雷公藤多苷治疗类风湿关节炎肺间质病变的临床研究

发布时间：2018-01-30 06:42

本文关键词： 雷公藤多苷类风湿关节炎肺间质病变临床研究　出处：《中华中医药学刊》2017年07期 　论文类型：期刊论文

【摘要】：目的:对雷公藤多苷治疗类风湿关节炎肺间质病变(RA-ILD)的临床疗效及安全性进行评价。方法:选取符合诊断条件的RA-ILD患者80例,按随机数字表法分为治疗组和对照组。对照组以甲氨蝶呤片为主,12.5 mg/次,每周1次,口服;治疗组在对照组治疗的基础上,联合雷公藤多苷20 mg/次,每日3次,口服。两组观察疗程均为6个月。观察两组治疗前后RA-ILD患者症状、实验室炎症指标、动脉血气分析、肺高分辨CT(HRCT)、肺功能等诸方面的变化。结果:两组临床疗效比较:对照组总有效率为69.3%,治疗组总有效率为87.8%(P0.05)。主要炎症指标方面,两组治疗后ESR、CRP、RF等指标较治疗前均有明显改善(P0.05或P0.01),疗后比较治疗组明显优于对照组(P0.05)。两组治疗后肺部HRCT积分及血气分析结果较疗前均改善,但治疗组变化较显著(P0.05);而两组肺功能结果前后也有差异,而且治疗组优于对照组,但无统计学意义(P0.05)。结论:雷公藤多苷能明显改善RA-ILD患者的临床症状,减轻肺间质病变程度,从而提高患者的生存质量。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of tripterygium wilfordii polyglycoside in the treatment of rheumatoid arthritis with pulmonary interstitial lesion (RA-ILD). Methods: 80 patients with RA-ILD were selected. The patients in the control group were divided into two groups: the control group was treated with methotrexate and the control group was treated with methotrexate (12.5 mg / time) once a week. The treatment group was treated with tripterygium wilfordii 20 mg / time, 3 times a day, oral. The course of treatment was 6 months. The symptoms of patients with RA-ILD were observed before and after treatment. Laboratory inflammation, arterial blood gas analysis, lung high-resolution CTT HRCTU, pulmonary function and other changes. Results: two groups of clinical efficacy comparison: the total effective rate of the control group was 69.3%. The total effective rate of the treatment group was 87.8%. RF and other indicators were significantly improved than before treatment P0.05 or P0.01). The results of pulmonary HRCT score and blood gas analysis in the two groups were improved after treatment, but the changes in the treatment group were more significant than those in the control group. The pulmonary function of the two groups before and after the difference, and the treatment group is better than the control group, but there is no statistical significance of P0.050.Conclusion: Tripterygium wilfordii polyglycoside can significantly improve the clinical symptoms of patients with RA-ILD. Reduce the extent of pulmonary interstitial lesions, thereby improving the quality of life of patients.
【作者单位】：河南中医药大学第一附属医院风湿科;
【基金】：国家自然科学基金项目(81573952) 河南省中医药科学研究专项项目(2014ZY02028)
【分类号】：R259
【正文快照】： 类风湿关节炎(Rheumatoid arthritis,RA)是一种以周围关节病变为主的自身免疫性疾病,除了关节表现外,还容易引起内脏的损伤,其中肺间质病变(Interstitial Lung Dis-ease,ILD)是RA肺部受累最常见的表现形式[1]。文献报道约有11%~20.6%的类风湿关节炎患者可伴有肺间质的病变[2-3

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