白芍总苷胶囊联合依那西普治疗幼年特发性关节炎的临床研究

Clinical study of Total Glucosides of Paeony Capsules combined with etanercept in treatment of juvenile idiopathic arthritis

目的观察白芍总苷胶囊联合依那西普治疗幼年特发性关节炎的临床疗效。方法将2013年7月—2016年6月郑州儿童医院收治的56例患儿随机分为对照组和治疗组,每组各28例。两组患儿均给予常规治疗,对照组皮下注射注射用依那西普,每次0.4 mg/kg,2次/周;治疗组在对照组的基础上口服白芍总苷胶囊,30 mg/(kg·d),3次/d。两组患儿均治疗12周。治疗后,观察两组患者临床疗效,同时比较治疗前后两组患者临床症状、血液指标、炎症因子水平及不良反应情况。结果治疗后,对照组和治疗组的总有效率分别为71.43%、85.71%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者晨僵时间、关节压痛数、关节压痛指数、关节肿胀数和关节肿胀指数均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组患者临床症状改善情况显著优于对照组,两组比较差异具有统计学意义(P<0.05)。两组患者血沉、C反应蛋白、类风湿因子水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组患者上述血液指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组TNF-α、IL-1和IL-17水平均显著下降,同组比较差异具有统计学意义(P<0.05);且治疗组患儿TNF-α、IL-1和IL-17水平改善情况明显优于对照组,两组比较差异具有统计学意义(P<0.05)。两组均无明显不良反应发生。结论白芍总苷胶囊联合依那西普治疗幼年特发性关节炎疗效确切,临床症状改善明显,血液指标及炎症因子降低明显,不良反应较轻,具有一定的临床推广应用价值。

Objective To observe the clinical effect of Total Glucosides of Paeony Capsules combined with etanercept in treatment of juvenile idiopathic arthritis. Methods Patients （56 cases） with juvenile idiopathic arthritis in Children＇s Hospital of Zhengzhou from July 2013 to June 2016 were randomly divided into control group and treatment group, and each group had 28 cases. Patients in two groups were given conventional therapy. Patients in the control group were ih administered with Etanercept for injection, 0.4 mg/kg per time, twice weekly. Patients in the treatment group were po administered with Total Glucosides of Paeony Capsules on the basis of the control group, 30 mg/（kg·d）, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and clinical symptoms, blood indexes, inflammatory factor levels, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.43% and 85.71% respectively, and there was difference between two groups （P 〈 0.05）. After treatment, morning stiffness time, tender joint count, tender articular index, swollen joint count, and swollen joint count index significantly decreased, the difference was statistically significant in the same group （P 〈 0.05）. And the improvement of clinical symptoms in the treatment group was significantly better than that in the control group, with significant difference between two groups （P 〈 0.05）. Erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor levels in two groups significantly decreased, the difference was statistically significant in the same group （P 〈 0.05）. And the blood indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment,TNF-α, IL-1, and IL-17 levels in two groups significantly decreased, the difference was statistically significant in the same group （P 〈0.05）. And the improvement of those indexes in the treatment group was significantly better than that in the control group, with significant difference between two groups （P 〈 0.05）. There were no adverse reactions in two groups. Conclusion Total Glucosides of Paeony Capsules combined with etanercept has curative effect in treatment of juvenile idiopathic arthritis, can significantly improve clinical symptoms, and can significantly decrease blood index and inflammatory factors with mild adverse reactions, which has a certain clinical application value.