雷公藤多苷联合甲氨蝶呤治疗类风湿性关节炎的疗效  

Short term effect of tripterygium glycosides and methotrexate in treating rheumatoid arthritis and its influence on IL-1,IL-6 and TNF-α

作　　者：高鹏[1] 霍爱鑫 刘宇宏[1] 

机构地区：[1]延安大学附属医院免疫风湿科,陕西延安716000

出　　处：《西部医学》2017年第11期1511-1515,共5页Medical Journal of West China

基　　金：陕西省科技统筹项目(2012KTCL02-07)

摘　　要：目的探讨雷公藤多苷与甲氨蝶呤联合治疗类风湿性关节炎(RA)的近期疗效及对患者外周血IL-1、IL-6和TNF-α水平的影响。方法选取本院2015年2月~2017年1月收治的112例RA患者进行研究,将患者按随机数字表法分为观察组与对照组各56例,对照组给予甲氨蝶呤10mg口服,1周1次,观察组在对照组的基础上加雷公藤多苷20mg口服治疗,1日3次。回顾分析两组患者的临床资料,比较并分析两组患者近期疗效及外周血TNF-α、IL-6、IL-1水平。结果治疗后,观察组患者临床症状及体征缓解程度明显高于对照组(P<0.05);观察组TNF-α、IL-6、IL-1水平均较对照组下降明显(P<0.05);观察组治疗后总有效率明显高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者及医生的总体评价明显低于对照组(P<0.05);治疗后,对照组患者不良反应发生率明显高于观察组(P<0.05)。结论雷公藤多苷联合甲氨蝶呤治疗类风湿性关节炎有较好的临床疗效,两种药物发挥协同效应,可抑制外周血清L-6、IL-1和TNF-α的表达水平,减轻炎症反应,改善RA患者的体征及症状,降低不良反应发生率,提高治疗安全性,可作为RA患者治疗的一种安全有效的方案。Objective To investigate the short term effect of tripterygium glycosides and methotrexate in treating rheumatoid arthritis and its influence on IL-1,IL-6 and TNF-α.Methods 112 RA patients in our hospital from February 2015 to January 2017 were selected and divided into observation group and control group,56 cases in each group.Control group was given 10 mg oral methotrexate,one time one week.Observation group was given 20 mg oral tripterygium glycosides based on control group,three times one day.The clinic data,the short term effect and index level of TNF-α,IL-6 and IL-1 were observed.Results After treatment,clinic symptoms and physical sign relieved degree of observation group were higher than that of control group（P〈0.05）.After treatment,TNF-α,IL-6 and IL-1 of observation group declined more than that of control group（P〈0.05）.The total efficiency of observation group[54 cases,92.50%]was higher than that of control group[45 cases,80.36%]（P〈0.05）.After treatment,the overall evaluation of observation group was lower than that of control group（P〈0.05）.The adverse reaction rate of observation group（8.93 %）was lower than that of control group（26.79 %）（P〈0.05）.Conclusion Tripterygium wilfordii polyglycoside combined with methotrexate in the treatment of rheumatoid arthritis has a good clinical efficacy.Two kinds of drugs play a synergistic effect,can inhibit the expression of peripheral serum L-6,IL-1 and TNF-alpha level,reduce inflammation,improve the signs and symptoms of RA patients,reduce the incidence of adverse reactions and improve the security of treatment,which can be used as a safe and effective method in treatment of patients with RA.

关 键 词：雷公藤多苷 甲氨蝶呤 类风湿性关节炎 近期疗效 

分 类 号：R593.22[医药卫生—内科学]