雷公藤多苷片联合甲氨蝶呤对类风湿关节炎合并骨质疏松患者血清骨代谢标志物水平及炎症因子的影响  

Effects of tripterygium glycoside tablets combined with methotrexate on levels of serum bone metabolism markers and inflammatory factors in patients with rheumatoid arthritis and osteoporosis

作　　者：谷敬欣[1] 赵振军[1] 左惠芬[1] 蒋富斌[1] 李亚侃 朱秀惠[1] 王香玲[1] 潘立燕 英一铭[1] GU Jingxin;ZHAO Zhenjun;ZUO Huifen;JIANG Fubin;LI Yakan;ZHU Xiuhui;WANG Xiangling;PAN Liyan;Ying Yiming(Hebei Yiling Hospital,Shijiazhuang 050091,Hebei,China)

机构地区：[1]河北以岭医院,河北石家庄050091

出　　处：《现代中西医结合杂志》2020年第22期2424-2428,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2019197)。

摘　　要：目的观察雷公藤多苷片联合甲氨蝶呤对类风湿关节炎合并骨质疏松患者血清骨代谢标志物水平及炎症因子的影响。方法将2018年7月—2019年6月河北以岭医院诊治的100例类风湿关节炎合并骨质疏松患者随机分为对照组和观察组各50例,2组患者均采取相同基础治疗,对照组患者同时给予甲氨蝶呤治疗,观察组则给予雷公藤多苷片联合甲氨蝶呤治疗,2组均治疗12周。观察比较2组患者治疗效果及治疗前后血清骨代谢标志物水平、炎症因子水平的差异。结果观察组治疗总有效率为92%(46/50),明显高于对照组的80%(40/50)(P<0.05);治疗后2组腰椎、股骨颈处骨密度(BMD)均明显升高(P均<0.05),且观察组腰椎、股骨颈处BMD均较对照组更为显著(P均<0.05);治疗后2组总骨Ⅰ型前胶原N端肽(PINP)以及Ⅰ型胶原羧基末端肽(CTX)水平均较治疗前明显下降(P均<0.05),观察组各指标均明显低于对照组(P均<0.05);治疗后2组白细胞介素-β(IL-1β)、IL-6、IL-4、IL-17水平均较治疗前明显降低(P均<0.05),观察组各指标水平均明显低于对照组(P均<0.05);不良反应发生率组间比较差异无统计学意义(P>0.05)。结论雷公藤多苷片联合甲氨蝶呤治疗类风湿关节炎合并骨质疏松,可明显增加骨密度,下调PINP、CTX水平,缓解机体炎症反应,效果显著。Objective It is to observe the effects of tripterygium glycoside tablets combined with methotrexate on levels of serum bone metabolism marker and inflammatory factors in patients with rheumatoid arthritis and osteoporosis.Methods 100 patients with rheumatoid arthritis and osteoporosis diagnosed and treated in Hebei Yiling Hospital from July 2018 to June 2019 were randomly divided into control group and observation group,50 cases in each group.Both groups received the same basic therapy.The patients in the control group were treated with methotrexate,and the observation group was treated with tripterygium glycosides combined with methotrexate at the same time.The curative effects and the difference in the changes of serum bone metabolism marker and inflammatory factors after treatment were compared between the two groups.Results The total effective rate of treatment in the observation group was 92%(46/50),which was significantly higher than that 80%(40/50)in the control group(P<0.05).After treatment,the BMD of lumbar spine and the neck of the femur was significantly increased(P<0.05),and the improvement in the observation group were more significant than that in the control group(P<0.05);the levels of PINP and CTX after treatment were significantly lower than those before treatment in the two groups(P<0.05),and the decrease of each index in the observation group was more significant than that in the control group(P<0.05);the levels of IL-1β,IL-6,IL-4,IL-17 after treatment were significantly lower than those before treatment in the two groups(P<0.05),the decrease of each index in the observation group was more significant than that in the control group(P<0.05);the difference in the incidence of adverse reactions between the groups was not statistically significant(P>0.05).Conclusion Tripterygium wilfordii polyglycoside tablets combined with methotrexate can significantly increase bone density,improve PINP and CTX levels,alleviate inflammation in the body,obviously improve prognosis in the treatment of rheumatoid a

关 键 词：雷公藤多苷片 甲氨蝶呤 类风湿关节炎 骨质疏松 骨代谢标志物 

分 类 号：R591.427[医药卫生—内科学]