风湿病与关节炎
風濕病與關節炎
풍습병여관절염
Rheumatism and Arthritis
2014年
3期
17-20
,共4页
关节炎,类风湿%雷公藤多苷%甲氨蝶呤%治疗
關節炎,類風濕%雷公籐多苷%甲氨蝶呤%治療
관절염,류풍습%뢰공등다감%갑안접령%치료
arthritis,rheumatoid%tripterygium glycosides%methotrexate%treatment
目的：评价雷公藤多苷联合甲氨蝶呤治疗类风湿关节炎疗效及安全性。方法：将病情处于活动期类风湿关节炎患者40例，随机分为治疗组和对照组，每组20例。治疗组给予甲氨蝶呤10 mg，每周1次，口服；雷公藤多苷20 mg，每日3次，口服。对照组给予甲氨蝶呤10 mg，每周1次，口服；来氟米特每次20 mg，每日1次，口服。治疗12周后，比较临床指标的改善情况，并观察两组的不良反应发生率。结果：经12周治疗，治疗组ACR20的改善率占70%（14/20），对照组ACR20的改善率占75%（15/20），差异无统计学意义（ P>0.05）；且两组ACR50的改善率分别是35%（7/20）和45%（9/20），差异无统计学意义（ P>0.05）。两组患者在治疗12周后，关节疼痛程度、晨僵时间、关节肿胀数、关节压痛数、红细胞沉降率、C-反应蛋白等指标与治疗前比较均有明显改善，差异有统计学意义（P<0.01）；治疗后两组间上述临床指标比较，差异无统计学意义（ P>0.05）。治疗组胃肠道反应2例，白细胞减少、转氨酶升高、月经异常各1例；对照组胃肠道反应、白细胞减少各1例，转氨酶升高2例。结论：雷公藤多苷联合甲氨蝶呤能显著改善类风湿关节炎患者的病情，疗效及不良反应发生率与甲氨蝶呤联合来氟米特方案相当，可作为类风湿关节炎患者治疗的一种安全有效的方案。
目的：評價雷公籐多苷聯閤甲氨蝶呤治療類風濕關節炎療效及安全性。方法：將病情處于活動期類風濕關節炎患者40例，隨機分為治療組和對照組，每組20例。治療組給予甲氨蝶呤10 mg，每週1次，口服；雷公籐多苷20 mg，每日3次，口服。對照組給予甲氨蝶呤10 mg，每週1次，口服；來氟米特每次20 mg，每日1次，口服。治療12週後，比較臨床指標的改善情況，併觀察兩組的不良反應髮生率。結果：經12週治療，治療組ACR20的改善率佔70%（14/20），對照組ACR20的改善率佔75%（15/20），差異無統計學意義（ P>0.05）；且兩組ACR50的改善率分彆是35%（7/20）和45%（9/20），差異無統計學意義（ P>0.05）。兩組患者在治療12週後，關節疼痛程度、晨僵時間、關節腫脹數、關節壓痛數、紅細胞沉降率、C-反應蛋白等指標與治療前比較均有明顯改善，差異有統計學意義（P<0.01）；治療後兩組間上述臨床指標比較，差異無統計學意義（ P>0.05）。治療組胃腸道反應2例，白細胞減少、轉氨酶升高、月經異常各1例；對照組胃腸道反應、白細胞減少各1例，轉氨酶升高2例。結論：雷公籐多苷聯閤甲氨蝶呤能顯著改善類風濕關節炎患者的病情，療效及不良反應髮生率與甲氨蝶呤聯閤來氟米特方案相噹，可作為類風濕關節炎患者治療的一種安全有效的方案。
목적：평개뢰공등다감연합갑안접령치료류풍습관절염료효급안전성。방법：장병정처우활동기류풍습관절염환자40례，수궤분위치료조화대조조，매조20례。치료조급여갑안접령10 mg，매주1차，구복；뢰공등다감20 mg，매일3차，구복。대조조급여갑안접령10 mg，매주1차，구복；래불미특매차20 mg，매일1차，구복。치료12주후，비교림상지표적개선정황，병관찰량조적불량반응발생솔。결과：경12주치료，치료조ACR20적개선솔점70%（14/20），대조조ACR20적개선솔점75%（15/20），차이무통계학의의（ P>0.05）；차량조ACR50적개선솔분별시35%（7/20）화45%（9/20），차이무통계학의의（ P>0.05）。량조환자재치료12주후，관절동통정도、신강시간、관절종창수、관절압통수、홍세포침강솔、C-반응단백등지표여치료전비교균유명현개선，차이유통계학의의（P<0.01）；치료후량조간상술림상지표비교，차이무통계학의의（ P>0.05）。치료조위장도반응2례，백세포감소、전안매승고、월경이상각1례；대조조위장도반응、백세포감소각1례，전안매승고2례。결론：뢰공등다감연합갑안접령능현저개선류풍습관절염환자적병정，료효급불량반응발생솔여갑안접령연합래불미특방안상당，가작위류풍습관절염환자치료적일충안전유효적방안。
Objective:To evaluate the clinical efficacy and safety of Tripterygium Glycosides combined with methotrexate in treating rheumatoid arthritis.Methods:40 cases with active rheumatoid arthritis were randomly and equally divided into the treatment group and the control group.The former were given orally methotrexate,10 mg each time and 1 time a week;and Tripterygium Glycosides 20 mg each time and 3 times a day. The latter were given methotrexate orally,10mg each time,1 time a week;and lelfunomide tablets 20 mg each time and 1 time a day.After 12 weeks of treatment,improvements of their clinical indicators were compared,observing the incidence of the adverse reactions of the two groups.Results:After 12-week treatment,the ACR20 improvement rate of the treatment group was 70% (14/20),and that of the control group was 75% (15/20),with no signiifcant difference (P>0.05).While the ACR50 improvement rates of the two groups were 35%(7/20) and 45% (9/20) respectively,with no significant difference (P > 0.05).The degree of joint pain,morning stiffness,swollen joint count,tender joint count,erythrocyte sedimentation rate,and C-reactive protein of the two groups were significantly improved compared with those before treatment,the difference being statistically significant (P < 0.01);there was no statistical difference signiifcance (P>0.05) between the clinical indexes of the two groups after treatment.There were 2 cases with gastrointestinal reaction,and 3 cases respectively with leukopenia,elevated transaminases,and menstrual abnormalities in the treatment group;in the control group,there are 2 cases respectively with the gastrointestinal tract reaction and reduction in white blood cells and 2 cases with elevated transaminase.Conclusion:Tripterygium glycosides combined with methotrexate can significantly improve the condition of patients with rheumatoid arthritis,whose curative effect and adverse reaction rate are almost the same as in the treatment with methotrexate and lelfunomide,so it can be used as a safe and effective method in the treatment of rheumatoid arthritis.
