文章摘要
吴佳,梁翼,李敏,等.艾拉莫德联合甲氨蝶呤、雷公藤多苷对类风湿关节炎关节软骨细胞损伤的修复作用及安全性分析[J].安徽医药,2022,26(1):183-187.
艾拉莫德联合甲氨蝶呤、雷公藤多苷对类风湿关节炎关节软骨细胞损伤的修复作用及安全性分析
Repair effect of iguratimod combined with methotrexate and tripterygium on articular chondrocyte injury in patients with rheumatoid arthritis and safety analysis
  
DOI:10.3969/j.issn.1009-6469.2022.01.043
中文关键词: 关节炎,类风湿  艾拉莫德  甲氨蝶呤  雷公藤多苷
英文关键词: Arthritis, rheumatoid  Iguratimod  Methotrexate  Tripterygium
基金项目:
作者单位E-mail
吴佳 四川省骨科医院风湿骨关节病科四川成都 610000  
梁翼 四川省骨科医院风湿骨关节病科四川成都 610000 332449942@qq.com 
李敏 四川省骨科医院风湿骨关节病科四川成都 610000  
沙湖 四川省骨科医院风湿骨关节病科四川成都 610000  
王翠平 四川省骨科医院风湿骨关节病科四川成都 610000  
王磊 四川省骨科医院风湿骨关节病科四川成都 610000  
许静 四川省骨科医院风湿骨关节病科四川成都 610000  
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中文摘要:
      目的分析艾拉莫德联合甲氨蝶呤、雷公藤多苷对类风湿关节炎( RA)病人关节软骨细胞损伤的修复作用及安全性。方法选取四川省骨科医院 2016年 5月至 2018年 5月期间收治的活动期 RA病人 116例,按随机数表法分为观察组和对照组,各 58例。对照组给予甲氨蝶呤、雷公藤多苷治疗,观察组在对照组的基础上加用艾拉莫德治疗,持续治疗 18周。比较两组病人治疗前后 28关节疾病活动指数( DAS28)评分、美国风湿病学会疗效评价指标( ACR20)缓解率、 ACR50缓解率、晨僵时间、血清相关因子、骨代谢指标变化情况,并记录治疗过程中两组病人不良反应发生情况。结果治疗 18周后,观察组病人的关节肿胀数、关节压痛数、晨僵时间、 C反应蛋白( CRP)、血沉( ESR)、类风湿因子( RF)、白介-1β(IL-1β)、 IL-6、IL-8、水平均低于对照组( P<0.05)观察组的 DAS28评分( 2.18±0.51)分、环氧合酶 2(COX-2)(10.51±
英文摘要:
      Objective To analyze the repair effect of iguratimod combined with methotrexate and tripterygium on articular chondro-cyte injury in patients with rheumatoid arthritis (RA) and safety.Methods A total of 116 RA patients during active stage who were ad-mitted to the Sichuan Orthopedic Hospital from May 2016 to May 2018 were enrolled. They were divided into observation group andcontrol group according to random number table method, with 58 cases in each group. The control group was treated with methotrexateand tripterygium. On the basis of the control group, the observation group was additionally treated with iguratimod. They were continu-ously treated for 18 weeks. The changes in the 28-joint Disease Activity Score (DAS28), remission rates of the American College ofRheumatology 20% improvement criteria (ACR20) and ACR50, morning stiffness time, serum related factors and bone metabolism in-dexes before and after treatment were compared between the two groups. The occurrence of adverse reactions in both groups in the treat-ment process was recorded.Results After 18 weeks of treatment, joint swelling count, joint tenderness count, morning stiffness time, levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), , , rheumatoid factor (RF), interleukin-1β (IL-1β), IL-6, IL-8 and in the observation group were significantly lower than those in the control group (P<0.05). The DAS28 score, levels of cyclooxygen-ase 2 (COX-2) and macrophage colony-stimulating factor (M-CSF), tumor necrosis factor-α (TNF-α) in the observation group were(2.18±0.51) point,(10.51±2.39) pg/mL, (0.78±0.16)ng/mL, (4.21±0.31) pg/mL, respectively, which were significantly lower than those inthe control group [(3.58±0.84) point, (14.25±2.61) pg/mL, (1.04±0.25) ng/mL, (6.83±0.64) pg/mL ] (P<0.05), while the remission rate ofACR 20, remission rate of ACR 50 in the observation group were 77.59% (45/58), 46.55% (27/58), significantly higher than those inthe control group [53.45% (31/58), 27.59% (16/58)] (P<0.05). There was no significant difference in the incidence of adverse reactionsduring treatment between the observation group and the control group [10.34% (6/58) vs. 12.07% (7/58)] (P>0.05).Conclusion Igura-timod combined with methotrexate and tripterygium can effectively relieve joint pain and clinical symptoms of PA patients, improvebone metabolism status, repair articular chondrocyte injury, without increasing adverse reactions.
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