| 1Purpose1 Purpose Objective To observe the changes of Toll like receptor(TLR7/9)and related cytokine IFN-α,complement,immunoglobulin,sle-dai score,anxiety and depression score,quality of life score and TCM syndrome score in patients with systemic lupus erythematosus(SLE),and to explore the clinical efficacy of invigorating spleen and nourishing kidney method in the treatment of SLE,its influence on each index,and analyze its correlation and possible action Use mechanism.2methods2 methods2.1 theoretical analysis2.1 theoretical analysisBy looking at a large number of literature and in-depth study,this paper discusses the correlation between TLR7/9,IFN-α and the incidence and disease activity of SLE,and analyzes the relationship between spleen and kidney deficiency and the occurrence and development of SLE from the perspective of traditional Chinese medicine,so as to provide theoretical basis for the treatment of this prescription.2.2clinical studies2.2 clinical studies2.2.1 changes and correlation analysis of TLR7/9 and IFN-α in SLE patients20 healthy examinees were selected from the physical examination center of our hospital,all of them were female.Compared with 60 female patients in SLE group,there was no difference in general data(P > 0.05).The levels of TLR7 / 9、IFN – α、CRP、ESR、safety RBC、PLT、WBC、HGB、Ig A、Ig G、Ig M、C3、C4,anti-C1 q antibody,24-hour pro and urine β 2-mg in healthy control group and SLE group were detected by ELISA.2.2.2Effect of invigorating spleen and nourishing kidney on clinical efficacy and related laboratory indexes of SLE patientsA total of 60 outpatients and inpatients in Anhui Hospital of traditional Chinese medicine were selected.They were randomly divided into control group(30 cases)and treatment group(30 cases).Both groups participated in this study under the premise of general basic treatment.The changes of TLR7/9,IFN-α,immunological index,inflammatory index,safety index,sle-dai,anxiety and depression score,SF-36 score,TCM syndrome score and other indexes were observed before and after treatment in the two groups,and the comparison between the two groups was made after treatment.3Results3.1 theoretical research results3.1 theoretical research results3.1.1 TLR7,TLR9,IFN-α and other indicators are closely related to the pathogenesis and activity of SLE;3.1.2 The deficiency of spleen and kidney is an important etiology and pathogenesis of SLE;3.2clinical study results3.2 clinical study results3.2.1 Comparison of serum TLR7/9,IFN-α and IL-6 between SLE patients and healthy controls.Compared with the healthy control group,the levels of TLR7/9,IFN-α and IL-6 in SLE group were significantly higher(P < 0.01).3.2.2 comparison of blood routine indexes(RBC,WBC,PLT,HGB)between SLE group and healthy control groupCompared with the healthy control group,the indexes of RBC,WBC,PLT and HGB in SLE group were significantly lower(P < 0.01).3.2.3 comparison of anti-C1 q antibody and complement C3,C4 between SLE group and healthy control groupThe level of anti-C1 q antibody in SLE group was significantly higher than that in healthy group(P < 0.01),and the level of C3 and C4 in SLE group was significantly lower than that in healthy group(P < 0.01).3.2.4 comparison of 24 h pro and urine β2-MG between SLE group and healthy control groupCompared with healthy group,24 h pro and urine β2-MG in SLE group were significantly higher(P < 0.01).3.2.5 comparison of immunological and inflammatory indexes between SLE group and healthy control groupThe levels of Ig A、Ig G、Ig M、CRP and ESR in SLE group were significantly higher than those in healthy control group(P< 0.01).3.2.6 comparison of SAS,SDS and SF-36 scores between SLE group and healthy control groupThe scores of SAS and SDS in SLE group were significantly higher than those in healthy group(P< 0.01),and the scores of SF-36 in SLE group were significantly lower than those in healthy group(P < 0.01).3.2.7 correlation between serum TLR7/9,IFN-α、IL-6and other indicators in SLE group(1)In SLE group,TLR7/9,IFN-α and IL-6 were negatively correlated with C3(P<0.01 or P<0.05),TLR7/9 was negatively correlated with C4,TLR7/9 were positively correlated with anti-C1 q antibody(P < 0.05),but IL-6 and IFN-α were not correlated with anti-C1 q antibody.(2)The levels of TLR7/9 in SLE patients were negatively correlated with 24 hpro andβ2-MG(P<0.01 or P<0.05),but the levels of IL-6 and IFN-α were not significantly correlated with 24 hpro and β 2-MG.(3)The levels of TLR7/9,IFN-α and IL-6 were negatively correlated with CRP,Ig A and Ig G(P < 0.05 or P < 0.01),but not with Ig M.TLR7/9 were positively correlated with ESR(P < 0.05 or P <0.01).IFN-α was not significantly correlated with ESR.(4)The expression levels of TLR7/9 in serum of SLE patients were positively correlated with IL-6(P < 0.01).The expression levels of TLR7 in serum were positively correlated with TLR9,IFN-α and IL-6(P < 0.01 or P < 0.05).There was no significant correlation between TLR9 and IFN-α.3.2.8Effect of invigorating spleen and nourishing kidney on clinical efficacy and related indexes of SLE patientsThe results show that the method of invigorating the spleen and nourishing the kidney has a significant effect on the treatment of SLE.There was no difference between the two groups before treatment.(P > 0.05).After treatment,the indexes of the simple western medicine control group and the combined Chinese and Western medicine treatment group decreased and increased in varying degrees.TLR7/9 were significantly decreased after treatment.ESR,CRP,anti-C1 q antibody,C3,C4,RBC,WBC,HGB and PLT were significantly decreased or increased after treatment.Meanwhile,the levels of24 hpro,β 2-MG and IFN-α were significantly decreased.The treatment group of Jianpi Zishen decoction was better than the western medicine group in reducing the scores of SF-36,TCM syndrome scores,anxiety and depression scale scores,and had no obvious adverse reactions.The above results show that the method of invigorating spleen and nourishing kidney can significantly relieve the symptoms of SLE patients,improve the quality of life,improve the mood,and has no obvious side effects.4 Conclusion4 Conclusion4.1 the disease progression of SLE is closely related to the expression levels of TLR7 /9in serum.After treatment,the index levels of the two groups decreased significantly.4.2 the related indexes in the treatment group and the control group: WBC,RBC,HGB,PLT,C3,C4 were increased,but the increase in the treatment group was more obvious.The indexes of TLR7/9,IFN-α,IL-6,ESR,CRP,Ig A,Ig G,Ig M,anti-C1 q antibody,β2-MG and 24 hpro in the two groups were significantly lower than those before treatment,but the decrease in the treatment group was greater than that in the control group,indicating that the treatment group was better than the control group in reducing disease activity.4.3 invigorating the spleen and nourishing the kidney is an important method in the treatment of SLE.It has significant effect in improving the clinical symptoms of patients with hypocompleminemia,reduction of three blood systems,and proteinuria in early renal damage,which shows that the treatment of invigorating the spleen and nourishing the kidney of traditional Chinese medicine is superior to that of Western medicine.4.4 after treatment,compared with before treatment,TCM related symptoms such as mental fatigue,dark complexion and soreness of waist and knee in the two groups were significantly improved,and the sle-dai score,anxiety and depression score and anxiety and depression score of the patients were significantly improved The scores of each item of SF-36 in the two groups were decreased after treatment,but the effect of improving the scores in the treatment group was more significant,indicating that the method of invigorating the spleen and nourishing the kidney is more superior in improving the mood and quality of life of patients. |
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