)。治疗组SLEDAI、24h尿蛋白、Hgb、Ccr、C3指标的改善优于同期对照组(P<0.05)。治疗组肝功能受损、白细胞减少、舌苔厚腻、失眠、痤疮发生率明显少于对照组(P<0.05)。结论:调控Fas、FasL介导的凋亡可能是CTX、激素、滋肾化毒饮有效治疗活动狼疮性肾炎机制之一。
Objective: To observe the effects of Zishenhuayu Decoction combined with intermittent cyclophosphamide (CTX) intravenous pulse therapy on the apoptosis regulatory factors and clinical indicators of peripheral blood lymphocytes (PBL) in patients with active lupus nephritis (LN). Methods: 40 patients with active LN were randomly divided into treatment group and control group, 20 cases in each group. The treatment group was given Zishen Huayin Decoction intermittent CTX venous pulse therapy, and the control group was given intermittent CTX venous pulse therapy. The expression of Fas, FasL and Bcl-2 in PBL and the changes of clinical indexes were observed before and 3 months after treatment. The expressions of Fas, FasL and Bcl-2 were detected by immunohistochemistry. Results: After treatment, the expression of Bcl-2 in Fas, FasL and treatment groups was down-regulated (P <0.05), while the expression of Fas and FasL was down-regulated more than that in control group (P <0.05). Treatment group SLEDAI, 24h urinary protein, Hgb, Ccr, C3 indicators better than the control group (P <0.05). The treatment group had impaired hepatic function, leukopenia, thick greasy tongue coating, insomnia and acne. The incidence of acne in the treatment group was significantly less than that of the control group (P <0.05). Conclusion: The regulation of Fas and FasL-mediated apoptosis may be one of the mechanisms of effective treatment of active lupus nephritis by CTX, hormone and Zishen Huayu Yin.