中国临床药学杂志

目的探讨雷公藤多苷联合甘草锌治疗慢性荨麻疹的临床疗效及对患者血清细胞因子水平的影响。方法将120例慢性荨麻疹患者随机分为观察组(n=60)与对照组(n=60)。2组患者均用盐酸左西替利嗪片5 mg,po,早晚各1次。对照组用甘草锌颗粒5 g,po,tid。观察组在对照组基础上联合雷公藤多苷片1 mg·kg^-1·d^-1,po,tid。4周为一疗程,共2个疗程。采用酶联免疫吸附测定(ELISA)法检测2组治疗前后血清干扰素-γ(IFN-γ)、白介素4(IL-4)、IL-10和肿瘤坏死因子α(TNF-α)水平。结果观察组有效率高于对照组(90.00%vs 71.67%,P<0.05)。治疗后,2组IFN-γ水平均较同组治疗前升高, IL-4、TNF-α、IL-10水平均较同组治疗前降低,且上述指标治疗前后变化幅度观察组较对照组明显(P<0.01)。随访6个月,观察组复发率低于对照组(9.26%vs 34.88%,P<0.01)。结论雷公藤多苷联合甘草锌对慢性荨麻疹具有良好的临床疗效,纠正失衡的细胞因子水平可能是其重要作用机制之一。

AIM To investigate the effect of tripterygium glycosides combined with licorzinc on chronic urticaria(CU) and serum cytokines levels. METHODS A total of 120 patients with CU were randomly divided into observation group(n=60) and control group(n=60) respectively. Left cetirizine hydrochloride tablets(5 mg,po) were used in both groups, once in the morning and once in the evening.The control group was treated with licorzine granule 5 g, po, tid. The observation group combined with tripterygium glycosides tablet 1 mg·kg^-1·d^-1, po, tid, on the basis of the control group. Four weeks were as a course of treatment, with 2 courses in total. Serum levels of interferon-γ(IFN-γ), interleukin-4(IL-4), IL-10 and tumor necrosis factor α(TNF-α) of 2 groups were measured by ELISA before and after treatment. RESULTS The effective rate of the observation group was 90.00%, while that of the control group was 71.67%. There was significant difference between 2 groups(P<0.05). There was no significant difference in the levels of IL-4, TNF-α, IL-10 and IFN-γ between 2 groups before treatment(P>0.05). After treatment, the levels of IFN-γ in both groups were higher than those before treatment, and the levels of IL-4, TNF-α and IL-10 in 2 groups were lower than those before treatment, but the most obvious change was found in the observation group(P<0.01).The recurrence rate in the observation group(9.26%) was lower than that in the control group(34.88%) at 6 months of follow-up. There was significant difference between 2 groups(P<0.01). CONCLUSION Tripterygium glycosides combined with licorzine has a good clinical effect on CU.Correcting the imbalance of cytokine levels may be one of its important mechanisms.