雷公藤多苷片联合依那西普治疗强直性脊柱炎患者的临床研究  

Clinical trial of tripterygium glycoside tablets combined with etanercept in the treatment of patients with ankylosing spondylitis

作　　者：沈括[1] 王小蕊[1] 华青措 李仲龙[1] SHEN Kuo;WANG Xiao-rui;HUA Qing-cuo;LI Zhong-long(Department of Hematology and Rheumatology,Qinghai Provincial People’s Hospital,Xining 810007,Qinghai Province,China)

机构地区：[1]青海省人民医院血液风湿科,青海西宁810007

出　　处：《中国临床药理学杂志》2020年第19期2996-2999,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察雷公藤多苷片联合依那西普对强直性脊柱炎患者外周血单个核细胞(PBMC)中干扰素诱导蛋白-10(IP-10)、干扰素-γ(IFN-γ)、白细胞介素-23(IL-23)及转化生长因子-β(TGF-β)水平的影响。方法将94例强直性脊柱炎患者随机分为试验组和对照组,各47例。对照组给予依那西普25 mg·kg^-1·d^-1,每周2次,皮下注射。试验组在对照组的基础上给予雷公藤多苷片1 mg·kg^-1·d^-1,每天3次。2组患者均持续治疗24周。比较2组治疗后的临床疗效、单核细胞水平,以及药物不良反应发生情况。结果治疗后,试验组和对照组的总有效率分别为87.23%和68.08%,差异有统计学意义(P<0.05)。治疗后,对照组和试验组IP^-10 mRNA分别为1.17±0.24和0.82±0.11,IFN-γmRNA分别为1.53±0.38和1.07±0.29,IL-23分别为(177.65±34.71)和(120.59±33.57)ng·L^-1,TGF-β分别为(387.68±55.78)和(318.73±50.27)ng·L^-1,差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应发生率分别为12.77%和17.02%,差异无统计学意义(P>0.05)。结论依那西普联合雷公藤多苷治疗强直性脊柱炎比单纯依那西普治疗的疗效好,可抑制膜细胞增生,降低外周血单个核细胞中IP^-10、IFN-γ、IL-23及TGF-β水平,缓解炎性病变,安全性良好。Objective To investigate the effect of tripterygium glycoside tablets combined with etanercept on the levels of interferon induced protein-10(IP-10),interferon-γ(IFN-γ),interleukin-23(IL-23)and transforming growth factor-β(TGF-β)in peripheral blood mononuclear cells(PBMC)of patients with ankylosing spondylitis.Methods Ninety-four patients with ankylosing spondylitis were randomly divided into treatment group and control group,with 47 cases in each group.Control group was treated with etanercept 25 mg·kg^-1·d^-1,subcutaneous injection,twice a week.Treatment group was given tripterygium glycosides tablets 1 mg·kg^-1·d^-1,3 times·d^-1,on the basis of control group.Both groups were treated continuously for 24 weeks.After treatment,the clinical effects,monocytes and adverse drug reactions of the two groups were compared.Results After treatment,the total effective rates of treatment group and control group were 87.23%and 68.08%,with significant difference(P<0.05).After treatment,IP^-10 mRNA in control group and treatment group were 1.17±0.24 and 0.82±0.11,IFN-γmRNA were 1.53±0.38 and 1.07±0.29,IL-23 were(177.65±34.71)and(120.59±33.57)ng·L^-1,TGF-βwere(387.68±55.78)and(318.73±50.27)ng·L^-1,all with significant differences(all P<0.05).The incidences of adverse drug reactions in treatment group and control group were 12.77%and 17.02%,without significant difference(P>0.05).Conclusion Etanercept combined with tripterygium glycosides for ankylosing spondylitis is more effective than etanercept alone,which can inhibit membrane cell proliferation and reduce the levels of IP^-10,IFN-γ,IL-23 and TGF-βin peripheral blood mononuclear cells,and relieve inflammatory lesions,with good safety.

关 键 词：雷公藤多苷片 强直性脊柱炎 诱导蛋白 干扰素-Γ 白细胞介素-23 

分 类 号：R28[医药卫生—中药学]