维生素D3联合雷公藤多甙治疗类风湿性关节炎疗效及对骨修复指标的影响

Curative efficacy of vitamin D3 in combination with tripterygium wilfordii polyglycoside in patients with rheumatoid arthritis and its influences on indices of bone restoration

目的:探讨维生素D3联合雷公藤多甙治疗类风湿性关节炎(RA)疗效及对患者骨修复指标的影响。方法:收集320例RA患者作为观察对象,随机分为对照组160例和观察组160例。对照组给予雷公藤多甙治疗,观察组在对照组基础上联合维生素D3治疗,疗程均为3个月。比较两组患者临床疗效、关节症状改善情况、实验室检查指标变化、骨修复指标及不良反应。结果:3个月后,RA临床疗效评价显示,观察组治疗总有效率明显高于对照组(P<0.05)。治疗后,与对照组相比,观察组关节疼痛指数、关节压痛指数、关节肿胀指数降低,实验室指标RF、ASO、CRP水平降低,组间比较差异均有统计学意义(P<0.05);修复指标显示,观察组患者治疗后血清破骨细胞生成因子(RNKL)水平低于对照组,护骨素(OPG)水平高于对照组,组间比较差异均有统计学意义(P<0.05);治疗过程中,对照组和观察组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:维生素D3联合雷公藤多甙治疗RA疗效良好,能够明显改善关节症状、实验室指标和骨修复指标,值得进一步研究。

Objective: To investigate the curative efficacy of vitamin D3 in combination with tripterygium wilfordii polyglycoside in patients with rheumatoid arthritis(RA) and its influences on indices of bone restoration. Methods: 320 patients with RA were collected as observation objects to be randomly divided into the control group and the observation group with 160 cases in each group. The control group was given treatment of tripterygium wilfordii polyglycoside, while the observation group was given treatment of vitamin D3 in combination with tripterygium wilfordii polyglycoside. All patients received a course treatment with 3 months. The curative efficacy, improvement of joint symptoms, changes of laboratory tests, indices of bone restoration and adverse reactions were compared. Results: After 3 months, assessment of curative efficacy showed that the observation group had a total curative efficiency ratio of 90.6%, which was significantly higher than that of 81.2% in the control group(P<0.05). Among the indices which reflect the improvement of joint symptoms, the joint pain index, joint tenderness index and joint swollenness index were statistically reduced in the observation group than those in the control group(all P<0.05). And after treatment, in comparison with the control group, indices of laboratory tests of rheumatoid factor(RF), antistreptolyisn O antibody(ASO), c-reactive protein(CRP) were statistically lower respectively(all P<0.05) in the observation group. As to indices of bone restoration after treatment, the observation group had statistically lower serum level of receptor activator of nf-kb ligand(RNKL) and higher level of osteoprotegerin(OPG) than those in the control group(both P<0.05). During the treatment, incidences of adverse reactions in the control group and the observation group were statistically same(19.4% vs 21.2%, P>0.05). Conclusion: Vitamin D3 in combination with tripterygium wilfordii polyglycoside has well curative efficacy in patients with RA, which can significantly improve joint symptoms, indices of laboratory tests and bone restoration.