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目的探讨注射用丹参静脉滴注治疗系统性硬化病的临床疗效和作用机制。方法 46例系统性硬化病患者分成2组:治疗组予丹参冻干粉针0.8 g,iv,gtt,qod,口服青霉胺0.375 g,qd,沙利度胺100 mg,qd,积雪苷72 mg,qd,泼尼松10 mg,qd;对照组予前列地尔100μg,iv,gtt,qod,其他治疗同治疗组,连续治疗3 mo,比较2组患者治疗前后皮肤损害的Rodnan修定评分、Furst’s内脏评分、全血黏度、血浆黏度、相对黏度、聚集指数、过氧化脂质(LPO)、超氧化物岐化酶(SOD)的变化以判断疗效及作用机制。结果治疗组皮肤损害的Rodnan修定评分、Furst’s内脏评分(3.5±2.2、4.8±6.4)显著低于对照组(6.8±6.3、6.7±3.8)(P<0.01,0.05)。治疗组血液流变学指标显著改善,优于对照组(P<0.01,0.05);LPO明显降低,SOD明显上升与对照组比较有显著差异(P<0.01)。结论丹参冻干粉针能显著改善皮肤损害和减轻内脏受累,其作用机制可能与血液流变学的显著改善、LPO降低、SOD上升有关。
Objective To investigate the clinical efficacy and mechanism of intravenous injection of Salvia miltiorrhiza for systemic sclerosis. Methods Forty-six patients with systemic sclerosis were divided into two groups: the treatment group was given Danshen freeze-dried powder 0.8 g, iv, gtt, qod, oral penicillamine 0.375 g, qd, thalidomide 100 mg, qd, 72 mg, qd, prednisone 10 mg, qd; control group were treated with alprostadil 100 μg, iv, gtt, qod, other treatment with the treatment group, continuous treatment 3 mo, two groups of patients before and after treatment Rodnan revisions Score, Furst’s visceral score, whole blood viscosity, plasma viscosity, relative viscosity, aggregation index, lipid peroxidation (LPO), superoxide dismutase (SOD) changes to determine the efficacy and mechanism of action. Results The Rodnan revision score and Furst’s visceral score (3.5 ± 2.2, 4.8 ± 6.4) in the treatment group were significantly lower than those in the control group (6.8 ± 6.3, 6.7 ± 3.8) (P <0.01, 0.05). The indexes of hemorheology in the treatment group were significantly improved, which were better than those in the control group (P <0.01, 0.05). The LPO was significantly decreased and the SOD was significantly increased compared with the control group (P <0.01). Conclusion Danshen freeze-dried powder can significantly improve skin damage and reduce visceral involvement, the mechanism may be significantly improved blood rheology, LPO decreased, SOD increased.