不同剂量雷公藤总苷联合西药治疗类风湿性关节炎疗效比较  

Comparison of therapeutic effects of different doses of tripterygium glycosides combined with western medicine in the treatment of rheumatoid arthritis

作　　者：齐姗 孙红丽[1] 马斌[1] 李兴[1] QI Shan;SUN Hongli;MA Bin;LI Xing(Department of Rheumatology,Fuyang People's Hospital,Fuyang 236000,China)

机构地区：[1]阜阳市人民医院风湿科,安徽阜阳236000

出　　处：《长春中医药大学学报》2024年第6期660-663,共4页Journal of Changchun University of Chinese Medicine

基　　金：安徽省中医药传承创新科研项目(2020ccyb09)。

摘　　要：目的探讨不同剂量雷公藤总苷联合美洛昔康片治疗类风湿性关节炎的疗效及安全性。方法选择80例类风湿性关节炎患者,按照随机数表法分为大剂量组与小剂量组,各40例。2组均给予美洛昔康片治疗,大剂量组给予每次20 mg雷公藤总苷,小剂量组给予每次10 mg雷公藤总苷,2组均治疗2个月。比较2组临床疗效;治疗前、治疗2个月后,比较2组关节功能障碍分级、晨僵时间、关节视觉模拟疼痛评分(VAS)、双手平均握力、关节压痛数、关节肿胀数及白细胞介素-6(IL-6)、红细胞沉降率(ESR)、类风湿因子(RF)、C-反应蛋白(CRP)水平;观察2组不良反应发生情况。结果大剂量组临床疗效优于小剂量组(P<0.05)。治疗后,大剂量组关节功能障碍分级I级人数明显多于小剂量组(P<0.05),Ⅲ级人数明显少于小剂量组(P<0.05);大剂量组晨僵时间、VAS评分、关节压痛数、关节肿胀数水平、IL-6、ESR、RF、CRP水平低于小剂量组(P<0.05),双手平均握力水平高于小剂量组(P<0.05)。2组不良反应发生情况比较,大剂量组发生不良反应略多于小剂量组,差异无统计学意义(P>0.05)。结论大剂量雷公藤总苷联合美洛昔康片的疗效优于小剂量雷公藤联合美洛昔康片,能够有效减轻患者临床症状,降低炎症因子水平,但有可能增加不良反应发生风险,临床需要根据实际情况调整雷公藤总苷给药量。Objective To explore the efficacy and safety of different doses of tripterygium glycosides combined with Meloxicam tablets in the treatment of rheumatoid arthritis.Methods 80 patients with rheumatoid arthritis were selected and divided into the high-dose group and the low-dose group according to random number table method,with 40 cases in each group.Both groups were treated with Meloxicam tablets.The high-dose group received tripterygium glycosides,20 mg/time,and the low-dose group received tripterygium glycosides,10 mg/time.Both groups were treated for 2 months.The clinical effects of two groups were compared.Before treatment and after 2 months of treatment,the joint dysfunction grade,morning stiffness time,joint visual analogue score(VAS),average hand grip strength of both hands,joint tenderness count,joint swelling count,and the levels of inflammatory factors[interleukin-6(IL-6),erythrocyte sedimentaion rate(ESR),rheumatoid factor(RF),C-reactive protein(CRP)]were compared between two groups.The adverse reactions of two groups were compared.Results The therapeutic effect of the high-dose group was better than that of the low-dose group(P<0.05).After treatment,in the high-dose group the number of patients with joint dysfunction grade I was significantly higher than that in the low-dose group(P<0.05),and the number of patients with joint dysfunction grade III was significantly lower than that in the low-dose group(P<0.05).In the high-dose group,morning stiffness time,VAS score,joint tenderness count,joint swelling count,ESR,and the levels of IL-6,RF and CRP were lower than those in the low-dose group(P<0.05),and average hand grip strength of both hands was higher than that in low-dose group(P<0.05).There was no statiscally significant difference in adverse reactions between two groups(P>0.05),but the incidence of adverse reactions in the high-dose group was slightly higher than that in the low-dose group.Conclusion The efficacy of highdose tripterygium glycosides combined with Meloxicam tablets is superior to tha

关 键 词：类风湿性关节炎 雷公藤总苷 不同剂量 疗效 安全性 

分 类 号：R593.22[医药卫生—内科学]