Clinical Observation On Modified Xiaochaihu Decoction Combined With Glucocorticoid Treatment Of Mild To Moderate SLE

ObjectiveBy using of discriminate and treatment principles of "the Disease of Yin and Yang Toxin", which provides the theory of "When Yin and Yang benefit from each other; the vital energy can go smoothly; when Yin and Yang changes, the vital energy disperses", Xiaochaihu is added for recuperating Yin and Yang, Qi and blood as well as viscera function. Meanwhile, combining with glucocorticoid for anti-inflammatory to treat the slightly and midrange activeness systemic lupus eythematosus (short as SLE), the new thinking and methods could be offered in herb therapy for SLE.MethodsSelect60patients from clinic and inpatient department with slightly and moderate SLE in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from March2011to February2012, who are in accordance with the criteria of the American College of Rheumatology Revised SLE classification diagnostic in1997. Then according to the standards of the SLEDAI between5and10points, the patients are divided randomly into two groups by the treatment sequences, experimental group and control group with the same amount. The experimental group is treated with the diagnostic criteria of The Guiding Principle of Clinical Studies OF New Traditional Chinese Drugs for differentiating, the differentiation-classification being divided into seven types in the traditional Chinese medicine; using Xiaochaihu as the decoction with drug compositions:Bupleurum lOg, Codonopsis20g, France summer15g, Huang Qin lOg, jujube lOg, Ginger lOg, licorice lOg. The Anemarrhena lOg, paeonol15g are added for the Toxic heat flaming card; turtle30g (decoct first), habitat15g are added for Yin asthenia generating intrinsic heat; pseudo-ginsenglOg, red peony root15g are added for the Stagnant Heat Blockage of cards; Amur corktree bark10g and Atractylodes10g are added for rheumatic fever Arthralgia; spleen deficiency syndrome, the system aconite10g (decoct first); lucidum15g, Eclipta30g are added for the liver and kidney card Ligustrum; angelica10g, Astragalus30g are added for both qi and blood deficiency. Each patient takes prednisone acetate15mg once in every morning. Control group are given prednisone15mg/day, methotrexate10mg/week, hydroxychloroquine sulfate tablets400mg/day (200mg, bid).Observe the effect of small Bupleurum Decoction side combined with glucocorticoids on the clinical efficacy of TCM in patients with SLE climate effect, on the SLEDAI score, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), complement (C3, C4) level.Results(1)The aspect of symptoms:the experimental group after treatment can significantly improve three kinds of symptoms, as the heat, fatigue, insomnia. It has significant meaning for comparing with the control group (P<0.05). The scores of Chinese medicine symptom of two groups are decreased significantly, but the experimental group is more significant (P<0.05). The experimental group of TCM designates the total efficiency more than the control group, the differences between the two groups have a statistically significance (P<0.05).(2) In disease activity after treatment, two groups of SLEDAI are lower, but the differences between the two groups are not significant (P>0.05); the differences of SLEDAI score of the experimental group are more than the control group with the statistically significance (P <0.05).(3) The aspect of evaluation of clinical efficacy, disease control group is always more efficient than the experimental group, but no significant difference between the two groups (P>0.05).(4) Laboratory parameters after treatment, two groups of WBC, RBC, HGB, PLT, four indicators have increased with the WBC, RBC, HGB compared to the same group before treatment were significantly increased, the difference was statistically significant (P <0.05); two groups of CRP and ESR were lower with sex, experimental group, CRP, ESR was significantly lower than the control group, a statistically significant difference (P<0.05), after treatment, two groups of C3, C4, are significantly higher (P<0.05), C4with the same period of the experimental group and control group, the difference was statistically significant (P <0.05), indicating the increase in the hormone on the basis of Xiaochaihu decoction, lower ESR, CRP, to improve the role of the complement.(5) TCM group of drug with fewer side effects occurred in the control group is relatively high incidence of mainly common side effects of immunosuppressive agents in the gastrointestinal tract, bone marrow suppression, liver damage and secondary infection.ConclutionUsing the Xiaochaihu decoction side combined with glucocorticoids in the treatment of slightly and moderate SLE patients can improve symptoms and laboratory testindicators, to reduce the disease activity index. Combining Chinese and Western medicine with the treatment of SLE can achieve better clinical efficacy, side effects, can reduce the harm caused to patients and is worthy of andpromotion.