| 1 Obiective To observe the laboratory indexes,disease activity index(SLE-DAI)scores,clinical efficacy,quality of life,TCM symptoms and anxiety and depression of patients with systemic lupus erythematosus(SLE),such as urine protein,IL-10 and IL-23.And other indicators to explore the mechanism and correlation analysis of Jianpi Zishen Recipe on urinary protein,IL-10 and IL-23 in SLE patients,and to study its impact on disease activity in SLE patients.2 Methods2.1 Theoretical Research By searching a large number of literatures and conducting in-depth research,this paper analyzes the correlation between spleen and kidney deficiency and urinary protein,IL-10 and IL-23 in SLE patients,and analyzes the close relationship between the pathogenesis of SLE patients and the spleen and kidney.Contact,explain the theoretical basis for the treatment of urinary protein,IL-10 and IL-23 in SLE patients based on spleen and kidney.2.2 Clinical Research2.2.1 Changes and correlation analysis of urinary protein,IL-10 and IL-23 in SLE patients:Twenty healthy women were selected as healthy controls from the Health Management Center of Anhui Provincial Hospital of Traditional Chinese Medicine,and the general information of the healthy group was not significantly different from that of the SLE group(P>0.05).Serum IL-10 and IL-23 levels in patients with SLE and healthy controls were detected by enzyme-linked immunosorbent assay(ELISA);blood routine,erythrocyte sedimentation rate,hypersensitive C-reactive protein,complement C3,complement C4,immunoglobulin Laboratory indicators such as G,immunoglobulin A,immunoglobulin M,anti-C1 q antibody,24-hour urine protein quantitation,urinary albumin/urinary creatinine,total urine protein/urinary creatinine,and urinary five protein were detected by automatic biochemical analyzer..The statistical software used is SPSS21.0.2.2.2 Clinical efficacy,laboratory data and quality of life of patients with SLE treated with Jianpi Zishen Recipe combined with western medicine:60 patients with SLE were selected from the outpatient department and inpatient department of Anhui Provincial Hospital of Traditional Chinese Medicine,60 cases were in accordance with the American College of Rheology(ACR)SLE classification standard or the 2009 SLICC revised at the ACR annual meeting.The new SLE classification criteria,disease activity scores are between 0 and 14 points,and in line with the symptoms of Chinese medicine spleen and kidney deficiency type.Sixty patients were randomly divided into study group and control group,with 30 cases in each group.The study group(30 cases)was treated with traditional Chinese medicine Jianpi Zishen Decoction combined with western medicine and medicinal mycophenolate capsule in the basic treatment.The group(30 cases)received western medicine for the treatment of mycophenolate capsules in the basic treatment.There was no significant difference in the general data of the two groups before the treatment(P>0.05),which was comparable.SLE-DAI score,TCM symptom score,SF-36 dimension score,anxiety and depression scale score,24-hour urine protein quantitation,urinary albumin/urinary creatinine,total urine protein/urinary creatinine,urine were observed before and after treatment.Changes in pentaprotein,IL-10,IL-23 and other related indicators.3 Results3.1 Theoretical Research Results3.1.1 Urine protein,IL-10 and IL-23 are closely related to the activities of SLE disease;3.1.2 The abnormality of urinary protein in patients with SLE is closely related to the syndrome of "spleen and kidney deficiency" in traditional Chinese medicine;3.1.3 "Spleen and kidney deficiency" is one of the important components of SLE TCM pathogenesis;3.1.4 "The strengthening the spleen and complement the kidney" can reduce the disease activity of SLE,improve the prognosis of patients and improve the quality of life;3.1.5 "The strengthening the spleen and complement the kidney" is one of the treatment methods of SLE.3.2 Clinical Research Results3.2.1 Comparison of serum IL-10 and IL-23 between SLE group and healthy control group Compared with the healthy control group,serum IL-10 levels were significantly lower in the SLE group(P<0.01),and IL-23 levels were significantly higher(P<0.01).3.2.2 Comparison of 24 h urine protein quantitation,urinary albumin/urinary creatinine,total urine protein/urinary creatinine between SLE group and healthy control group Compared with the healthy group,the 24 h PRO,ACR and TPCR indexes in the SLE group were significantly higher than those in the healthy group(P<0.01).3.2.3 Comparison of urinary five proteins(IGGU,TRFU,ALBU,A1 MU,B2MU)between SLE group and healthy control group Compared with the healthy group,the levels of IGGU,TRFU,ALBU,A1 MU and B2 MU in the SLE group increased significantly(P<0.01).3.2.4 Comparison of blood routine indicators(WBC,RBC,HGB,PLT)between patients in SLE group and healthy controls Compared with the healthy control group,the blood levels of WBC,RBC,HGB and PLT were significantly lower in the SLE group(P<0.01).3.2.5 Comparison of Serum Immunological Parameters(Ig G,Ig A,Ig M,CRP,ESR)between SLE Patients and Healthy Control Patients Among the serum immunological indexes of patients in the SLE group,Ig G,Ig A,Ig M,CRP,and ESR were significantly higher than those in the healthy group(P<0.01).3.2.6 Comparison of anti-C1 q antibody and serum complement C3 and C4 between SLE group and healthy control group Compared with the healthy group,the anti-C1 q antibody level in the SLE group was increased,and the serum complement C3 and C4 levels were decreased,and the difference was statistically significant(P<0.05 or P<0.01).3.2.7 Comparison of anxiety and depression between