雷公藤多苷治疗类风湿关节炎急性期的疗效及对患者临床症状和实验室指标的影响

Effect of Tripterygium Wilfordii Polyglycosides on Clinical Symptoms and Laboratory Indexes of Patients with Rheumatoid Arthritis in Acute Stage

目的探讨雷公藤多苷片治疗类风湿关节炎急性期的疗效及对患者临床症状和实验室指标的影响。方法予以随机数字表法将86例2019年9月—2022年3月该院收治的类风湿关节炎急性期患者分为对照组和治疗组,各43例。对照组给予甲氨蝶呤片口服,治疗组在对照组基础上加服雷公藤多苷片,两组均持续治疗12周。比较两组治疗12周后的疗效,治疗前、治疗12周后的临床症状改善情况、关节功能、免疫功能、血清炎性因子水平及治疗期间的安全性。结果治疗组治疗12周后的总有效率高于对照组[93.02%(40/43)vs 76.74%(33/43),P<0.05]。与治疗前比较,治疗12周后,两组晨僵时间均缩短,治疗组短于对照组(P<0.05);两组关节肿胀数目、关节压痛数目均减少,治疗组少于对照组(P<0.05);两组关节压痛程度评分、关节肿胀指数、28关节疾病活动指数(DAS28)评分及血清免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、淀粉样蛋白A(SAA)、高迁移率族蛋白1(HMGB1)、白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)水平均降低,治疗组低于对照组差异有统计学意义(P<0.05)。治疗期间,对照组总不良反应发生率为18.60%(8/43),治疗组总不良反应发生率为13.95%(6/43),两组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论雷公藤多苷片可明显改善类风湿关节炎急性期患者关节功能,并可调节机体实验室指标水平,改善免疫功能,减轻炎症反应,进而有助于促进患者临床症状的改善,提高疗效,且具有良好的安全性。

Objective To investigate the effect of tripterygium wilfordii polyglycosides on the clinical symptoms and laboratory indexes of patients with rheumatoid arthritis in the acute stage.Methods Eighty-six patients with rheumatoid arthritis in the acute stage admitted to the hospital from September 2019 to March 2022 were divided into the control group and the treatment group by random number table method,with 43 patients in each group.The control group was given methotrexate tablets orally,and the treatment group was given tripterygium wilfordii polyglycosides tablets on the basis of the control group.Both groups were treated for 12 weeks.The efficacy after 12 weeks of treatment,the improvement of clinical symptoms,joint function,immune function and serum levels of inflammatory factor before and after 12 weeks of treatment,and the safety during treatment were compared of the two groups.Results The total effective rate of the treatment group after 12 weeks of treatment was higher than that of the control group[93.02%(40/43)vs 76.74%(33/43),P<0.05].Compared with that before treatment,after 12 weeks of treatment,the time of morning stiffness of both groups shortened,and that of the treatment group was shorter than that of the control group(P<0.05).The number of joint swelling and joint tenderness in both groups decreased,and the number of the treatment group was less than that in the control group(P<0.05).The scores of joint tenderness score,joint swelling index,28 joint disease activity index score(DAS28)and serum levels of immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM),amyloid A(SAA),high mobility group 1(HMGB1),interleukin-8(IL-8)and interleukin-1β(IL-1β)in both groups decreased,and those in the treatment group were lower than those in the control group(P<0.05).During treatment,the total incidence of adverse reactions in the control group was 18.60%(8/43),and that in the treatment group was 13.95%(6/43).There was no difference between the two groups(P>0.05).Conclusion Tripterygium wilfordii polyglycoside tablets could significantly improve the joint function of patients with rheumatoid arthritis at the acute stage,and could adjust the levels of body laboratory indicators,improve the immune function and reduce the inflammatory reaction,thereby helping to improve the clinical symptoms of patients and the efficacy with higher safety.