风湿骨痛片联合羟氯喹治疗类风湿关节炎的临床研究
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摘要
目的探讨风湿骨痛片联合羟氯喹治疗类风湿关节炎患者的临床效果。方法选取2017年3月—2018年3月重庆市开州区人民医院收治的类风湿关节炎患者155例,随机分成对照组(77例)和治疗组(78例)。对照组口服硫酸羟氯喹片,2片/次,2次/d;治疗组患者在对照组基础上口服风湿骨痛片,2片/次,2次/d。两组患者均连续治疗3个月。观察两组患者临床疗效,同时比较治疗前后两组患者血清类风湿因子(RF)、白介素-17(IL-17)和转化生长因子β(TGF-β)水平及HAQ、DAS28评分、症状积分和不良反应情况。结果治疗后,对照组临床总有效率为85.71%,显著低于治疗组的96.15%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血清RF、IL-17、TGF-β水平显著降低(P<0.05),且治疗组患者血清RF、IL-17、TGF-β水平显著低于对照组(P<0.05)。治疗后,两组患者HAQ评分、DAS28评分及症状积分显著降低(P<0.05),且治疗组患者上述评分显著低于对照组(P<0.05)。治疗期间,对照组患者药物不良反应发生率为16.88%,显著高于治疗组的5.13%(P<0.05)。结论风湿骨痛片联合羟氯喹治疗类风湿关节炎疗效好,安全性高,可显著改善患者生活质量,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Fengshi Gutong Tablets combined with hydroxychloroquine in treatment of rheumatoid arthritis. Methods Patients(155 cases) with rheumatoid arthritis in the People's Hospital of Kaizhou District, CQ from March 2017 to March 2018 were randomly divided into control(77 cases) and treatment(78 cases) groups. Patients in the control group were po administered with Hydroxychloroquine Sulfate Tablets, 2 tablets/time, twice daily. Patients in the treatment group were po administered with Fengshi Gutong Tablets on the basis of the control group, 2 tablets/time, twice daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and the serum levels of RF, IL-17 and TGF-β, HAQ scores,DAS28 scores, symptom scores and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 85.71%, which was significantly lower than 96.15% in the treatment group,and there were differences between two groups(P < 0.05). After treatment, the serum levels of RF, IL-17 and TGF-β in two groups were significantly decreased(P < 0.05), and which in the treatment group were significantly lower than those in the control group(P <0.05). After treatment, the HAQ scores, DAS28 scores, symptom scores in two groups were significantly decreased(P < 0.05), and these scores in the treatment group were significantly lower than those in the control group(P < 0.05). During the treatment, the adverse reactions rate in the control group was 16.88%, which was significantly higher than 5.13% in treatment the group(P < 0.05).Conclusion Fengshi Gutong Tablets combined with hydroxychloroquine has good curative effect and high safety in treatment of rheumatoid arthritis, can significantly improve the quality of life, and which has a certain clinical application value.
Objective To investigate the clinical efficacy of Fengshi Gutong Tablets combined with hydroxychloroquine in treatment of rheumatoid arthritis. Methods Patients(155 cases) with rheumatoid arthritis in the People's Hospital of Kaizhou District, CQ from March 2017 to March 2018 were randomly divided into control(77 cases) and treatment(78 cases) groups. Patients in the control group were po administered with Hydroxychloroquine Sulfate Tablets, 2 tablets/time, twice daily. Patients in the treatment group were po administered with Fengshi Gutong Tablets on the basis of the control group, 2 tablets/time, twice daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and the serum levels of RF, IL-17 and TGF-β, HAQ scores,DAS28 scores, symptom scores and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 85.71%, which was significantly lower than 96.15% in the treatment group,and there were differences between two groups(P < 0.05). After treatment, the serum levels of RF, IL-17 and TGF-β in two groups were significantly decreased(P < 0.05), and which in the treatment group were significantly lower than those in the control group(P <0.05). After treatment, the HAQ scores, DAS28 scores, symptom scores in two groups were significantly decreased(P < 0.05), and these scores in the treatment group were significantly lower than those in the control group(P < 0.05). During the treatment, the adverse reactions rate in the control group was 16.88%, which was significantly higher than 5.13% in treatment the group(P < 0.05).Conclusion Fengshi Gutong Tablets combined with hydroxychloroquine has good curative effect and high safety in treatment of rheumatoid arthritis, can significantly improve the quality of life, and which has a certain clinical application value.
引文
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[11]国家风湿病数据中心及CSTAR专家共识组.羟氯喹治疗风湿性疾病专家共识[J].中华风湿病学杂志,2014,18(3):148-150.
[12]代华贵.类风湿因子检测的临床应用[J].当代医药论丛,2011,9(2):30.
[13]徐雪,吕玲.白细胞介素-17与类风湿关节炎[J].中华风湿病学杂志,2008,12(10):719-721.
[14]王娅南,杨林,孙天英.转化生长因子-β1与类风湿性关节炎[J].华北理工大学学报:医学版,2006,8(4):459-462.
[2]磨红,马宗伯,吴成龙.类风湿关节炎治疗研究进展[J].内科,2017,12(3):334-337.
[3]张江林,黄烽.羟氯喹的药理作用及在风湿性疾病中的应用[J].解放军药学学报,2000,16(2):85-88.
[4]侯景伦,张北北,曹子青.风湿骨痛宁胶囊药效学实验研究[J].中成药,1995,17(10):27-28.
[5]中华医学会风湿病学分会.类风湿关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(4):265-270.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:115-119.
[7]Bruce B,Fries J F.The Health Assessment Questionnaire(HAQ)[J].Clin Exp Rheumatol,2005,23(5 Suppl 39):S14-S18.
[8]Piet LCM van Riel,Fransen J.DAS28:a useful instrument to monitor infliximab treatment in patients with rheumatoid arthritis[J].Arthritis Res Ther,2005,7(5):189-190.
[9]张亦军,赛佳明.类风湿关节炎危险因素研究进展[J].齐鲁医学杂志,2007,22(6):556-557,560.
[10]许相洋,张文州.类风湿关节炎的诊断及其药物治疗研究进展[J].中国医药导报,2016,13(30):56-59.
[11]国家风湿病数据中心及CSTAR专家共识组.羟氯喹治疗风湿性疾病专家共识[J].中华风湿病学杂志,2014,18(3):148-150.
[12]代华贵.类风湿因子检测的临床应用[J].当代医药论丛,2011,9(2):30.
[13]徐雪,吕玲.白细胞介素-17与类风湿关节炎[J].中华风湿病学杂志,2008,12(10):719-721.
[14]王娅南,杨林,孙天英.转化生长因子-β1与类风湿性关节炎[J].华北理工大学学报:医学版,2006,8(4):459-462.