SLE patients and healthy controls The scores of anxiety and depression scales in the SLE group were significantly higher than those in the healthy group(P<0.01).3.2.8 Comparison of SF-36 Dimensional Integral Points between SLE Patients and Healthy Control Patients There was no significant difference in the emotional function(RE)between the SLE group and the healthy control group(P>0.05),and the scores in the other seven aspects were significantly lower than the healthy control group(P<0.01).3.2.9 Correlation between serum IL-10 and IL-23 levels and other related indicators in patients with SLE(1)Correlation between serum IL-10 and IL-23 levels and anti-C1 q antibody,serum complement C3,C4 in patients with SLE The results showed that serum IL-10 levels in SLE patients were positively correlated with complement C3 and C4 levels(P<0.05 or P<0.01),and were not correlated with anti-C1 q antibody levels(P>0.05).Serum IL-23 levels in SLE patients.There was a negative correlation between the level of C4 and complement C(P<0.01),and no correlation with the levels of complement C3 and anti-C1 q antibody(P>0.05).(2)Correlation between serum IL-10 and IL-23 levels and serum immunological parameters in patients with SLE The results showed that serum IL-10 levels were negatively correlated with CRP,ESR and Ig M levels in SLE patients(P<0.01),and serum IL-23 levels were positively correlated with CRP,ESR and Ig M levels(P<0.05 or P<0.01).There was no correlation between serum IL-10 and IL-23 levels and Ig G and Ig A levels in SLE patients(P>0.05).(3)Correlation between serum IL-10 and IL-23 levels and 24 h urine protein quantitation,urinary albumin/urinary creatinine,total urine protein/urinary creatinine and urinary five protein in patients with SLE The results showed that serum IL-10 levels in SLE patients were negatively correlated with 24 h PRO,ACR,B2 MU levels(P<0.05),serum IL-23 levels were positively correlated with 24 h PRO,ACR,B2 MU levels(P<0.05);SLE patients There were no correlations between serum IL-10 and IL-23 levels and TPCR,IGGU,TRFU,ALBU and A1MU(P>0.05).3.2.10 Clinical Efficacy of Traditional Chinese Medicine Jianpi Zishen Recipe Combined with Western Medicine in Treating SLE Patients and Its Influence on Related Indicators Jianpi Zishen Recipe combined with western medicine can significantly improve the clinical efficacy of SLE patients,reduce the SLE disease activity scores,significantly improve the TCM symptoms,anxiety and depression,and improve the quality of life of patients;it is reducing IL-23,24 h PRO,ACR,TPCR,urinary pentaprotein(IGGU,TRFU,ALBU,A1 MU,B2MU),serum immunological indicators(Ig G,Ig A,Ig M,CRP,ESR)and anti-C1 q antibodies and other indicators are effective,increasing IL-10,WBC,RBC,HGB,PLT,serum complement C3,C4 and other indicators also have significant advantages.Compared with the simple Western medicine group for the treatment of SLE,Jianpi Zishen Recipe combined with Western medicine group in clinical efficacy,reduce disease activity,improve most Chinese medicine symptoms,improve anxiety and depression,improve quality of life,and reduce IL-23,24 h PRO,ACR,IGGU,ALBU,B2 MU,Ig G,Ig M,CRP,ESR,anti-C1 q antibodies and other indicators,increased IL-10,WBC,HGB,PLT,serum complement C3,C4 and other indicators have obvious advantages.It shows that the effect of Jianpi Zishen Recipe combined with Western medicine in the treatment of SLE patients is better.4 Conclusion4.1 The disease progression of SLE is closely related to the levels of urine protein,IL-10 and IL-23 in patients;4.2 The occurrence and development of SLE and the etiology and pathogenesis of patients with abnormal urine protein are closely related to the "spleen and kidney deficiency" of traditional Chinese medicine."The strengthening the spleen and complement the kidney" is one of the main treatment methods of SLE;4.3 The clinical efficacy of Jianpi Zishen Recipe combined with western medicine in the treatment of SLE was significantly better than that in the western medicine group alone;4.4 The combination of Jianpi Zishen Recipe and Western medicine can significantly reduce the 24 h PRO,ACR,TPCR and urinary five proteins(IGGU,TRFU,ALBU,A1 MU,B2MU)in SLE patients,and reduce 24 h PRO,ACR,IGGU,ALBU and The degree of B2 MU is superior to that of the western medicine group alone,indicating that"The strengthening the spleen and complement the kidney" can help improve the urine protein of patients with SLE and reduce kidney damage;4.5 Jianpi Zishen Recipe combined with Western medicine can significantly reduce IL-23,serum immunological indicators(Ig G,Ig A,Ig M,CRP,ESR),anti-C1 q antibodies and SLEDAI scores in SLE patients,significantly improve IL-10,WBC,RBC,HGB,PLT,serum complement C3,C4 and other indicators,suggesting that"The strengthening the spleen and complement the kidney" can effectively reduce the disease activity of SLE and delay the progress of the disease;4.6 Compared with the healthy control group,the scores of SF-36 in different dimensions of SLE patients were significantly reduced,and the scores of anxiety and depression scale and TCM symptom scores were significantly increased,suggesting that patients with SLE have a decline in quality of life;4.7 Jianpi Zishen Recipe combined with western medicine can improve the scores of SF-36 in different dimensions of SLE patients,reduce the scores of TCM symptoms and anxiety and depression scales,and the effect is significantly better than that of western medicine alone,indicating that "The strengthening the spleen and complement the kidney" can improve SLE The quality of life of the patient improves the state of survival. |
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