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中药增强泼尼松治疗难治性类风湿关节炎的疗效

[Effect of chinese herbs in enhancing prednisone for treatment of refractory rheumatoid arthritis].

作者信息

Liu Wei, Liu Xiao-ya, Wang Yi

机构信息

Department of Rheumatism, The First Hospital Affiliated to Tianjin College of TCM, Tianjin.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Aug;27(8):742-4.

Abstract

OBJECTIVE

To investigate the Chinese herbal medicine in enhancing effect of prednisone for treatment of refractory rheumatoid arthritis (RA).

METHODS

One hundred and twenty patients with refraetory RA were assigned to two groups, the treated group was orally administered with Qingbi Tablet, a patent Chinese herbal preparation formulated based on the clearing heat and removing toxic substances principle, and the control group was treated with intramuscular injection of amethopterin (MTX), oral intake of voltaren 75 mg and hydroxychloroquine 0.2 g once a day. Besides prednisone was given to all patients orally, the initiating dosage used in the treated group was lesser than that in the control group. The clinical index, dosage and adverse reaction of prednisone were recorded every 2 weeks.

RESULTS

The curative effect evaluated by American College of Rheumatology (ACR) standard showed no statistical difference between the two groups (P > 0.05). Either clinical or laboratory indexes were improved significantly in both groups (P < 0.05), but the improvement in resting pain, patient's self-evaluation and doctor's evaluation in the treated group were better than those in the control group, showing statistical difference (P < 0.05). The 20-week total amount of prednisone used in the treated group was less than that in the control group (32,935 mg vs. 51,170 mg), while the dosage of prednisone used in various observation time points between the two groups was also significantly different respectively (P < 0.05), the former was less than the latter.

CONCLUSION

Chinese herbal medicine can enhance the effect of prednisone in patients of refractory RA and alleviate the adverse reactions of prednisone.

摘要

目的

探讨中药对泼尼松治疗难治性类风湿关节炎(RA)的增效作用。

方法

将120例难治性RA患者分为两组,治疗组口服清痹片,这是一种基于清热排毒原则配制的中药专利制剂,对照组采用肌肉注射氨甲蝶呤(MTX),口服扶他林75mg及羟氯喹0.2g,每日1次。除所有患者均口服泼尼松外,治疗组起始剂量低于对照组。每2周记录泼尼松的临床指标、用量及不良反应。

结果

按美国风湿病学会(ACR)标准评估疗效,两组间无统计学差异(P>0.05)。两组临床及实验室指标均显著改善(P<0.05),但治疗组静息痛、患者自评及医生评估的改善情况优于对照组,有统计学差异(P<0.05)。治疗组20周泼尼松总用量低于对照组(32935mg对51170mg),两组各观察时间点泼尼松用量也分别有显著差异(P<0.05),前者低于后者。

结论

中药可增强泼尼松对难治性RA患者的疗效并减轻泼尼松的不良反应。

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