摘要
目的评价乌头汤联合甲氨蝶呤治疗早期中高疾病活动度类风湿关节炎(rheumatoid arthritis, RA)的疗效。方法回顾性纳入2015年7月-2017年6月上海市光华中西医结合医院224例接受乌头汤联合甲氨蝶呤与单纯甲氨蝶呤治疗12周的早期中高疾病活动度RA患者,按治疗方法分为联合组131例和甲氨蝶呤组93例。检测治疗前及治疗后4、8、12周的CRP、ESR水平,采用28个关节活动评分(Disease Activity Score in 28 Joints, DAS28)和健康评估问卷(Health Assessment Questionnaire, HAQ)评估疾病活动度与生活质量,并根据DAS28的改善程度计算临床缓解率和低疾病活动度(low disease activity, LDA)患者比例,评价临床疗效。结果治疗后8、12周,联合用药组CRP(t值分别为2.100、2.488),ESR(t值分别为2.130、2.777)水平及DAS28(t值分别为2.886、3.718)、HAQ(t值分别为2.144、2.362)评分均低于甲氨蝶呤组(P<0.05或P<0.01)。治疗后12周,联合用药组临床缓解率[12.2%(16/131)比4.3%(4/93);χ^2=4.188,P=0.041]与LDA患者比例[38.9% (51/131)比25.8%(24/93);χ^2=4.207,P=0.040]均高于甲氨蝶呤组;联合用药组临床显效率治疗后8周[37.4%(49/131)比21.5%(20/93);χ^2=6.450,P=0.011]、12周[72.5%(95/131)比52.7%(49/93);χ^2=9.316,P=0.002]均高于甲氨蝶呤组。结论乌头汤与甲氨蝶呤联用可明显改善早期中高疾病活动度RA患者的临床症状,降低疾病活动度,提高生活质量,疗效优于单纯甲氨蝶呤治疗。
Objective The current study aimed to compare the efficacy of Wutou Decoction(WTD)&Methotrexate(MTX)in treating early active rheumatoid arthritis(RA)patients.Methods A total of 224 early active RA patients who underwent WTD&MTX or MTX alone treatment for 12 weeks in ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine,from Jul 2015 to Jun 2017,were retrospectively enrolled.Then the patients were divided into united group(n=131)and MTX group(n=93)according to their treatments.At time of Week 0,Week 4,Week 8,Week 12,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),disease activity score in 28 joints(DAS28),Health Assessment Questionnaire(HAQ)were collected and assessed.And the clinical remission rate,low disease activity(LDA)rate and total effective rate were calculated.Results At Week 8 and Week 12,compared with MTX group,the CRP(t values were 2.100 and 2.488,respectively),ESR(t values were 2.130 and 2.777,respectively),DAS28(t values were 2.886 and 3.718,respectively),and HAQ(t values were 2.144 and 2.362,respectively)in the united group were significantly decreased(P<0.05 or P<0.01).At Week 12,clinical remission rate[12.2%(16/131)vs.4.3%(4/93);χ^2=4.188,P=0.041],LDA rate[38.9%(51/131)vs.25.8%(24/93);χ^2=4.207,P=0.040]in the united group were significantly higher than those in the MTX group.At Week 8,total effective rate[37.4%(49/131)vs.21.5%(20/93);χ^2=6.450,P=0.011]in the united group was significantly higher than that of MTX group;and at Week 12,total effective rate[72.5%(95/131)vs.52.7%(49/93);χ^2=9.316,P=0.002]in the united group was also higher than that of the MTX group.Conclusions WTD in combination with MTX presents better efficacy in decreasing inflammation level and disease activity,and in improving quality of life as well as total effective rate of RA patients compared with MTX.
作者
白凤敏
岳涛
Bai Fengmin;Yue Tao(Department of Arthrology,ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200052,China)
出处
《国际中医中药杂志》
2020年第11期1074-1078,共5页
International Journal of Traditional Chinese Medicine
基金
上海市科学技术委员会科研计划项目(17401971300)。
关键词
关节炎
类风湿
乌头汤
抗风湿药(中药)
甲氨蝶呤
抗风湿药
Arthritis
rheumatoid
Wu Tou Tang
Antirheumatic drugs(TCD)
Methotrexate
Antirheumatic agents
