摘要
目的评价托法替布与甲氨蝶呤联合雷公藤多苷片治疗类风湿关节炎的临床效果。方法选取2022年8月至2024年6月于邢台市第一医院就诊的类风湿关节炎患者112例,按照随机数字表法分为观察组与对照组,各56例,对照组采用甲氨蝶呤(每次10 mg,每周1次)与雷公藤多苷片(每次2片,每日3次)治疗,观察组在对照组的基础上加用枸橼酸托法替布片(每次1片,每日2次)治疗,两组患者均持续治疗3个月。观察两组患者临床疗效,比较两组患者临床症状改善时间、治疗前后血清免疫因子[免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、类风湿因子(RF)]水平、炎症因子[血沉(ESR)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]水平、骨代谢指标[血清骨碱性磷酸酶(B-ALP)、Ⅰ型前胶原羧基端前肽含量(PICP)与骨钙素(BGP)]水平、治疗期间产生的不良反应。结果观察组总有效率96.43%(54/56)高于对照组85.71%(48/56)(χ^(2)=4.846,P<0.05)。治疗后,观察组晨僵时间、关节肿胀与压痛数量[分别为(28.73±5.72)min、(5.33±1.45)个、(6.64±1.59)个],少于对照组[分别为(37.05±6.39)min、(7.82±1.76)个、(8.90±1.85)个](t=7.259、8.171、6.933,均P<0.001)。治疗后,两组免疫因子IgG、IgM与RF水平均较治疗前下降,且观察组IgG、IgM与RF水平[分别为(9.67±2.48)g·L^(-1)、(1.41±0.25)g·L^(-1)、(70.63±20.24)U·mL^(-1)]均低于对照组[分别为(10.91±3.02)g·L^(-1)、(1.56±0.44)g·L^(-1)、(79.55±23.74)U·mL^(-1)](t=2.375、2.218、2.140,均P<0.05);治疗后,两组血清炎症因子ESR、CRP、IL-6与TNF-α水平较治疗前下降,且观察组ESR、CRP、IL-6与TNF-α水[分别为(26.62±5.35)mm·h^(-1)、(7.43±1.95)mg·L^(-1)、(9.48±2.71)ng·mL^(-1)、(26.32±5.22)ng·L^(-1)]均低于对照组[(34.38±6.04)mm·h^(-1)、(11.72±2.83)mg·L^(-1)、(14.42±3.17)ng·mL^(-1)、(33.47±6.51)ng·L^(-1)](t=7.197、9.341、8.864、6.412,均P<0.001);治疗后,两组骨代谢指标
Objective To evaluate the clinical efficacy of methotrexate and tofacitinib combined with tripterygium wilfordii polyglycosides in the treatment of rheumatoid arthritis.Methods A total of 112 patients with rheumatoid arthritis admitted to Xingtai First Hospital from August 2022 to June 2024 were selected and divided into an observation group and a control group according to the random number table method,with 56 in each group.The patients in the control group took methotrexate(10 mg/time,once a week)and tripterygium wilfordii polyglycosides tablets(two tablets/time,three times a day),and those in the observation group took tofacitinib citrate tablets(one tablet/time,twice a day)based on the regimen in the control group.All the patients in both groups received treatment for 3 months.The clinical efficacy,clinical symptom improvement time,serum immune factor(immunoglobulin G(IgG),immunoglobulin M(IgM),rheumatoid factor(RF)levels before and after treatment,inflammatory factor(erythrocyte sedimentation rate(ESR),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α))levels,bone metabolism index(serum bone alkaline phosphatase(B-ALP),type I procollagen carboxyl-terminal propeptide content(PICP)and osteocalcin(BGP))levels,and adverse reactions during treatment were determined and compared between the two groups.Results After treatment,the total effective rate in the observation group was 96.43%(54/56),which was higher than that of 85.71%(48/56))in the control(χ2=4.846,P<0.05).The duration of morning stiffness,number of joint swelling and tenderness in the observation group((28.73±5.72)min,(5.33±1.45)joints,(6.64±1.59)joints)were significantly lower than those in the control((37.05±6.39)min,(7.82±1.76)joints,8.90±1.85 joints)(t=7.259,8.171,6.933,all P<0.001).The levels of immune factors IgG,IgM and RF were significantly decreased after treatment,and their levels in the observation group((9.67±2.48)g·L^(-1),(1.41±0.25)g·L^(-1),(70.63±20.24)U·mL^(-1))were significantl
作者
王颖
董欣
赵相卓
王京旭
朱晓莉
Wang Ying;Dong Xin;Zhao Xiang-zhuo;Wang Jing-xu;Zhu Xiao-li(Department of Endocrinology and Nephrology,the First Affiliated Hospital of Xingtai Medical College,Xingtai First Hospital,Xingtai 054001,China;Department of Rheumatology,the First Affiliated Hospital of Xingtai Medical College,Xingtai First Hospital,Xingtai 054001,China;Department of Intensive Care Medicine,the First Affiliated Hospital of Xingtai Medical College,Xingtai First Hospital,Xingtai 054001,China)
出处
《中国药物应用与监测》
CAS
2024年第6期826-831,共6页
Chinese Journal of Drug Application and Monitoring
关键词
类风湿关节炎
甲氨蝶呤
托法替布
雷公藤多苷片
免疫功能
炎症因子
成骨细胞
Rheumatoid arthritis
Methotrexate
Tofacitinib
Tripterygium wilfordii polyglycoside tablet
Immune function
Inflammatory factor
Osteoblast
