摘要
目的探讨雷公藤多苷对类风湿关节炎患者滤泡辅助性T细胞（TfH）及其细胞因子白细胞介素21（IL-21）水平的影响。方法将2015年1～8月河北省沧州中西医结合医院诊治的90例类风湿关节炎患者根据随机数字表法分为观察组和对照组，各45例。观察组采用口服雷公藤多苷20mg，每日3次，双氯芬酸钠肠溶片50mg，每日3次，甲氨蝶呤10mg，每周1次；对照组给予双氯芬酸钠肠溶片50mg，每日3次，甲氨蝶呤10mg，每周1次，疗程均为12周。观察两组患者的治疗效果及TfH细胞、IL-21蛋白的变化。结果治疗后，观察组的总有效率高于对照组[93．3％（42／45）比71．O％（32／45）]，差异有统计学意义（P〈0．05）。治疗后，观察组生活质量评分高于对照组[（71±13）分比（65±13）分]，差异有统计学意义（P〈0．05）。治疗后，观察组压痛关节数、肿痛关节数、白细胞、血小板及红细胞沉降率、总体类风湿关节炎患者病情评价评分均低于对照组[（4．8±1．1）个比（9．3±1．7）个，（3．0±0．8）个比（6．9±1．1）个，（6．4±1．2）×109／L比（8．5±1．0）×109／L，（280±66）×109／L比（313±68）×109／L，（40±11）mm／1h比（57±11）mm／1h，（2．7±0．6）分比（3．9±0．9）分]，差异均有统计学意义（P〈0．05或P〈0．01）。治疗后，观察组Tfh细胞及IL-21水平低于对照组[（10±3）％比（20±6）％，（335±78）ng/L比（414±99）ng／g]，差异有统计学意义（P〈0．01）。经Pearson相关性分析，Tm细胞及IL-21水平与DAS28评分呈正相关（r=0．712，0．709，P〈0．05）。结论雷公藤多苷对类风湿关节炎治疗效果好，并能够显著改善TfH细胞及其细胞因子IL-21水平。
Objective To explore the effects of tripterygium wilfordii glycosides on the level of follicular helper T cells（Tfh） and their cytokines interleukin（IL）-21 of patients withrheumatoid arthritis. Methods Total of 90 patients with rheumatoid arthritis admitted to Cangzhou Integrated Traditional Chinese and West- ern Medicine Hospital from Jan. 2015 to Aug. 2015 were divided into observation group and control group according to the random number table method ,45 cases each. The observation group was treated with oral ad- ministration of tripterygium wilfordii 20 mg,tid ＋ voltaren 50 mg tid ＋ methotrexate 10 mg QW, The control group was given votalin 50 mg tid ＋ methotrexate 10 mg QW,the course of treatment was 12 weeks for both groups. The therapeutic effect and the changes of Tfh, IL-21 protein of both groups were observed. Results After treatment, the total＂ efficacy of the observation group was higher than the control group [ 93.3 % （42/45） vs 71, 0% （32/45） ], the difference was statistically significant （P 〈 0. 05 ）. After the treatment,quality of life score of the observation group was higher than the control group[ （71 ± 13） scores vs （65 ± 13） scores] ,the difference was statistically significant （ P 〈 0. 05 ）. After treatment,the tender joint count, swollen joint count, white blood cells,platelets and erythrocyte sedimentation rate, the overall evaluation of patients with rheuma- toid arthritis disease scores of the observation group were lower than those of the control group [ （4.8±1.1 ） vs （9.3 ±1.7）,（3.0±0.8） vs （6.9 ±1.1）,（6.4 ±1.2） × 109/L vs （8.5 ±1.0） × 109/L,（280 ± 66） ×109/Lvs （313±68） ×109/L,（40±11） mm/1 hvs （57±11） ram/1 h,（2.7±0.6） seores vs （3.9±0. 9） scores] ,the differences were statistically significant（P 〈0. 05）. After treatment,the Tfh eells and IL-21 levels of the observation group were lower than the control group [ （10 ± 3 ）% vs （20 ± 6 ）% , （335 ±78） ng/L vs （414 ±99） ng/L] ,the differences were statistically significant （P 〈0. 01 ）. By Pearson correlation analysis ,Tfh ceils and IL-21 levels were positively correlated with the DAS28 score（ r = 0. 712, 0. 709, P 〈 0. 05）. Conclusion Tripteryglum glycosides treatment of rheumatoid arthritis has good effect, and can significantly improve Tfh and !L-21 levels.
出处
《医学综述》
2016年第3期566-569,共4页
Medical Recapitulate
