雷公藤多甙治疗麻风结节性红斑的疗效观察

目的：评价雷公藤多甙对麻风结节性红斑（erythema nodosun leprosun，ENL）的疗效和副作用。方法：采用开放性研究，将入选的34例患者分成雷公藤多甙单独治疗组（A组，18例）及皮质类固醇和雷公藤多甙联合治疗组（B组，16例）。A组患者口服雷公藤多甙60-80mg／天，治疗4周，然后停药或减量出院继续治疗2-4周；B组治疗方法为在A组基础上加服皮质类固醇。结果：治疗4周后，临床平均评分显示，A组18例患者从疗前的10．94下降到0．94；B组16例患者从疗前的13．19下降到1．63。两组分别在治疗2周时即见到临床改善，与治疗前比较差异有统计学意义（P值均〈0．01）。尽管两组在药物减量或停药后都有患者出现ENL复发，但是症状较轻，与疗前相比，差异仍有统计学意义（P〈0．01）。结论：雷公藤多甙在治疗麻风2型反应方面有显著疗效，药物副作用轻微，但需要制定出一个缓慢减量的治疗方案以控制ENL复发。

Effect of Triptolide in Treating Erythema Nodosum Leprosum

Objective：To observe the efficacy of triptolide in treating erythema nodosum lepro- sum （ENL）. Methods：The study wasan open clinical trial. The qualified patients were formed two different groups, group of triptolide alone （ Group A） and group of triptolide and prednisone together（ Group B）. The adult patients in the group A received a daily dosage of 60 -80 mg （6 - 8 tablets） for four weeks in the hospital, and then tapered the dosage for another four weeks at home. The patients in group B received prednisone besides the same triptolide as group A. The clinical status was evaluated by the same doctors and using a designed scale form. Results：The general score of clinical status for 18 patients in the group A decreased from 10. 94 before the stud- y to 0. 94 after 4 weeks of treatment. The general score of clinical status for 16 patients in the group B also decreased from 13. 19 before the study to 1.63 after 4 weeks of treatment. There was a significant difference in clinical improvement between the beginning and the end of four weeks＇ treatment in each group （P 〈 0. 01 ）. Even there was some ENL relapses in both groups after stop- ping or tapering the triptolide, there was still significant difference between the beginning and the end of 8 weeks＇ treatment （P 〈 0. 01 ）. Conclusion ：Triptolide has a significant efficacy in treating ENL. The side-effects of the drug were few, and most patients tolerated the drug. It is necessary to make out a very slow tapering regimen to prevent ENL from relapse.