雷公藤多甙片联合甲氨喋呤治疗类风湿关节炎的临床疗效及对炎症因子的影响分析
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摘要
目的探讨雷公藤多甙片联合甲氨蝶呤治疗类风湿关节炎的临床疗效及对炎症因子的影响,为本病临床治疗方案的优化提供理论依据。方法选取98例类风湿关节炎患者为研究对象,随机分为观察组和对照组各49例。对照组采用甲氨蝶呤口服治疗,观察组采用雷公藤多甙片联合甲氨蝶呤治疗。比较两组患者的临床疗效;比较两组患者治疗前后的晨僵时间、有压痛症状和肿胀症状的关节数目、关节压痛的疼痛程度。比较两组患者治疗前后的红细胞沉降率(ESR)、C反应蛋白(CRP)以及类风湿因子(RF)检测结果。结果观察组的总有效率为93.88%,显著高于对照组(P <0.05);观察组治疗后的晨僵时间为(16.49±6.27)min,关节压痛数目为(3.81±1.03)个,关节肿胀数目为(3.41±1.08)个,关节疼痛NRS评分为(3.16±0.61)分,均显著低于治疗前和对照组治疗后(P <0.05);观察组治疗后的ESR为(21.52±3.27)mm/h,CRP为(16.58±2.63)mg/L,RF为(42.84±9.08)U/mL,均显著低于治疗前和对照组治疗后(P <0.05)。结论雷公藤多甙片联合甲氨蝶呤可更有效减轻患者的炎症反应,显著提高类风湿关节炎的临床疗效。
Objective To investigate the clinical efficacy of Tripterygium wilfordii polyglycoside tablets combined with methotrexate in the treatment of rheumatoid arthritis and its influence on inflammatory factors, so as to provide theoretical basis for the optimization of clinical treatment of rheumatoid arthritis. Methods Ninety-eight patients with rheumatoid arthritis were selected and randomly divided into the observation group and the control group, with 49 cases in each group. The control group was treated with oral methotrexate, while the observation group was treated with Tripterygium wilfordii polyglycoside tablets combined with methotrexate. The clinical effects of the two groups were compared, and the morning stiffness time, the number of joints with tenderness and swelling symptoms, and the degree of tenderness pain were compared before and after treatment. The results of erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and rheumatoid factor(RF) were compared between the two groups before and after treatment. Results The total effective rate of the observation group was 93.88%, which was significantly higher than that of the control group(P < 0.05). In the observation group, the morning stiffness time was(16.49±6.27) minutes and the number of tenderness was(3.81±1.03), the number of joint swelling and NRS score of joint pain were(3.41±1.08) and(3.16±0.61) respectively, which were significantly lower than those before and after treatment in control group(P < 0.05). The ESR, CRP and RF of the observation group were(21.52±3.27) mm/h,(16.58±2.63) mg/L and(42.84±9.08) U/mL respectively, which were significantly lower than those before and after treatment(P < 0.05). Conclusion Tripterygium wilfordii polyglycoside tablets combined with methotrexate can effectively alleviate inflammation in patients with rheumatoid arthritis and significantly improve the clinical efficacy.
Objective To investigate the clinical efficacy of Tripterygium wilfordii polyglycoside tablets combined with methotrexate in the treatment of rheumatoid arthritis and its influence on inflammatory factors, so as to provide theoretical basis for the optimization of clinical treatment of rheumatoid arthritis. Methods Ninety-eight patients with rheumatoid arthritis were selected and randomly divided into the observation group and the control group, with 49 cases in each group. The control group was treated with oral methotrexate, while the observation group was treated with Tripterygium wilfordii polyglycoside tablets combined with methotrexate. The clinical effects of the two groups were compared, and the morning stiffness time, the number of joints with tenderness and swelling symptoms, and the degree of tenderness pain were compared before and after treatment. The results of erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and rheumatoid factor(RF) were compared between the two groups before and after treatment. Results The total effective rate of the observation group was 93.88%, which was significantly higher than that of the control group(P < 0.05). In the observation group, the morning stiffness time was(16.49±6.27) minutes and the number of tenderness was(3.81±1.03), the number of joint swelling and NRS score of joint pain were(3.41±1.08) and(3.16±0.61) respectively, which were significantly lower than those before and after treatment in control group(P < 0.05). The ESR, CRP and RF of the observation group were(21.52±3.27) mm/h,(16.58±2.63) mg/L and(42.84±9.08) U/mL respectively, which were significantly lower than those before and after treatment(P < 0.05). Conclusion Tripterygium wilfordii polyglycoside tablets combined with methotrexate can effectively alleviate inflammation in patients with rheumatoid arthritis and significantly improve the clinical efficacy.
引文
[1]郭锦晨,刘健,万磊,等.氧化应激及炎症反应在类风湿关节炎中的研究进展[J].风湿病与关节炎,2016,5(9):68-71,76.
