| 郑红霞,汪卫,王圳,陶筱娟,于健宁,张雯,刘林昌,郑敏威.白芍总苷联合甲氨蝶呤、羟氯喹维持性治疗类风湿关节炎疗效及关节超声评价[J].浙江中西医结合杂志,2018,28(11): |
| 白芍总苷联合甲氨蝶呤、羟氯喹维持性治疗类风湿关节炎疗效及关节超声评价 |
| Total glucoside of paeony combined with methotrexate and hydroxychloroquine in the maintenance treatment of rheumatoid arthritis and the evaluation of joint ultrasound |
| 投稿时间：2018-04-22 修订日期：2018-05-30 |
| DOI： |
| 中文关键词: 类风湿关节炎 白芍总苷 超声评价 DAS28CRP |
| 英文关键词:rheumatoid arthritis,total glucosides of paeony,ultrasound, DAS28CRP |
| 基金项目:杭州市医学重点专科专病项目（项目编号：20150733Q43） |
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| 中文摘要: |
| 目的 白芍总苷联合甲氨蝶呤、羟氯喹维持性治疗类风湿关节炎疗效及关节超声评价。方法 将82例活动期RA患者随机分为对照组、治疗组。两组患者基础用药相同,甲氨蝶呤片15mg每周一次,羟氯喹0.2g 每日二次。治疗组同时联用白芍总苷0.6g 每日三次,观察周期48周。入组开始可以根据疾病活动性情况调整西乐葆胶囊用量诱导缓解关节炎症,使用24周停用。12周后定期评估患者,如果DAS28CRP评分≥2.7,病例退组。分别在0、12、24、48周对两组患者进行疾病活动性得分DAS28CRP和手关节超声评价。并记录不良反应。结果 终点完成病例数,对照组23例,治疗组29例。因DAS28CRP评分≥2.7而退组病例,24至48周(不包括24周)对照组10例,治疗组3例,退组病例有统计学差异, P<0.05。48周评估两组SJC、TCJ、PhGA及DAS28CRP无显著性差异,P＞0.05。而PGA、CRP治疗组较对照组下降,差异有统计学意义,P<0.05。两组临床缓解率对照组34.8%,治疗组48.3%,缓解率比较差异无统计学意义,P＞0.05。超声缓解率对照组4.3%,治疗组27.5%,差异有统计学意义,P<0.05。结论 白芍总苷联合甲氨蝶呤、羟氯喹不但在维持治疗RA患者方面有疗效,而且能够改善关节的超声影像学进展。 |
| 英文摘要: |
| Objective Total glucoside of paeony(TGP) combined with methotrexate(MTX) and hydroxychloroquine(HCQ) in the maintenance treatment of rheumatoid arthritis and the evaluation of joint ultrasound. Methods The 82 patients with active RA were randomly divided into control group and treatment group. The two groups of patients had the same basic drug use, and the MTX was 15mg once a week, and HCQ 0.2g twice a day. The treatment group was combined with 0.6g of TGP in three times a day for 48 weeks. In the beginning of the group, we can adjust the dosage of Celebrex capsule to alleviate the inflammation of the joints according to the activity of the disease, and use it for 24 weeks. Patients were assessed regularly after 12 weeks, if DAS28CRP score was greater than 2.7,Case withdrawal. Two groups of patients were evaluated with DAS28CRP and hand joint ultrasound in 0, 12, 24 and 48 weeks respectively. And record adverse reactions. Results The number of cases was completed, 23 cases in the control group and 29 cases in the treatment group. In the case of DAS28CRP score greater than or equal to 2.7, there were 10 cases in the control group from 24 to 48 weeks (excluding 24 weeks), 3 cases in the treatment group, and statistically significant differences in the withdrawal group, P<0.05. There was no significant difference between the two groups of SJC, TCJ, PhGA and DAS28CRP in 48 weeks,P > 0.05.Compared with the control group, PGA and CRP treatment group decreased, and the difference was statistically significant, P<0.05. The clinical remission rate of the two groups was 34.8% in the control group, 48.3% in the treatment group, and there was no statistically significant difference in the remission rate, P > 0.05. The ultrasonic remission rate, the control group was 4.3%, the treatment group was 27.5%, the difference was statistically significant, P<0.05. Conclusion TGP Combined with MTX and HCQ, it is not only effective in maintaining the treatment of RA patients, but also better than the combination of two drugs in improving the ultrasonic imaging of the joint. |
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