目的 探究白芍總苷膠囊聯(lián)合他克莫司膠囊治療系統(tǒng)性紅斑狼瘡的臨床療效。方法 選取2014年10月-2016年6月什邡市人民醫(yī)院收治的系統(tǒng)性紅斑狼瘡患者90例為研究對(duì)象，將患者按隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各45例。對(duì)照組口服他克莫司膠囊，起始劑量0.05 mg/（kg·d），2次/d，維持血藥濃度5~10 μg/L。治療組在對(duì)照組治療的基礎(chǔ)上口服白芍總苷膠囊，2粒/次，2次/d。兩組患者均連續(xù)治療6個(gè)月。觀察兩組的臨床療效，比較兩組的系統(tǒng)性紅斑狼瘡疾病活動(dòng)指數(shù)（SLEDAI）評(píng)分、糖皮質(zhì)激素日用量、血清因子和復(fù)發(fā)率。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為75.56%、91.11%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組SLEDAI評(píng)分和糖皮質(zhì)激素日用量均明顯下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組疫球蛋白A（IgA）、IgG、IgM水平均明顯下降，補(bǔ)體C3、C4水平均明顯上升，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些血清因子水平均明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組抗雙鏈DNA抗體（A-dsDNA）、抗Sm抗體（ASm）、抗核抗體（ANA）及抗組蛋白抗體（AHA）轉(zhuǎn)陰率均明顯高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)照組和治療組復(fù)發(fā)率分別為為31.11%、13.33%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 白芍總苷膠囊聯(lián)合他克莫司膠囊治療系統(tǒng)性紅斑狼瘡具有較好的臨床療效，可改善患者免疫功能，減少糖皮質(zhì)用量，降低復(fù)發(fā)率，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Total Glucosides of Paeony Capsules combined with Tacrolimus Capsules in treatment of systemic lupus erythematosus. Methods Patients (90 cases) with systemic lupus erythematosus in Shifang People's Hospital from October 2014 to June 2016 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were po administered with Tacrolimus Capsules, starting dosage 0.05 mg/(kg·d), twice daily, the maintenance of blood drug concentration was 5-10 μg/L. Patients in the treatment group were po administered with Total Glucosides of Paeony Capsules on the basis of the control group, 2 grains/time, twice daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and SLEDAI scores, glucocorticoid daily dosage, serum factors, and recurrence rate in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.56% and 91.11%, respectively, and there was difference between two groups (P<0.05). After treatment, SLEDAI scores and glucocorticoid daily dosage in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of IgA, IgG, and IgM in two groups were significantly decreased, but the levels of C3 and C4 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the serum factors levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the negative rate of A-dsDNA, ASm, ANA, and AHA in the treatment group were significantly higher than those in the control group, and there was difference between two groups (P<0.05). The recurrence rates in the control and treatment groups were 31.11% and 13.33%, respectively, and there was difference between two groups (P<0.05). Conclusion Total Glucosides of Paeony Capsules combined with Tacrolimus Capsules has clinical curative effect in treatment of systemic lupus erythematosus, can improve immune function, decrease glucocorticoid dosage and reduce recurrence rate, which has a certain clinical application value.