雷公藤多苷联合甲氨蝶呤对强直性脊柱炎的疗效观察

Effect of Tripterygium wilfordii Glycosides Combined with Methotrexate on Ankylosing Spondylitis

目的:分析雷公藤多苷联合甲氨蝶呤对强直性脊柱炎的疗效。方法:选取2019年12月至2021年10月内蒙古包钢医院收治的强直性脊柱炎患者103例作为研究对象,按照随机数字表法分为对照组(n=45)和观察组(n=58),对照组给予口服甲氨蝶呤片治疗,观察组在对照组基础上联合雷公藤多苷治疗。比较2组患者临床疗效、晨僵时间、胸廓扩张范围、关节疼痛评分、红细胞沉降率(ESR)、血清超氧化物歧化酶(SOD)、Ⅰ-型胶原蛋白C末端多肽(CTX-Ⅰ)、血清C反应蛋白(CRP)、血小板计数(PLT)、血小板压积(PCT),以及不良反应发生情况。结果:治疗后,观察组总有效率高于对照组(P<0.05);观察组晨僵时间短于对照组,胸廓扩张范围大于对照组,关节疼痛评分低于对照组(均P<0.05);2组ESR、CRP水平均降低,且观察组低于对照组(均P<0.05);2组血清CTX-Ⅰ水平降低,SOD水平较升高,且观察组优于对照组(均P<0.05);2组PLT、PCT水平均降低,且观察组低于对照组,差异有统计学意义(均P<0.05);观察组药物不良反应(15.52%)与对照组不良反应(22.22%)总发生率差异无统计学意义(P>0.05)。结论:雷公藤多苷联合甲氨蝶呤治疗治疗强直性脊柱炎的临床疗效显著,联合用药对减轻机体炎症反应,改善临床症状,缓解病情进展安全有效。

Objective:To analyze the effect of Tripterygium wilfordii polyglycosides(TWP) combined with methotrexate on ankylosing spondylitis.Methods:A total of 103 ankylosing spondylitis patients who were treated in Baogang Hospital from December 2019 to October 2021 were randomized into the experimental group(n=58) and control group(n=45) with the random number table method.The control group was given Methotrexate Tablets(oral),and the experimental group Methotrexate Tablets(oral) and TWP.The clinical efficacy, duration of morning stiffness, chest expansion, joint pain score, erythrocyte sedimentation rate(ESR),serum superoxide dismutase(SOD),C-terminal telopeptide of type Ⅰ collagen(CTX-Ⅰ),serum C-reactive protein(CRP),platelet count(PLT),platelet hematocrit(PCT),and adverse reactions were recorded.Results:After treatment, the total effective rate of the experimental group was higher than that of the control group(P<0.05).The duration of morning stiffness in the experimental group was shorter than that in the control group(P<0.05) and chest expansion was larger than that in the control group(P<0.05).Moreover, the joint pain score was lower than that in the control group(P<0.05).After treatment, levels of ESR and CRP were lower than those before treatment in both groups(P<0.05) and lower in the experimental group than in the control group(P<0.05).Serum CTX-Ⅰ level was decreased and SOD level was increased in the two groups(P<0.05),particularly the experimental group which showed significant difference from the control group(P<0.05).Levels of PLT and PCT were lower than those before treatment in both groups(P<0.05) and lower in the experimental group than in the control group(P<0.05).The total incidence of adverse drug reactions in the experimental group(15.52%) was insignificantly different from that in the control group(22.22%)(P>0.05).Conclusion:The combination of TWP and methotrexate shows remarkable efficacy on ankylosing spondylitis, which alleviates the inflammatory response and clinical symptoms and delays the progression of the disease.