雷公藤甲素干预前后类风湿性关节炎患者炎症表达、关节肿胀疼痛度的变化

Changes of inflammation expression and joint swelling pain in patients with rheumatoid arthritis beforeand after intervention by triptolide

目的探讨雷公藤甲素干预对类风湿性关节炎患者炎症表达及关节肿胀疼痛度的影响。方法选择本院收治的72例类风湿性关节炎患者为研究对象，随机分为对照组36例和观察组36例，对照组患者给予口服甲氨喋呤和美洛昔康治疗，观察组患者在对照组治疗的基础上，给予口服雷公藤甲素。比较两组患者治疗前后血沉速度（ESR）、c反应蛋白（CRP）、类风湿性因子（RF）、血清中炎性细胞因子TNF—d及IL—10水平的变化和关节肿胀疼痛度的差异。结果观察组患者治疗后ESR、CRP、RF、TNF—d、IL-10分别为（35．44±16．64）mm／h、（14．36±9．84）mg／L、（65．36±41．53）IU／m1、（38．14±6．76）pg／ml、（82．55±70．22）pg／ml，对照组分别为（49．22±22．81）mm／h、（22．59±10．58）mg／L、（136．68±95．76）IU／ml、（42．37±5．46）pg／ml、（71．31±69．89）pg／ml，差异具有统计学意义（t=7．25、10．16、15．22、4．78、6．33，P〈0．05）；观察组患者治疗后关节压痛数、关节肿胀数、晨僵时间分别为（9．6土6．8）个、（8．5±5．6）个、（36．6±35．8）rain，对照组分别为（11．4±6．6）个、（10．3±8．8）个、（65．3±21．5）min，差异具有统计学意义（t=5．62、6．35、9．58，P〈0．05）。结论雷公藤甲素能够有效降低急性炎症指标，抑制炎性细胞因子的表达，缓解关节肿胀、疼痛等临床症状，值得临床进一步推广。

Objective To study the changes of inflammation expression and joint swelling pain in patients before and after intervention by triptolide. Methods 72 patients with rheumatoid arthritis treated at our hospital were selected as study objects and randomly divided into a control group and an observation group, 36 for each group. The control group orally took methotrexate and meloxicam; in addition, the observation group orally took triptolide. The ESR, the levels of CRP, RF, TNF-a, and IL-10, and joint swelling pain were compared between these two groups. Results After the treatment, the ESR and the levels of CRP, RF, TNF-a, and IL-10 were （35.44±16.64） ram/h, （14.36±9.84） mg/L, （65.36±41.53） IU/ml, （38.14±6.76） pg/ml, and （82.55±70.22） pg/ml in the the observation group and were （49.22±22.81） turn/h, （22.59±10.58） mg/L, （136.68±95.76）IU/ml, （42.37±5.46） pg/ml, and （7 1.3 l±69.89） pg/ml in the control group, with statistical differences （t=-7.25,10.16, 15.22, 4.78, 6.33, P〈0.05）. The joint pressure number, joint swelling number, and morning stiffness time were （9.6±6.8）, （8.5±5.6） and （36.6±35.8） min in the observation group and were （11.4±6.6）, （10.3±8.8）, （65.3±21.5） rain in the control group, with statistical differences （t=5.62, 6.35, 9.58, P〈0.05）. Conclusions Triptolide can decrease the levels of acute inflammation indicators and effectively inhibit the expression of inflammatory cytolines, remit joint swelling pain, so it is worth being clinically generalized.