雷公藤多苷治疗类风湿关节炎肺间质病变的临床研究

Clinical Research on Treatment of Rheumatoid Arthritis Associated Interstitial Lung Disease by Tripterygium Glycosides

目的:对雷公藤多苷治疗类风湿关节炎肺间质病变(RA-ILD)的临床疗效及安全性进行评价。方法:选取符合诊断条件的RA-ILD患者80例,按随机数字表法分为治疗组和对照组。对照组以甲氨蝶呤片为主,12.5 mg/次,每周1次,口服;治疗组在对照组治疗的基础上,联合雷公藤多苷20 mg/次,每日3次,口服。两组观察疗程均为6个月。观察两组治疗前后RA-ILD患者症状、实验室炎症指标、动脉血气分析、肺高分辨CT(HRCT)、肺功能等诸方面的变化。结果:两组临床疗效比较:对照组总有效率为69.3%,治疗组总有效率为87.8%(P<0.05)。主要炎症指标方面,两组治疗后ESR、CRP、RF等指标较治疗前均有明显改善(P<0.05或P<0.01),疗后比较治疗组明显优于对照组(P<0.05)。两组治疗后肺部HRCT积分及血气分析结果较疗前均改善,但治疗组变化较显著(P<0.05);而两组肺功能结果前后也有差异,而且治疗组优于对照组,但无统计学意义(P>0.05)。结论:雷公藤多苷能明显改善RA-ILD患者的临床症状,减轻肺间质病变程度,从而提高患者的生存质量。

Objective： To observe the clinical effect of traditional Chinese medicine tripterygium glycosides on rheuma- toid arthritis associated interstitial lung disease （ RA - ILD ）. Method ： Eighty patients with RA - ILD were randomly di- vided into control group received methotrexate, and treatment group received methotrexate and tripteryginm glycosides o- rally for 6 months. The changes of symptoms, signs, main laboratory inflammation indexes, arterial blood gas analysis, lung high resolution CT（HRCT） and lung function were observed. Result： After treatment, the symptoms and the signs, the results of main laboratory inflammation indexes, lung HRCT and arterial blood gas analysis were improved compared with those before treatment, while the changes of the treatment group were significantly better than the effects of the con- trol group （ P 〈0. 05 ）. Conclusion ： Tripterygium glycosides is obviously effective in treatment on RA - ILD and the qual- ity of life of patients with RA - ILD were improved.