[目的]系统研究干燥综合征(sjogren syndrome,SS)血清IgG参数在SS临床中的意义以及益气养阴祛瘀中药治疗SS的临床疗效及作用机制。[方法]比较SS患者76例免疫球蛋白G(IgG)、疾病活动度(SSDAI)、血沉(ESR)、类风湿因子(RF)的差异,分析血清IgG的浓度与ESR、RF、SSDAI的相关性;并将76例SS患者随机分成中药组(益气养阴祛瘀中药治疗)和西药组(羟氯喹治疗),治疗6个月后观察临床疗效(口干、眼干和关节痛)、IgG的浓度与ESR、RF的变化情况,同时检测中药组治疗前后的血清BAFF和IL-10表达水平。[结果]SS患者血清IgG参数与SSDAI、ESR成正相关,尤其与SSDAI相关系数r达到0.545(P〈0.01);两组患者治疗6个月后的口干、眼干、关节痛均较治疗前有明显改善(P〈0.01或P〈0.05),中药组在治疗后对SS患者口干、眼干的改善程度优于西药组(P〈0.05);两组患者治疗6个月后的血清IgG、ESR、RF均较治疗前有明显改善(P〈0.01或P〈0.05);中药组对SS患者血清BAFF和Il-10含量在治疗后有较好的抑制作用(P〈0.01或P〈0.05)。[结论]SS患者血清IgG参数作为评价SS活动性的临床指标有一定的价值;益气养阴祛瘀中药治疗SS具有较好的疗效,可改善SS患者口干、眼干、关节痛症状,降低血清IgG、ESR、RF,其作用机制与降低血清BAFF和IL-10表达水平相关。
[Objective]To study the serum IgG parameters in the Sjogren's syndrome(SS) clinical significance , as well as to evaluate the effect of clinical treatment for SS with Yiqi Yangyin Quyu Chinese medicine, and to explore its mechanism.[Method]Comparison of 76 SS patients with immunoglobulin G(IgG), disease activity(SSDAI), erythrocyte sedimentation rate(ESR), rheumatoid factor(RF) difference, correlation analysis between the concentration of serum IgG and ESR, RF, SSDAI; 76 cases of SS patients were randomly divided into Chinese medicine group(Chinese medicine Yiqi Yangyin Quyu therapy) and western medicine group(hydroxychloroquine treatment), to observe the clinical effect after 6 months treatment(dry mouth, dry eyes and joint pain), changes in concentration and ESR, RF IgG; The expression level of.serum BAFF and IL-10 would be detected before and after treatment of traditional Chinese medicine group.[Results] The semm IgG parameters in SS patients had positive correlation with SSDAI, ESR. Compared with before treatment, dry mouth, dry eyes, joint pain symptoms serum IgG, ESR, RF were obviously improved after 6 months treatment in two groups. However, traditional Chinese medicine group in the degree of improvement in SS patients with dry mouth, dry eye is better than western medicine group, Serum BAFF and I1-10 content, decreased significantly after treatment in the Traditional Chinese medicine group. [Conclusion] Serum IgG parameter as a clinical index to evaluate the activity of SS is of certain value. The Yiqi Yangyin Quyu Chinese medicine has a good effect to treat SS, can improve the patients with dry mouth, dry eyes, joint pain symptoms, and can decrease the level of serum IgG, ESR, RF. Its mechanism may be due to reduced serum BAFF and IL- 10 levels.