强直性脊柱炎慢作用药治疗3年以上随访分析

The treatment of ankylosing spondylitis (AS) with slowacting antirheumatic drugs(SAARDs)

目的：了解柳氮磺胺吡啶、甲氨蝶呤、雷公藤多甙以及三种药物联合治疗强直性脊柱炎的远期疗效。方法：４６ 例活动性 Ａ Ｓ 分别给予柳氮磺胺吡啶 、甲氨蝶呤、雷公藤多甙以及三种药物联合治疗３ 年以上，通过观察晨僵、腰痛、实验室及放射学检查以及医师与患者全面评价的变化来确定疗效。结果：总临床疗效分别为显效８ ２６ ％ ，有效１５２ ％ 。有５６５ ％ 患者经单种慢作用药治疗可以控制病情发展，６５ ％ 病例需应用两种以上慢作用药，尤其是“重症 Ａ Ｓ”。３７ ％ 患者疗程中因疗效、副作用、药源、经济等问题需要更换其他药物。结论： 柳氮磺胺吡啶、甲氨蝶呤及雷公藤多甙对 Ａ Ｓ 均有不同程度的远期疗效，不失为治疗 Ａ Ｓ 的有效慢作用药。 Ａ Ｓ 治疗应注意个体化。

Aim:To study the long term efficacy and safety of Salicylazo sulfapyridine (SASP),Methotrexate(MTX),Tripterygium Wilfordii Hoof(T2)and combination of SASP+MTX+T2 therapy in the treatment of ankylosing spondylitis(AS).Methods:Forty six patients with active AS were consecutively treated with SASP,MTX,T2 and combination therapy respectively in an open prospectively trial over three years.Treatment response was based on morning stiffness, back pain,laboratory and radiological assessment,and physician and patient's overall assessment.Results:The total response of marked improvement,improvement were 82.6% and 15.2% respectively.In 56.5% patients symptoms were controlled with only one.In 6.5% patients especially severe cases symptoms need be controlled by combination therapy.37% patients need to replace SAARDs during trial for absent effect,side effect,and source of drugs and financial difficulties.Conclusions:It's proved that SASP,MTX and T2 have variable long term efficacy in treatment of AS.The treatment of AS should be individual.