云克联合白芍总苷治疗类风湿关节炎的临床研究

Clinical research of Tc-MDP combined with total glucosides of paeony on rheumatoid arthritis

目的观察云克(99Tc-MDP)联合白芍总苷治疗类风湿关节炎的临床疗效及辅助检测指标的变化。方法选取2017年3月至2019年3月该院中西医结合科住院57例类风湿关节炎患者随机分为观察组30例和对照组27例。观察组采用99Tc-MDP联合白芍总苷治疗,对照组采用甲氨蝶呤联合羟氯喹治疗。观察治疗前、后类风湿关节炎疾病活动性评分(DAS28评分)改善程度、按美国风湿病学会(ACR)类风湿关节炎疗效标准ACR50和ACR70达标率,以及红细胞沉降率、C-反应蛋白、类风湿因子、抗环瓜氨酸肽抗体、骨密度变化。结果两组患者治疗后DAS28评分改善程度、红细胞沉降率、C-反应蛋白、类风湿因子、抗环瓜氨酸肽抗体、骨密度均较治疗前有明显改善,差异有统计学意义(P<0.05);观察组治疗后骨密度、抗环瓜氨酸肽抗体优于对照组,差异有统计学意义(P<0.05);观察组治疗后ACR70达标率优于对照组,差异有统计学意义(P<0.05);观察组治疗后不良反应发生情况与对照组比较,差异有统计学意义(P<0.05)。结论 99Tc-MDP联合白芍总苷可明显改善类风湿关节炎临床症状和辅助检查指标,安全性高。

Objective To observe the clinical efficacy of 99Tc-MDP combined with total paeony glucosides in the treatment of rheumatoid arthritis and the changes of trauxiliary examination indexes.Methods From March 2017 to March 2019,57 patients were admitted to the department of traditional Chinese and western medicine of a hospital.A total of 30 patients with rheumatoid arthritis were randomly divided into observation group(30 cases)and control group(27 cases).The observation group was treated with 99Tc-MDP combined with total glucosides of paeony,while the control group was treated with methotrexate combined with hydroxychloroquine.The improvement of DAS28 score,according to the American College of Rheumatogy(ACR)rheumatoid arthritis efficacy standard ACR50 and ACR70 standard-reaching rate,erythrocyte sedimentation rate,C-reactive protein,rheumatoid factor,anti-cyclic citrullinated peptide antibody and bone mineral density before and after treatment were observed.Results The improvement of DAS28 score,erythrocyte sedimentation rate,C-reactive protein,rheumatoid factor,anti-cyclic citrullinated peptide antibody and bone mineral density in the two groups after treatment were significantly improved compared with those before treatment,and the difference was statistically significant(P<0.05).After treatment,observation group bone mineral density and anti-cyclic cltrullinated peptide antibody were better than the control group,and the difference was statistically significant(P <0.05).After treatment,the ACR70 compliance rate of observation group was better than the control group,and the difference was statistically significant(P<0.05).The occurrence of adverse reactions after treatment in the observation group was statistically significant compared with that in the control group(P<0.05).Conclusion 99Tc-MDP combined with total glucosides of paeony can significantly improve the clinical symptoms and auxiliary examination indicators of rheumatoid arthritis,with high safety.