雷公藤多甙治疗麻风结节性红斑的疗效观察

Effect of Triptolide in Treating Erythema Nodosum Leprosum

目的:评价雷公藤多甙对麻风结节性红斑(erythema nodosun leprosun,ENL)的疗效和副作用。方法:采用开放性研究,将入选的34例患者分成雷公藤多甙单独治疗组(A组,18例)及皮质类固醇和雷公藤多甙联合治疗组(B组,16例)。A组患者口服雷公藤多甙60～80 mg/天,治疗4周,然后停药或减量出院继续治疗2～4周;B组治疗方法为在A组基础上加服皮质类固醇。结果:治疗4周后,临床平均评分显示,A组18例患者从疗前的10.94下降到0.94;B组16例患者从疗前的13.19下降到1.63。两组分别在治疗2周时即见到临床改善,与治疗前比较差异有统计学意义(P值均<0.01)。尽管两组在药物减量或停药后都有患者出现ENL复发,但是症状较轻,与疗前相比,差异仍有统计学意义(P<0.01)。结论:雷公藤多甙在治疗麻风2型反应方面有显著疗效,药物副作用轻微,但需要制定出一个缓慢减量的治疗方案以控制ENL复发。

Objective：To observe the efficacy of triptolide in treating erythema nodosum lepro- sum （ENL）. Methods：The study wasan open clinical trial. The qualified patients were formed two different groups, group of triptolide alone （ Group A） and group of triptolide and prednisone together（ Group B）. The adult patients in the group A received a daily dosage of 60 -80 mg （6 - 8 tablets） for four weeks in the hospital, and then tapered the dosage for another four weeks at home. The patients in group B received prednisone besides the same triptolide as group A. The clinical status was evaluated by the same doctors and using a designed scale form. Results：The general score of clinical status for 18 patients in the group A decreased from 10. 94 before the stud- y to 0. 94 after 4 weeks of treatment. The general score of clinical status for 16 patients in the group B also decreased from 13. 19 before the study to 1.63 after 4 weeks of treatment. There was a significant difference in clinical improvement between the beginning and the end of four weeks＇ treatment in each group （P 〈 0. 01 ）. Even there was some ENL relapses in both groups after stop- ping or tapering the triptolide, there was still significant difference between the beginning and the end of 8 weeks＇ treatment （P 〈 0. 01 ）. Conclusion ：Triptolide has a significant efficacy in treating ENL. The side-effects of the drug were few, and most patients tolerated the drug. It is necessary to make out a very slow tapering regimen to prevent ENL from relapse.