| 摘要: | 雷諾氏現象為系統性紅斑狼瘡患者常見之症,以往之研究報告顯示:本症患者肢端血流有減少現象。依據傳統中醫學理,此多屬「熱厥」範疇,宜以清熱涼血藥物治療。本研究在門診篩選系統性紅斑狼瘡併見雷諾氏現象患者25名,依醫界公認之治療方法給予西藥,症狀穩定後,維持在最低劑量,並隨機分為二組,實驗組給予清瘟敗毒飲濃縮藥粉每次4公克,對照組給予安慰劑,一日三次,持續服藥8週。服藥前後各組均以雷射血流測定儀觀測右手中指掌側遠端指節皮下血流,記錄其平均血流灌流量,並以無母數分析兩組服藥前後之差異。 研究結果顯示:實驗組服藥8週後,基準點血流灌流量下降(p=0.033),血流回復率無明顯改變;對照組則兩者皆無顯著差異。清瘟敗毒飲能降低系統性紅斑狼瘡併見雷諾氏現象患者之末梢血流灌流量,對回復率則無影響。
Raynaud's phenomenon (RP) has been reported in 10-44% of the patients with systemic lupus erythematosus (SLE). The pathogenetic mechanism of SLE presenting with RP is compatible with "heat reversal" in Chinese medicine. According to the principle of classic Chinese medicine, heat reversal should be treated with "qing-wen-bai-du-yin (QW)" a Chinese herb prescription. We proceeded to carry out a double-blind case-controlled study of QW in SLE patients with RP. Ninety-four outpatients with SLE regularly treated with western medicine were selected. Laser Doppler flowmetry (LDF) were performed on them. Among them 25 patients with SLE presenting RP were randomly allocated to two groups. Thirteen patients took QW orally, 12g a day for 8 weeks, and 12 patients were given a placebo. Finger cooling test was applied to induce RP during the examination. Quantitative analysis of the blood perfusion on the volar fingertip of right middle finger was performed before and after treatment. The results showed that the baseline perfusion of the SLE patients with RP was higher than the SLE patients without RP (p=0.0054). The recovery ratios of the SLE patients with RP at 0 minute and 7 minute were lower than those without RP (p=0.0116 and 0.0136 respectively). The baseline perfusion of the cases decreased after treatment (p=0.033), but the recovery ratio of perfusion did not change significantly. The controls made no significant differences neither in baseline perfusion nor in recovery ratio of perfusion. There were differences between the SLE patients with RP and those without RP in peripheral perfusion. QW could reduce the perfusion of the SLE patients with RP, but it could not affect the recovery ratio of perfusion. |
