昆仙胶囊治疗类风湿关节炎的临床研究
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摘要
目的比较昆仙胶囊(KUN XIAN)与来氟米特(Leflunomide, LEF)单药治疗类风湿关节炎(rheumatiod arthritis, RA)患者的临床疗效。方法选取RA患者80例,随机分为KUAN XIAN组(50例)和LEF组(30例)。分别于第0、4、12周比较两组的临床指标,包括红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein, CRP)、类风湿因子(rheumatoid factor, RF)、抗环瓜氨酸抗体(anti-cyclic citrullinated peptide antibody, CCP);同时监测疾病活动度,包括28个关节疾病活动度评分(disease activityscore28,DAS28)、疼痛视觉模拟评分(visualanaloguescore,VAS)及健康评估问卷(healthassessmentquestionnaire, HAQ)。结果 KUN XIAN组在治疗4周后,ESR、CRP、 DAS28、VAS及HAQ评分均较治疗前明显下降,而LEF组则在治疗12周后有显著下降。且在治疗12周后KUN XIAN组ESR、CRP及DAS28水平均明显低于LEF组,而两组的VAS及HAQ评分无显著差异。在治疗12周时,两组的RF及CCP水平均较治疗前显著下降,但两组之间无差异。结论 KUN XIAN治疗RA疗效优于LEF,且起效快。
Objective To compare the clinical efficacy of KUN XIAN with Leflunomide(LEF) in the treatment of rheumatoid arthritis(RA) patients. Methods Eighty patients with RA were randomly divided into KUN XIAN group(50)and LEF group(30). The clinical symptoms, erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), rheumatoid factor(RF), anti-cyclic citrullinated peptide antibody(CCP), disease activity score 28(DAS28), visual analogue score(VAS)and health assessment questionnaire(HAQ) scores of the two groups were determined at the 0, 4 th and 12 th week respectively. Results The values of ESR, CRP, DAS28, VAS and HAQ score were decreased in KUN XIAN group 4 weeks after treatment, and also decreased in LEF group 12 weeks after treatment. The levels of ESR, CRP and DAS28 were decreased more obviously in KUN XIAN group than in LEF group. Furthermore, the values of RF and CCP in both groups were decreased significantly. Conclusion KUN XIAN is superior and faster for the treatment of RA compared to LEF.
Objective To compare the clinical efficacy of KUN XIAN with Leflunomide(LEF) in the treatment of rheumatoid arthritis(RA) patients. Methods Eighty patients with RA were randomly divided into KUN XIAN group(50)and LEF group(30). The clinical symptoms, erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), rheumatoid factor(RF), anti-cyclic citrullinated peptide antibody(CCP), disease activity score 28(DAS28), visual analogue score(VAS)and health assessment questionnaire(HAQ) scores of the two groups were determined at the 0, 4 th and 12 th week respectively. Results The values of ESR, CRP, DAS28, VAS and HAQ score were decreased in KUN XIAN group 4 weeks after treatment, and also decreased in LEF group 12 weeks after treatment. The levels of ESR, CRP and DAS28 were decreased more obviously in KUN XIAN group than in LEF group. Furthermore, the values of RF and CCP in both groups were decreased significantly. Conclusion KUN XIAN is superior and faster for the treatment of RA compared to LEF.
引文
[1]中华医学会风湿病学分会.类风湿关节炎诊治指南[J].现代实用医学,2004,16(3):184-188.
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[17]高建华,张剑勇,何伟珍,等.昆仙胶囊对狼疮鼠外周血IL-10、TNF-α表达的影响[J].河北中医药学报,2011,26(2):8,36.
[18]林昌松,王笑丹,徐强,等.昆仙胶囊对胶原诱导关节炎大鼠滑膜组织IL-8及IP-10mRNA表达的影响[J].新中医,2012,44(5):144-146.
[19]林昌松,王笑丹,徐强,等.昆仙胶囊联合甲氨蝶呤治疗类风湿关节炎疗效观察[J].陕西中医,2010,31(8):987-990.
