低剂量雷公藤多苷治疗中老年活动性类风湿关节炎的临床效果  

Clinical efficacy of low-dose tripterygium glycosides in the treatment of active rheumatoid arthritis in the middle-aged and elderly patients

作　　者：何卉[1] HE Hui(Department of Rheumatology,Pinghu Traditional Chinese Medicine Hospital,Zhejiang Province,Pinghu 314200,China)

机构地区：[1]浙江省平湖市中医院风湿科,浙江平湖314200

出　　处：《中国当代医药》2023年第36期41-45,共5页China Modern Medicine

基　　金：浙江省平湖市科技计划项目(平科技[2021]16号6)。

摘　　要：目的 探讨低剂量雷公藤多苷治疗中老年活动性类风湿关节炎的临床效果。方法 选取2021年1月至2022年11月平湖市中医院收治的70例中老年活动性类风湿关节炎患者作为研究对象,按照随机抽签法将其分为对照组(33例)和观察组(37例)。对照组采用甲氨蝶呤或来氟米特治疗,观察组联合低剂量雷公藤多苷治疗。比较两组患者关节压痛数(TJC)、关节肿胀数(SJC)、C反应蛋白(CRP)、红细胞沉降率(ESR)、视觉模拟评分(VAS)、健康评估问卷(HAQ)、28个关节疾病活动评分(DAS28)。比较两组患者治疗后美国风湿病学会(ACR)20、ACR50缓解率和DAS28达标率。比较两组不良反应发生情况。结果 治疗前,两组患者TJC、SJC、CRP、ESR、VAS、HAQ及DAS28比较,差异无统计学意义(P>0.05);治疗后,两组患者TJC、SJC均少于本组治疗前,CRP、VAS、HAQ及DAS28均低于本组治疗前,ESR慢于本组治疗前,且观察组患者TJC、SJC均少于对照组,VAS、DAS28均低于对照组,ESR慢于对照组,差异有统计学意义(P<0.05)。治疗后,观察组患者DAS28达标率高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后ACR20、ACR50缓解率比较,差异无统计学意义(P>0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。治疗后,对照组患者血清白蛋白水平高于治疗前及观察组,差异有统计学意义(P<0.05)。结论 低剂量雷公藤多苷治疗中老年活动性类风湿关节炎的效果显著,可减轻炎症反应,改善患者症状,但也可导致血清白蛋白下降。Objective To explore the clinical efficacy of low-dose tripterygium glycosides in the treatment of active rheumatoid arthritis in the middle-aged and elderly patients.Methods A total of 70 middle-aged and elderly patients with active rheumatoid arthritis admitted to Pinghu Traditional Chinese Medicine Hospital from January 2021 to November 2022were selected as the study subjects.They were divided into the control group(33 cases) and the observation group(37 cases)by random lot-drawing.The control group was treated with Methotrexate or Leflunomide,while the observation group was treated with low-dose tripterygium glycosides in combination.Tender joint count(TJC),swollen joint count(SJC),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),visual analogue scale(VAS),health assessment questionnaire(HAQ)and disease activity score using 28 joint counts(DAS28) between the two groups were compared.American College of Rheumatology(ACR) 20 remission rates,ACR50 remission rates and DAS28 achievement rates after treatment between the two groups were compared.The occurrence of adverse reactions between the two groups was compared.Results Before treatment,there were no statistically significant differences in TJC,SJC,CRP,ESR,VAS,HAQ and DAS28 between the two groups(P>0.05).After treatment,TJC and SJC in the two groups were less than those before treatment,CRP,VAS,HAQ and DAS28 in the two groups were lower than those before treatment,ESR in the two groups was slower than that before treatment,and TJC and SJC in the observation group were less than those in the control group.VAS and DAS28 in the observation group were lower than those in the control group,and ESR in the observation group was slower than that in the control group,the differences were statistically significant(P<0.05).After treatment,DAS28 compliance rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in ACR20 and ACR50 remission

关 键 词：类风湿关节炎 老年 雷公藤多苷 白蛋白 

分 类 号：R593.22[医药卫生—内科学]