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脊痛宁胶囊治疗强直性脊柱炎的疗效和安全性。

The efficacy and safety of Jitongning Capsule () in patients with ankylosing spondylitis.

机构信息

Department of Rheumatology, Chinese PLA General Hospital, Beijing, China.

出版信息

Chin J Integr Med. 2013 Feb;19(2):98-103. doi: 10.1007/s11655-012-1212-x. Epub 2013 Jan 31.

Abstract

OBJECTIVE

To confirm the efficacy and safety of Jitongning Capsule in the treatment of ankylosing spondylitis (AS).

METHODS

A total of 120 AS patients with early-intermediate were randomly and equally assigned to Jitongning Capsule group and sulfasalazine group. Jitongning Capsule was orally taken 4.5 g per day and sulfasalazine was orally taken 2 g daily for 12 months. The primary endpoint was the proportion of patients achieving the Assessment in Ankylosing Spondylitis 20 (ASAS 20), secondary end points included Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), patient's global assessment by VAS rating, spinal pain, general pain and night pain, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ) and interleukin-4 (IL-4) in the peripheral blood mononuclear cells (PBMC) of AS patients were measured.

RESULTS

A total of 111 patients completed the study. There were 58 patients in Jitongning group and 53 patients in sulfasalazine group. Both drugs showed mild and occasional side effects. After treated by Jitongning Capsule and sulfasalazine, the proportion of ASAS20 responders at 12 month was 72.41% (42/58) and 67.92% (36/53) respectively. Both Jitongning Capsule and sulfasalazine treatment induced significant decrease in the proportion of CD4(+)T cell and CD8(+)T cell expressing TNF-α and IFN-γ at 12-month of treatment compared with baseline values (P<0.05).

CONCLUSION

Jitongning Capsule are effective in a setting close to real-life medical care with a sustained improvement in signs and symptoms of AS, and reduce cytokine levels in PBMC. It showed comparable effects to sulfasalazine.

摘要

目的

确证芪通宁胶囊治疗强直性脊柱炎(AS)的疗效和安全性。

方法

将 120 例早期-中期 AS 患者随机均分为芪通宁胶囊组和柳氮磺胺吡啶组。芪通宁胶囊组患者每天口服 4.5 g,柳氮磺胺吡啶组患者每天口服 2 g,疗程均为 12 个月。主要终点为达到强直性脊柱炎评估 20(ASAS20)的患者比例,次要终点包括 Bath 强直性脊柱炎疾病活动指数(BASDAI)、Bath 强直性脊柱炎功能指数(BASFI)、Bath 强直性脊柱炎衡量指数(BASMI)、患者视觉模拟评分(VAS)评定的总体评估、脊柱疼痛、全身疼痛和夜间疼痛、红细胞沉降率(ESR)和 C 反应蛋白(CRP)。检测 AS 患者外周血单个核细胞(PBMC)中肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)和白细胞介素-4(IL-4)。

结果

共 111 例患者完成了研究。芪通宁胶囊组 58 例,柳氮磺胺吡啶组 53 例。两组药物均表现为轻度和偶发性副作用。治疗 12 个月后,芪通宁胶囊组和柳氮磺胺吡啶组 ASAS20 应答者比例分别为 72.41%(42/58)和 67.92%(36/53)。芪通宁胶囊和柳氮磺胺吡啶治疗均能显著降低治疗 12 个月时 CD4+T 细胞和 CD8+T 细胞表达 TNF-α和 IFN-γ的比例,与基线值相比差异有统计学意义(P<0.05)。

结论

芪通宁胶囊在接近真实医疗环境下治疗 AS 具有持续的疗效,可改善患者的体征和症状,并降低 PBMC 中的细胞因子水平。它与柳氮磺胺吡啶的疗效相当。

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