雷公藤多苷配伍甲氨蝶呤及来氟米特治疗类风湿性关节炎的临床效果分析

Clinical analysis of tripterygium glycosides combined with methotrexate and leflunomide in the treat-ment of rheumatoid arthritis

目的探讨雷公藤多苷（tripterygium wilfordii polyglycoside ，TWP）配伍甲氨蝶呤及来氟米特治疗类风湿性关节炎（rheumatoid arthritis，RA）的临床疗效。方法将取武汉市第一医院2014年3月至2016年6月期间收治的100例RA患者随机分为对照组和实验组，每组各50例。对照组采用甲氨蝶呤＋来氟米特联合药治疗，实验组采用雷公藤＋甲氨蝶呤＋来氟米特治疗，观察治疗前后两组患者的各项及体征指标如晨僵时间、关节肿胀数、红细胞沉降率（erythrocyte sedimentation rate，ESR）、C-反应蛋白（C-reactive protein，CRP）、类风湿因子（rheumatoid factor，RF）、炎症因子、抑炎因子等变化情况，并进行统计学分析。结果实验组的治疗有效率（94%）优于对照组（78%），且关节肿胀数、关节压痛数、患者评价、医生评价、ESR、CRP、RF等均优于对照组；关节肿胀数、关节压痛数治疗后分别为（3.11±1.68）和（4.54±2.98），低于对照组的（5.85±1.26）、（6.82±1.87），差异具有统计学意义（P〈0.05）。炎症因子、抑炎因子等变化均与相关报道的结果一致，且实验组各项指标的改善程度优于对照组。结论TWP配伍甲氨蝶呤及来氟米特治疗RA有效率高，可改善患者各项体征及指标，具有协同增效功能。

ObjectiveTo study the effect of tripterygium wilfordii polyglycoside（TWP） combined with methotrexate and leflunomide on the treatment of rheumatoid arthritis（RA）.MethodAll 100 patients were randomly divided into the control group and the experimental group with 50 cases in each group.The control group was treated with methotrexate plus leflunomide, and the experimental group was treated with tripterygium glycosides, methotrexate and leflunomide.Observation and detection of two groups before and after treatment of all kinds of signs such as the time of morning stiffness、joint swelling、erythrocyte sedimentation rate（ESR）、C-reactive protein（CRP）、rheumatoid factor（RF）、inflammatory cytokines、anti-inflammatory cytokines changes.And the results were statistically analyzed.ResultsThe experimental results showed that the effective rate of RA in the experimental group was 94%, which was better than that of the control group by 78%.And the observation and testing indicators, such as joint swelling number、joint tenderness、patient evaluation、doctor evaluation、ESR、CRP、RF and so on, the experimental group is better than the control group.The number of joint swelling and joint tenderness in the experimental group were（3.11±1.68）and（4.54±2.98）after treatment respectively, which were significantly lower than（5.85±1.26）and（6.82±1.87）in the control group.The difference was statistically significant（P〈0.05）. Inflammatory factors, anti-inflammatory factors were all related to the results of the reports, and the improvement of the experimental data was better than that of the control group.ConclusionTWP combined with western medicine in the treatment of rheumatoid arthritis shows high efficiency, and improvement the signs of RA patients.TMP may has excellent synergistic function.