[2]黄晶,舒晓明,王贵,等.甲氨蝶呤治疗类风湿关节炎的作用机制[J].中华临床医师杂志(电子版),2016,10(21):3276-3280.
[3]张鑫,武祯,李航.雷公藤多甙片药理学研究进展及临床应用[J].临床药物治疗杂志,2014,12(4):8-13.
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[6]孙建,刘东伟,刘章锁,等.河南漯河地区中老年人群类风湿关节炎流行病学调查[J].中华医学杂志,2013,93(41):3309-3311.
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[10]谢玲.甲氨蝶呤抑制大鼠脊髓损伤后炎性反应的研究[J].海峡药学,2017,29(6):18-20.
[11]吴逢波,孙闻续,黄媛,等.依那西普联合甲氨蝶呤与甲氨蝶呤单用比较治疗类风湿关节炎有效性和安全性的Meta分析[J].四川医学,2016,37(10):1144-1148.
[12]王敏,韩善夯.雷公藤制剂治疗强直性脊柱炎的研究进展[J].医疗装备,2016,29(4):201-202.
[13]李凌汉,麦培根,陈宝红.雷公藤多甙联合免疫抑制剂治疗类风湿关节炎疗效及对炎性因子的影响[J].现代中西医结合杂志,2017,26(10):1088-1090.
[14]赵金石,张宁.活动期类风湿关节炎患者高密度脂蛋白胆固醇代谢特点[J].中华临床免疫和变态反应杂志,2016,10(4):377-380.
[15]潘丽丽,王天,王绿娅,等.类风湿关节炎患者血脂紊乱特点及与疾病活动的关系[J].中国动脉硬化杂志,2016,24(1):54-58.
[16]于水莲,陶怡,王羿升,等.炎症因素与早期类风湿关节炎心血管病变相关性研究[J].中华风湿病学杂志,2016,20(11):739-745.
[17]吉庆伟,周玉杰.动脉钙化:一种慢性炎症性疾病[J].心肺血管病杂志,2015,34(1):67-69.
[2]黄晶,舒晓明,王贵,等.甲氨蝶呤治疗类风湿关节炎的作用机制[J].中华临床医师杂志(电子版),2016,10(21):3276-3280.
[3]张鑫,武祯,李航.雷公藤多甙片药理学研究进展及临床应用[J].临床药物治疗杂志,2014,12(4):8-13.
[4]中华医学会风湿病学分会.类风湿关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(4):265-270.
[5]Aletaha D,Neogi T,Silman AJ,et al.2010 rheumatoid arthritis classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative.[J].Annals of the Rheumatic Diseases:A Journal of Clinical Rheumatology and Connective Tissue Research,2010,62(9):1580-1588.
[6]孙建,刘东伟,刘章锁,等.河南漯河地区中老年人群类风湿关节炎流行病学调查[J].中华医学杂志,2013,93(41):3309-3311.
[7]王鑫,赵琴,邓肇达,等.老年类风湿性关节炎治疗进展[J].中国骨伤,2017,30(6):576-580.
[8]张磊.益赛普联合甲氨蝶呤治疗类风湿关节炎的作用机制[J].中国老年学杂志,2014,34(12):3338-3339.
[9]王振杰,王菁.益赛普联合甲氨蝶呤治疗老年类风湿关节炎的疗效及对血清超敏C反应蛋白的影响[J].河北医学,2016,22(7):1123-1125.
[10]谢玲.甲氨蝶呤抑制大鼠脊髓损伤后炎性反应的研究[J].海峡药学,2017,29(6):18-20.
[11]吴逢波,孙闻续,黄媛,等.依那西普联合甲氨蝶呤与甲氨蝶呤单用比较治疗类风湿关节炎有效性和安全性的Meta分析[J].四川医学,2016,37(10):1144-1148.
[12]王敏,韩善夯.雷公藤制剂治疗强直性脊柱炎的研究进展[J].医疗装备,2016,29(4):201-202.
[13]李凌汉,麦培根,陈宝红.雷公藤多甙联合免疫抑制剂治疗类风湿关节炎疗效及对炎性因子的影响[J].现代中西医结合杂志,2017,26(10):1088-1090.
[14]赵金石,张宁.活动期类风湿关节炎患者高密度脂蛋白胆固醇代谢特点[J].中华临床免疫和变态反应杂志,2016,10(4):377-380.
[15]潘丽丽,王天,王绿娅,等.类风湿关节炎患者血脂紊乱特点及与疾病活动的关系[J].中国动脉硬化杂志,2016,24(1):54-58.
[16]于水莲,陶怡,王羿升,等.炎症因素与早期类风湿关节炎心血管病变相关性研究[J].中华风湿病学杂志,2016,20(11):739-745.
[17]吉庆伟,周玉杰.动脉钙化:一种慢性炎症性疾病[J].心肺血管病杂志,2015,34(1):67-69.