艾拉莫德对膝骨关节炎的疗效及作用机制初探

Efficacy of Iguratimod on knee osteoarthritis and its mechanism

目的 探讨艾拉莫德治疗膝骨关节炎(KOA)的有效性及安全性.方法 选择2017 年4月至2018年4月在深圳市福田区风湿病专科医院接受治疗的KOA患者46例,随机分为观察组和对照组,各23例.对照组患者给予氨基葡萄糖钾片(500 mg,每日2次),观察组患者给予艾拉莫德(25 mg,每日2次),均口服.比较两组的临床疗效,评估治疗前后两组患者疼痛程度[疼痛视觉模拟评分法(VAS)]和膝关节功能(WOMAC骨性关节炎指数),检测患者血清炎症因子IL?6、TNF?a水平,记录治疗过程中不良反应的发生情况.结果 两组患者VAS评分、WOMAC评分、血清炎症因子IL?6、TNF?a水平较治疗前均明显下降(P<0.05);观察组VAS评分[(2.66±0.33)分比(4.84±0.44)分]、WOMAC评分[(20.12±4.29)分比(30.15±5.21)分]、血清炎症因子IL?6[(1.18±0.11)pg/ml比(10.36±1.84)pg/ml]、TNF?a[(20.65±4.33)pg/ml比( 35.87±5.36)pg/ml]水平、不良反应发生率(4.3%比8.7%)明显低于对照组(均P<0.05).结论 艾拉莫德治疗膝骨关节炎可有效减轻疼痛程度、抑制炎性因子表达,不良反应较小,其作用机制可能与抑制相关炎性细胞因子有关.

Objective To determine the efficacy and safety of Iguratimod in the treatment of knee osteoarthritis(KOA).Methods Forty?six KOA patients,who were treated at the Futian Hospital of Rheumatic Diseases in Shenzhen between April 2017 and April 2018,were included in the study and randomly divided into the study group and control group(n=23 each).The control group was given potassium glucosamine tablets(500 mg,twice daily),and the study group was given Iguratimod(25 mg,twice daily)with oral administration.The clinical efficacy in the two groups was compared.The pain degree[pain visual analogue scale(VAS)]and knee function(WOMAC osteoarthritis index)at the baseline and after the treatment in the two groups were evaluated.The levels of serum inflammatory cytokines IL?6 and TNF?αwere measured.The occurrence of adverse reactions during the treatment was recorded.Results The VAS score,WOMAC score,and levels of serum inflammatory cytokines IL?6 and TNF?αin the two groups significantly decreased compared with those at the baseline(P<0.05).The VAS score[(2.66±0.33)points vs(4.84±0.44)points],WOMAC score[(20.12±4.29)points vs(30.15±5.21)points],levels of serum inflammatory cytokines IL?6[(1.18±0.11)pg/ml vs(10.36±1.84)pg/ml]and TNF?α[(20.65±4.33)pg/ml vs(35.87±5.36)pg/ml],and the incidence of adverse reactions(4.3%vs 8.7%)in the study group were lower than those in the control group(all P<0.05).Conclusion Iguratimod effectively reduces the degree of pain and inhibits the expression of inflammatory cytokines with less adverse reactions,and its mechanism may be related to the inhibition of related inflammatory cytokines.