历节胶囊与雷公藤多苷片治疗活动期类风湿关节炎的临床疗效比较

Comparison of the Clinical Effect of Lijie Capsule and Tripterygium Wilfordii Glycosides Tablets in the Treatment of Active Rheumatoid Arthritis

目的比较历节胶囊与雷公藤多苷片治疗活动期类风湿关节炎(RA)的临床效果。方法选择2012年4月至2014年4月恩施市中心医院收治的100例活动期RA患者为研究对象,依据随机数字表法分为研究组和对照组,各50例。研究组采用历节胶囊治疗,每次4粒,每日口服3次,1个月为1个疗程;对照组采用雷公藤多苷片治疗,每次3片,每日口服3次,1个月为1个疗程。比较两组患者的临床疗效,治疗前后的临床指标、实验室指标以及不良反应发生情况。结果研究组总有效率与对照组接近[92.0%(46/50)比84.0%(42/50)],总显效率显著高于对照组[64.0%(32/50)比44.0%(22/50)],差异有统计学意义(P<0.05)。治疗后,研究组关节功能级别显著优于对照组[(1.04±0.32)比(1.40±0.34)](P<0.01);治疗后,研究组患者红细胞沉降率(ESR)、CD+4、CD+4/CD+8显著低于对照组[(20±7)mm/1 h比(36±10)mm/1 h,(29.8±2.5)%比(37.2±5.5)%,(1.3±0.3)比(1.7±0.4)],而CD+8显著高于对照组[(29.8±2.5)%比(27.2±5.5)%],差异均有统计学意义(均P<0.01)。结论在历节胶囊治疗活动期RA疗效优于雷公藤多苷片,可以有效缓解活动期RA的全身病变,不良反应少,是一种值得临床推广应用的治疗药物。

Objective To compare clinical effect of the Lijie capsules and tripterygium wilfordii glycosides tablets in treatment of active rheumatoid arthritis（ RA）. Methods Total of 100 RA patients admitted to Enshi Center Hospital from Apr. 2012 to Apr. 2014 were divided into research group and the control group,according to random number table method,50 cases in each group. Patients in the research group were given Lijie tablets treatment,three times a day,four capsules per time,a month as a period of treatment.Patients in the control group were given tripterygium wilfordii glycosides treatment,three times a day,3 tablets per time,a month as a period of treatment. The clinical curative effect,clinical and laboratory indexes before and after treatment,and adverse reactions of the two groups were compared. Results The total effective rate in the research group was close to the control group[92. 0%（ 46 /50） vs 84. 0%（ 42 /50） ],and the total marked effective rate was significantly higher than that of the control group[64. 0%（ 32 /50） vs 44. 0%（ 22 /50） ],and the difference was statistically significant（ P〈0. 05）. After treatment,the joint functional levels of the research group was significantly better than that of the control group[（ 1. 04 ± 0. 32） vs（ 1. 40 ± 0. 34） ]（ P 0. 01）. After treatment,erythrocyte sedimentation rate（ ESR）,CD4^＋,CD4^＋/ CD8^＋of the research group were lower than those of the control group[（ 20 ± 7） mm /1 h vs（ 36 ± 10） mm /1 h,（ 29. 8 ± 2. 5） %vs（ 37. 2 ± 5. 5） %,（ 1. 3 ± 0. 3） vs（ 1. 7 ± 0. 4） ],and CD8＋was higher than of the control group[（ 29. 8 ±2. 5） % vs（ 27. 2 ± 5. 5） % ],the differences were statistically significant（ P 〈0. 01）. Conclusion In the treatment of active RA,the comprehensive results of Lijie capsule is better than that of tripterygium wilfordii glycosides tablets,which can more effectively alleviate the general situation of RA disease,wth less adverse reaction,thus is a treatment worthy of popularization and application in the clinical.