复方夏天无片联合甲氨蝶呤、羟氯喹治疗类风湿关节炎的疗效观察  

Efficacy observation of compound Xiatianwu combined with methotrexate and hydroxychloroquine in treatment of rheumatoid arthritis

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作  者:姜兆雨 吴天进 陈琳 刘爱慧 应振华[1] JIANG Zhaoyu;WU Tianjin;CHEN Lin;LIU Aihui;YING Zhenhua(Center of General Medicine Department of Rheumatology and Immunology,Zhejiang Provincial People's Hospital(Affiliated People's Hospital of Hangzhou Medical College)(Institute of Rheumatology and Immunology,Hangzhou Medical College,Zhejiang Key Laboratory of Traditional Chinese Medicine for Arthritis Diagnosis and Treatment Research),Hangzhou 310014,China;不详)

机构地区:[1]浙江省人民医院(杭州医学院附属人民医院)全科医学中心风湿免疫科(杭州医学院风湿免疫病研究所、浙江省关节炎诊疗研究中医药重点实验室),杭州310014 [2]海宁市中心医院心血管内科

出  处:《浙江医学》2024年第16期1740-1745,共6页Zhejiang Medical Journal

基  金:浙江省中医药科学研究基金项目(A类)(2020ZA016)。

摘  要:目的探讨类风湿关节炎(RA)患者应用复方夏天无片+甲氨蝶呤(MTX)+羟氯喹(HCQ)的疗效。方法回顾性选择2020年1月至2022年12月就诊于浙江省人民医院的RA患者80例。根据治疗方案不同,分为复方夏天无片+MTX+HCQ(观察组)40例,MTX+HCQ(对照组)40例。治疗48周后,比较两组患者治疗前后血脂指标、炎症指标、血常规、肝肾功能以及不良反应。结果观察组治疗后的载脂蛋白A1(ApoA1)、HDL-C水平高于对照组,且高于治疗前,动脉粥样硬化指数低于对照组,且低于治疗前,差异均有统计学意义(均P<0.05)。观察组治疗后CRP、ESR以及抗环瓜氨酸肽抗体水平低于对照组,且均低于治疗前,类风湿因子、抗角蛋白抗体和抗核周蛋白抗体阳性率低于治疗前,差异均有统计学意义(均P<0.05)。两组患者治疗后WBC、Glb水平均低于治疗前,差异均有统计学意义(均P<0.05)。两组患者均未出现明显不良反应。结论复方夏天无片+MTX+HCQ可更好地控制炎症,安全性良好并改善血脂异常并降低患者共患心血管疾病风险。Objective To analyze the efficacy and safety of Chinese medicine compound Xiatianwu combined with methotrexate(MTX)and hydroxychloroquine(HCQ)in treatment of patients with rheumatoid arthritis(RA).Methods Eighty RA patients admitted to Zhejiang Provincial People's Hospital from January 2020 to December 2022 were divided two groups with 40 cases in each group:patients in study group were treated with compound Xiatianwu tablets,MTX and HCQ,patients in control group were treated with MTX plus HCQ.The clinical efficacy and laboratory indices before and after treatment in two groups were compared.Results The ApoA1 and HDL-C levels of the study group after treatment were increased compared to those before treatment,and also were higher than those of the control group;the atherosclerosis index(AI)of the study group was declined after treatment,and also lower than that of the control group(all P<0.05).The CRP,ESR,and anti-CCP levels of the study group were decreased after treatment,and also lower than those of the control group(all P<0.05).The positive rates of RF,AKA and APF antibodies,the levels of WBC and Glb in the study group were lower than those before treatment(all P<0.05).There were no obvious adverse reactions occurred in either groups.Conclusion Chinese medicine compound Xiatianwu tablets combined with western medicine show a better control effect on inflammation with good safety in treatment of RA patients,and can also improve dyslipidemia to reduce the risk of cardiovascular disease,which is worth promoting the clinical application.

关 键 词:类风湿关节炎 血脂异常 心血管疾病 复方夏天无片 

分 类 号:R593.22[医药卫生—内科学]

 

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