沙利度胺、白芍总苷、柳氮磺吡啶联合治疗对强直性脊柱炎患者病情活动度的影响

Effects of thalidomide,total glucosides of paeony,sulfasalazine combined therapy on the disease activity of patients with ankylosing spondylitis

目的探讨沙利度胺、白芍总苷、柳氮磺吡啶联合治疗对强直性脊柱炎(AS)患者病情活动度的影响。方法78例首诊为AS患者,经随机数字表法分为A组与B组,各39例。A组患者接受沙利度胺、柳氮磺吡啶联合治疗,B组患者接受沙利度胺、白芍总苷、柳氮磺吡啶联合治疗。对比两组患者的基于C反应蛋白(CRP)计算的AS疾病活动度评分(ASDAS)(ASDAS-CRP)评分、疾病活动度、治疗前后实验室指标[CRP、肿瘤坏死因子-α(TNF-α)、血沉(ESR)、骨钙素(BGP)、Ⅰ型胶原C末端肽(CTX-Ⅰ)]水平。结果治疗12周后,B组患者的ASDAS-CRP评分(1.39±0.21)分低于A组的(1.63±0.27)分,差异有统计学意义(P<0.05)。B组患者的疾病活动度分级情况优于A组,差异有统计学意义(P<0.05)。治疗12周后,A组患者的CRP、TNF-α、ESR、BGP、CTX-Ⅰ水平分别为(10.88±1.76)mg/L、(7.11±1.67)pg/ml、(19.92±2.17)mm/h、(4.20±0.56)pg/ml、(8.25±0.92)pg/ml,B组患者分别为(8.36±0.94)mg/L、(5.36±0.72)pg/ml、(14.36±1.50)mm/h、(3.07±0.45)pg/ml、(5.88±0.71)pg/ml,治疗12周后,两组患者的CRP、TNF-α、ESR、BGP、CTX-Ⅰ水平均低于治疗前,且B组患者低于A组,差异均有统计学意义(P<0.05)。结论沙利度胺、白芍总苷、柳氮磺吡啶联合治疗可有效抑制AS患者的病情活动。

Objective To discuss the effect of thalidomide,total glucosides of paeony,sulfasalazine combined therapy on the disease activity of patients with ankylosing spondylitis(AS).Methods A total of 78 AS patients were divided into group A and group B,with 39 cases in each group.Group A was treated by thalidomide and sulfasalazine combined therapy,and group B was treated by thalidomide,total glucosides of paeony,sulfasalazine combined therapy.The ankylosing spondylitis disease activity score(ASDAS)-C reactive protein(ASDAS-CRP)score,disease activity,laboratory indicators[CRP,tumor necrosis factor-α(TNF-α),erythrocyte sedimentation rate(ESR),boneγ-carboxyglutamic acid-containing protein(BGP),typeⅠcollagen C-terminal peptide(CTX-Ⅰ)]before and after treatment were compared between the two groups.Results After 12 weeks of treatment,the ASDAS-CRP score(1.39±0.21)points in group B was lower than(1.63±0.27)points in group A,and the difference was statistically significant(P<0.05).The classification of disease activity in group B was better than that in group A,and the difference was statistically significant(P<0.05).After 12 weeks of treatment,the levels of CRP,TNF-α,ESR,BGP and CTX-Ⅰwere(10.88±1.76)mg/L,(7.11±1.67)pg/ml,(19.92±2.17)mm/h,(4.20±0.56)pg/ml and(8.25±0.92)pg/ml respectively in group A,which were(8.36±0.94)mg/L,(5.36±0.72)pg/ml,(14.36±1.50)mm/h,(3.07±0.45)pg/ml and(5.88±0.71)pg/ml respectively in group B.After 12 weeks of treatment,the levels of CRP,TNF-α,ESR,BGP and CTX-Ⅰin the two groups was lower than those before treatment,and group B was lower than group A.Their difference was statistically significant(P<0.05).Conclusion Thalidomide,total glucosides of paeony,sulfasalazine combined therapy can effectively inhibit the disease activity of patients with AS.