五组慢作用药治疗强直性脊柱炎远期疗效比较

目的 :探讨柳氮磺吡啶、甲氨蝶呤和雷公藤多苷分别单用和联合应用治疗强直性脊柱炎 (AS)的远期疗效与安全性。方法 :15 3例AS患者分别服用柳氮磺吡啶、甲氨蝶呤、雷公藤多苷、甲氨蝶呤 雷公藤多苷、甲氨蝶呤 柳氮磺吡啶。随访 3a以上 ,比较不同服药组治疗 1a后各临床参数的变化和 3a间病情缓解率。结果 :5种治疗方案 1a后晨僵时间、疼痛关节数、红细胞沉降率 (ESR)和C 反应蛋白 (CRP)均显著改善 (P均 <0 0 1) ;各治疗方案间的比较 ,晨僵时间和CRP在 2个联合用药组改善程度均显著高于 3个单用药组 (P均 <0 0 5 ) ;临床缓解率在 5个组间差异有显著性 ,临床缓解率高低顺序依次是 :甲氨蝶呤 雷公藤多苷、甲氨蝶呤 柳氮磺吡啶、甲氨蝶呤、雷公藤多苷、柳氮磺吡啶。结论 :3种慢作用抗风湿药柳氮磺吡啶、甲氨蝶呤、雷公藤多苷对AS均有疗效 ;联合用药优于单一用药 ;包含甲氨蝶呤的治疗优于不含甲氨蝶呤的治疗。

Comparison of long-term curative effects of 5 groups slow-acting drugs in ankylo-sing spondylitis

AIM: To evaluate the long term curative effect and safety of sulfasalazine(SASZ),methotrexate(MTX) and triperygium glycosides (TG) used singly or in combination in the treatment of ankylosing spondylitis(AS). METHODS: One hundred and fifty three AS patients were divided into 5 groups and were treated with SASZ, MTX, TG, MTX TG or MTX SASZ respectively. All patients were followed up over 3 a. Changes of clinical parameters after one year's treatment and remissions after 3 a were observed. RESULTS: Clinical and laboratory parameters such as morning stiffness duration, number of painful joints, erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) were improved after one year's treatment. Morning stiffness duration and CRP got better in SASZ MTX and SASZ TG groups than in other 3 groups ( P <0 05). There were statistic differences in rate of clinical remission among groups and they were in sequence from higher to lower: MTX TG, MTX SASZ, MTX, TG and SASZ. CONCLUSION: SASZ, MTX and TG have long term curative effect in the treatment of AS and it is better to use MTX and use such drugs in combination.