雷公藤多苷片对类风湿关节炎合并间质性肺病患者的临床疗效  

Clinical effects of Tripterygium wilfordii Polyglycoside Tablets on patients with rheumatoid arthritis complicated with interstitial lung disease

作　　者：李舒 万磊[1] 刘健[1] 黄传兵[1] 朱子衡 马熙檬 程静 李方泽 胡赛赛 陈莹莹 LI Shu;WAN Lei;LIU Jian;HUANG Chuan-bing;ZHU Zi-heng;MA Xi-meng;CHENG Jing;LI Fang-ze;HU Sai-sai;CHEN Ying-ying(The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中成药》2023年第9期2896-2901,共6页Chinese Traditional Patent Medicine

基　　金：国家自然科学基金面上项目(81973655,82274501);国家中医药管理局第七批全国老中医药专家学术经验继承项目(国中医药人教函[2022]76号);新安医学教育部重点实验室项目(2020xayx04);安徽省高校优秀青年人才支持计划项目(皖教秘人[2022]11号);安徽省高校自然科学研究项目(KJ2020A0397,KJ2021A0561)。

摘　　要：目的考察雷公藤多苷片对类风湿关节炎合并间质性肺病患者的临床疗效。方法90例患者随机分为对照组和观察组,每组45例,对照组给予来氟米特,观察组在对照组基础上加用雷公藤多苷片,疗程12周。检测ACR20/50/70、HRCT定量评分、中医证候评分、实验室指标(ESR、hs-CRP、RF、IgA、IgG、IgM、C3、C4、TNF-α、IL-10)、肺功能参数(VC、TLC、FEV1、FVC、FEV1/FVC、DLco)、生活质量(GH、RP、PF、RE、SF、BP、VT、MH评分)、不良反应发生率变化。结果观察组ACR50高于对照组(P<0.05)。治疗后,2组HRCT定量评分降低(P<0.05),以观察组更明显(P<0.05);观察组中医证候评分(干咳除外)降低(P<0.05),也低于对照组(干咳、咳痰除外)(P<0.05);观察组ESR、hs-CRP、RF、IgM、TNF-α降低(P<0.05),IL-10升高(P<0.05),比对照组更明显(P<0.05);观察组VC、TLC、FVC、DLco升高(P<0.05),其中DLco高于对照组(P<0.05);观察组PF、SF、BP、VT评分升高(P<0.05),其中SF、VT高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论雷公藤多苷片可安全有效地调节类风湿关节炎合并间质性肺病患者免疫炎症,改善关节和肺部炎症、肺通气功能、弥散功能,从而提高临床疗效、生活质量。AIM To investigate the clinical effects of Tripterygium wilfordii Polyglycoside Tablets on patients with rheumatoid arthritis complicated with interstitial lung disease.METHODS Ninety patients were randomly assigned into control group(45 cases)for 12-week administration of leflunomide,and observation group(45 cases)for 12-week administration of both Tripterygium wilfordii Polyglycoside Tablets and leflunomide.The changes in ACR20/50/70,HRCT quantitative score,TCM syndrome scores,laboratory indices(ESR,hs-CRP,RF,IgA,IgG,IgM,C3,C4,TNF-α,IL-10),pulmonary function parameters(VC,TLC,FEV1,FVC,FEV1/FVC,DLco),life qualities(GH,RP,PF,RE,SF,BP,VT,MH scores)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher ACR50 than the control group(P<0.05).After the treatment,the two groups displayed decreased HRCT quantitative score(P<0.05),especially for the observation group(P<0.05);the observation group exhibited decreased TCM syndrome scores(except for dry cough)(P<0.05),which were lower than those in the control group(except for dry cough and expectoration)(P<0.05);the observation group demonstrated decreased ESR,hs-CRP,RF,IgM,TNF-α(P<0.05),and increased IL-10(P<0.05),which were more obvious than those in the control group(P<0.05);the observation group displayed increased VC,TLC,FVC,DLco(P<0.05),among which DLco was higher than that in the control group(P<0.05);the observation group exhibited increased PF,SF,BP,VT scores(P<0.05),among which SF,VT were higher than those in the control group(P<0.05).No significant difference in incidence of adverse reactions was found between the two groups(P>0.05).CONCLUSION For the patients with rheumatoid arthritis complicated with interstitial lung disease,Tripterygium wilfordii Polyglycoside Tablets can safely and effrectively regulate immune inflammation,improve joint and lung inflammation,lung ventilation function and diffusion function,thus enhance clinical efficacy and life quality.

关 键 词：雷公藤多苷片 来氟米特 类风湿关节炎 间质性肺病 

分 类 号：R287[医药卫生—中药学]