白芍总苷联合甲氨蝶呤治疗风湿关节炎的临床效果观察  

Observation on clinical efficacy of TGP combined with methotrexate in treatment of RA

作　　者：郭欣[1] 谭淳予[1] Guo Xin;Tan Chunyu(Department of Rheumatology&Immunology,West China Hospital of Sichuan University,Chengdu,Sichuan,610041,China)

机构地区：[1]四川大学华西医院风湿免疫科,成都610041

出　　处：《西南国防医药》2020年第4期301-303,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：国家自然科研基金项目(81501412)。

摘　　要：目的观察白芍总苷联合甲氨蝶呤治疗风湿关节炎(RA)的临床效果。方法 86例RA患者按入院顺序单双编号分为单一组(甲氨蝶呤片治疗,n=43)与联合组(白芍总苷胶囊联合甲氨蝶呤片,n=43),比较两组临床临床疗效和治疗前后抗环瓜氨酸肽抗体(ACCP)、类风湿因子(RF)、C反应蛋白(CRP)、红细胞沉降率(ESR)、白介素-6(IL-6)、白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平及不良反应发生情况。结果治疗后,与单一组相比较,联合组总有效率明显更高(P <0.05);治疗后两组ACCP、RF、CRP、ESR、IL-6、IL-1β、TNF-α水平均较治疗前明显降低,且联合组显著低于单一组(P <0.05);联合组不良反应总发生率较单一组高,但差异无统计学意义(P> 0.05)。结论白芍总苷联合甲氨蝶呤可提高RA的治疗临床疗效,其作用机制或与联合方案能够有效调节患者ACCP、RF水平、减轻炎性反应等有关,但应密切监测患者不良反应发生情况,必要时调整给药剂量,以提高用药安全性。Objective To observe the clinical efficacy of total glucosides of paeony(TGP) combined with methotrexate in treatment of rheumatoid arthritis(RA). Methods A total of 86 patients with RA were divided into group A(treated with methotrexate tablets alone, n=43) and group B(treated with TGP capsules combined with methotrexate tablets, n=43) according to their admission numbers(patients with odd or even admission numbers were included in the same group). The clinical efficacy and adverse reactions were compared between the two groups. The following indicators before and after the treatment were compared between the two groups as well: levels of anti-cyclic citrullinated peptide(ACCP) antibody, rheumatoid factor(RF), C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), interleukin-6(IL-6), interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α). Results The total effective rate of group B after treatment was significantly higher than that of group A(P < 0.05). After the treatment, the levels of ACCP, RF,CRP, ESR, IL-6, IL-1β and TNF-α were significantly lower in both groups, and the levels of these indicators in group B were significantly lower than that in group A(P < 0.05). The total incidence of adverse reactions in group B was higher than that in group A, showing no significant statistical difference(P > 0.05). Conclusion Administration of TGP combined with methotrexate can improve the clinical efficacy in treatment of rheumatoid arthritis, the mechanism of action may be related to its effective regulation of levels of ACCP and RF along with alleviation of inflammatory reactions. Yet, the adverse reactions of the patients should be closely monitored and the dosage should be adjusted when necessary to improve the safety of medication.

关 键 词：风湿关节炎 白芍总苷 甲氨蝶呤 临床疗效 

分 类 号：R684.3[医药卫生—骨科学]