甲氨蝶呤联合雷公藤多苷片治疗中重度类风湿关节炎效果及对DAS28评分、炎症指标水平的影响  

Combined treatment effect of methotrexate and tripterygium wilfordii polyglycosides in patients with moderate to severe rheumatoid arthritis and its effect on DAS28 score and inflammatory index levels

作　　者：罗寰[1] 张霞 冯娅娆 任占芬[1] 杨金良[1] 赵悦 LUO Huan;ZHANG Xia;FENG Ya-rao;REN Zhan-fen;YANG Jin-liang;ZHAO Yue(The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China)

机构地区：[1]河北北方学院附属第一医院,河北张家口075000

出　　处：《实用医院临床杂志》2022年第4期5-8,共4页Practical Journal of Clinical Medicine

基　　金：河北省卫健委2021年度医学科学研究课题计划(编号:20211727)。

摘　　要：目的探讨甲氨蝶呤联合雷公藤多苷片(GTT)治疗中重度类风湿关节炎效果及对DAS28评分、炎症指标水平的影响。方法我院门诊收治的127例中重度类风湿关节炎患者,依据治疗方案差异分为对照组62例(泼尼松片+甲氨蝶呤片)和观察组65例(泼尼松片+甲氨蝶呤片+雷公藤多苷片)。比较两组疗效、DAS28评分、炎症指标水平,观察治疗安全性。结果观察组总有效率高于对照组(P<0.05)。治疗后3、6个月,两组DAS28评分均下降,观察组显著低于对照组(P<0.05)。治疗后,两组TNF-α、CPR、RF水均下降,且观察组低于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论甲氨蝶呤+雷公藤多苷片治疗中重度类风湿关节炎能够降低患者炎症指标及疾病活动度,且不增加不良反应发生风险。Objective To investigate the efficacy of combined therapy of methotrexate and tripterygium wilfordii polyglycoside tablets in patients with moderate to severe rheumatoid arthritis and its effects on DAS28 score,and inflammatory index levels.Methods One hundred and twenty-seven patients with moderate to severe rheumatoid arthritis admitted to our outpatient department were selected.According to the difference of treatment plans,they were divided into a control group(n=62,treated with glucocorticoid prednisone tablets+Methotrexate tablets)and an observation group(n=65,treated with glucocorticoid prednisone tablets+methotrexate tablets+Tripterygium wilfordii polyglycosides tablets).The therapeutic efficacy,DAS28 score and inflammatory index levels were compared between the two groups.The safety of treatment was also observed.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The DAS28 score was decreased in both groups after 3 and 6 months of treatment,and the DAS28 score in the observation group was significantly lower than that in the control group(P<0.05).After treatment,the levels of tumor necrosis factor(TNF-α),C-reactive protein(CPR)and rheumatoid factor(RF)were decreased in both groups,and the observation group was lower than the control group(P<0.05).There was no statistical significance in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Methotrexate+Tripterygium glycosides tablets in the treatment of moderate to severe rheumatoid arthritis can reduce inflammatory indicators and disease activity,but do not increase the risk of adverse reactions.

关 键 词：中重度类风湿关节炎 甲氨蝶呤 雷公藤多苷片 DAS28评分 

分 类 号：R593.22[医药卫生—内科学]