雷公藤多苷片联合塞来昔布治疗活动期湿热痹阻证类风湿性关节炎临床疗效观察

Clinical observation on Tripterygium wilfordii Polyglycosides Tablets combined with celecoxib on rheumatoid arthritis with damp-heat obstruction syndrome in active stage

目的 观察雷公藤多苷片联合塞来昔布对活动期湿热痹阻证类风湿性关节炎(RA)临床疗效。方法 将我院60例活动期湿热痹阻证RA患者随机分西药组与中西医结合组各30例。西药组口服塞来昔布,中西医结合组口服雷公藤多苷片联合塞来昔布。对比分析两组总疗效,晨僵时间、关节压痛数、关节肿胀数、健康评估问卷-残疾指数(HAQ-DI)、28关节疾病活动指数(DSA28)评分,类风湿因子(RF)、血沉(ESR)、C反应蛋白(CRP)、抗环瓜氨酸肽抗体(CCP-AB)、免疫球蛋白G(IgG)、淀粉样蛋白A(SAA)水平。结果治疗后,中西医结合组总有效率显著高于西药组(P<0.05);两组晨僵时间、关节压痛数、关节肿胀数、HAQ-DI评分、DSA28评分、RF、ESR、CRP、CCP-AB、IgG、SAA水平均较治疗前减少,中西医结合组IgG水平较治疗前减少(P<0.05),且中西医结合组上述指标水平均低于西药组(P<0.05)。结论 雷公藤多苷片联合塞来昔布可显著改善活动期湿热痹阻证RA患者的症状,改善免疫炎症反应,疗效确切。

Objective To observe the clinical effect of Tripterygium wilfordii Poly glycosides Tablets combined with celecoxib on rheumatoid arthritis(RA) with damp-heat obstruction syndrome in active stage.Methods Sixty cases of RA patients with active damp-heat arthralgia syndrome were randomly divided into western medicine group and integrated traditional Chinese and western medicine group,30 cases in each group.Western medicine group was given oral celecoxib,and integrated traditional Chinese and western medicine group was given oral Tripterygium wilfordii Poly glycosides Tablets combined with celecoxib.The total efficacy,morning stiffness time,joint tenderness count, joint swelling count,health assessment questionnairedisability index(HAQ-DI),28 joint disease activity index(DSA28) scores, rheumatoid factor(RF) erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),anti-cyclic citrullinated peptide antibody(CCP-AB),immunoglobulin G(IgG),amyloid A(SAA) levels of the two groups was compared and analyzed.Results After treatment,the total effective rate of integrated traditional Chinese and western medicine group was significantly higher than that of western medicine group(P<0.05);the time of morning stiffness, joint tenderness, joint swelling,HAQ-DI score,DSA28 score,the levels of RF,ESR,CRP,CCP-AB and SAA were all decreased compared with those before treatment in both groups,and the level of IgG in integrative Chinese and western medicine group was decreased compared with that before treatment(P<0.05),and the above mdexes were lower in integrated traditional Chinese and western medicine group than in western medicine group(P<0.05).Conclusion Tripterygium wilfordii Polyglycosides Tablets combined with celecoxib can significantly improve the symptoms of RA patients with active damp-heat arthralgia syndrome and improve the immune inflammatory response with definite curative effect.