白芍总甙治疗类风湿性关节炎的临床药理研究

Effect of total glucoside of paeony on rheumatoid arthris patients

对２９例类风湿性关节炎（ＲＡ）患者进行了白芍总甙（ＴＧＰ）的开放性临床试验．结果表明，大剂量ＴＧＰ（１．２～１．８ｇ·ｄ－１）服用８ｗｋ，对ＲＡ患者有明显疗效．不仅改善临床症状与体征以及降低血球沉降率与类风湿因子滴度，而且对ＲＡ患者的异常免疫功能，如外周血单个核细胞产生ＩＬ－１水平；外周血淋巴细胞的致分裂素反应与产生ＩＬ－２水平以及ＩＬ－２受体密度；抑制性Ｔ细胞的数目等均有机能依赖性恢复作用。与氨甲喋呤（ＭＴＸ）的比较试验表明．ＴＧＰ的抗关节炎作用起效较ＭＴＸ早．但疗效较温和，对ＲＡ患者异常免疫功能的影响也不完全相同，且ＴＧＰ的耐受性远较小剂量ＭＴＸ为优。本试验还表明．ＩＬ－１可作为监护ＴＧＰ疗效和调整剂量的一种灵敏而简便的指标。

Open trial to invertigate the efficacy of total glucoside of paeony(TGP) in the treatment of 29 rheumatoid arthritis(RA) patients were studied.Received TGP daily in highdoses of 1.2￣1.8g for 8 wk,a significant improvement from baseline was noticed for not only clinical symptom but also 1h erythrocyte sedimentation rate and serum rheumatoid factor titer.In addition,some immune dysfunction in RA patients, such as the higher levels of Interleukin-1(IL-1)producted by peripheral blood mononuclear cell (PBMC),the diminished PHA-induced proliferative responses and IL-2 production of lymphocytes,the depressed percentage of OKT8+ T cells in peripheral blood,and the elevated density of IL-2 receptor on lymphocytes,were recovered in state-dependent immunoregulation. Compared with low-dose methotrexate(MTX)(5￣15mg given weekly),the response with TGP occured earlier and milder than that with MTX, TGP was better tolerated and more safety than MTX.In conclusion,mete data indicated that TGP possess combined immunomodulatory and antiinflammatory activity,and hold promise as an important new therapeatic drug in RA.The result also indicated that IL-1 could be a simple and sensitive immunological manken for monitoring TGP effective and adjusting its doses.