[20]何伟珍,曾惠琼,孔卫红,等.依那西普联合昆仙胶囊治疗老年类风湿关节炎的临床观察[C].全国第十二届中西医结合风湿病学术会议,2014.
[2]陈婷,李海坚,麦伟民.昆仙胶囊联合强的松治疗难治性肾病综合征的临床观察[J].中药药理与临床,2011,27(6):97-99.
[3]高明利,李晓晨,齐庆.昆仙胶囊降低狼疮性肾炎尿蛋白的临床观察[J].中药材,2010,33(4):651-652.
[4]林昌松,刘明岭,徐强,等.昆仙胶囊治疗强直性脊柱炎疗效观察[J].新医学,2011,42(3):175-178.
[5]路杰,许勇芝,唐德燊.昆仙胶囊联合甲氨蝶呤治疗老年类风湿关节炎有效性和安全性研究[J].中药材,2011,34(5):835-837.
[6]姜兆荣,高明利,刘岩岩.昆仙胶囊治疗活动期类风湿关节炎临床观察[J].光明中医,2015,30(2):279-281.
[7]Arnett FC,Edworthy SM,Bloch DA,et al.The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J].Arthritis Rheum,1988,31(3):315-324.
[8]张丽,崔美英,丁露露,等.汉防己甲素联合来氟米特治疗类风湿关节炎的临床研究[J].解剖科学进展,2018,24(1):69-71,75.
[9]中华医学会风湿病学分会.2018中国类风湿关节炎诊疗指南[J].临床医学研究与实践,2018,3(12):201.
[10]Moon SJ,Hong YS,Ju JH,et al.Increased levels of interleukin 34in serum and synovial fluid are associated with rheumatoid factor and anticyclic citrullinated peptide antibody titers in patients with rheumatoid arthritis[J].J Rheumatol,2013,40(11):1842-1849.
[11]Tian Y,Shen H,Xia L,et al.Elevated serum and synovial fluid levels of interleukin-34 in rheumatoid arthritis:possible association with disease progression via interleukin-17production[J].J Interferon Cytokine Res,2013,33(7):398-401.
[12]Zhang L,Cui M,Ding L,et al.Interleukin-34 aggravates the severity of arthritis in collagen-induced arthritis mice by inducing interleukin-17 production[J].J Interferon Cytokine Res,2018,38(5):221-225.
[13]林昌松,杨岫岩,戴冽,等.昆仙胶囊治疗类风湿关节炎多中心临床研究[J].中国中西医结合杂志,2011,31(6):769-774.
[14]马慧萍,贾正平,葛欣,等.淫羊藿总黄酮抗大鼠实验性骨质疏松作用研究[J].华西药学杂志,2002,17(3):163-167.
[15]Kusunoki N,Yamazaki R,Kitasato H,et al.Triptolide,an active compound identified in a traditional Chinese herb,induces apoptosis of rheumatoid synovial fibroblasts[J].BMC Pharmacol,2004,4(1):1-2.
[16]汤勇,展鸿谋.昆明山海棠的免疫抑制机理研究进展[J].云南医药,2005,26(3):289-291.
[17]高建华,张剑勇,何伟珍,等.昆仙胶囊对狼疮鼠外周血IL-10、TNF-α表达的影响[J].河北中医药学报,2011,26(2):8,36.
[18]林昌松,王笑丹,徐强,等.昆仙胶囊对胶原诱导关节炎大鼠滑膜组织IL-8及IP-10mRNA表达的影响[J].新中医,2012,44(5):144-146.
[19]林昌松,王笑丹,徐强,等.昆仙胶囊联合甲氨蝶呤治疗类风湿关节炎疗效观察[J].陕西中医,2010,31(8):987-990.
[20]何伟珍,曾惠琼,孔卫红,等.依那西普联合昆仙胶囊治疗老年类风湿关节炎的临床观察[C].全国第十二届中西医结合风湿病学术会议,2014.