雷公藤联合小剂量强的松治疗老年类风湿关节炎的疗效观察

目的观察雷公藤联合小剂量强的松治疗老年类风湿关节炎（RA）的临床疗效和安全性。方法 52例老年RA患者随机分为治疗组和对照组;治疗组（26例）口服雷公藤和小剂量强的松治疗,对照组（26例）口服雷公藤治疗,比较治疗前后两组患者临床症状和实验室指标的变化。结果治疗3个月后治疗组患者在晨僵时间、关节压痛数、关节肿胀数、患者VAS评分、红细胞沉降率（ESR）、C反应蛋白（CRP）、类风湿因子（RF）、DAS28指标上改善优于对照组（P〈0.05）,且两组治疗3个月后各项指标与治疗前比较,差异有统计学意义（P〈0.05）;治疗组患者ACR20、ACR50、ACR70缓解率优于对照组（P〈0.05）;两组不良反应发生率比较差异无统计学意义（P〉0.05）。结论雷公藤联合小剂量强的松治疗老年类风湿关节炎能快速改善临床症状和实验室指标,不良反应少。

Curative effect observation of tripterygium wilfordii combined with small dose of prednisone in the treatment of senile rheumatoid arthritis

Objective To observe the clinical effect and safety of tripterygium wilfordii combined with small dose of prednisone in the treatment of senile rheumatoid arthritis （RA）. Methods A total of 52 cases of senile RA were randomly divided into treatment group and control group. The treatment group （n=26） received treatment of tripterygium wilfordii and small dose of prednisone, and the control group （n=26） received treatment of tripterygium wilfordii. Clinical symptoms and lab index changes of two groups before and after treatment were compared. Results The stiffness time, joint tenderness count, joint swelling count, patient VAS score, erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, rheumatoid factor （RF） and DAS28 index of the treatment group patients were better than that of the control group after 3 months （P〈0.05）. These indexes of the two groups had significant differences, compared with those before the treatment （P〈0.05）. The ACR20, ACR50 and ACRT0 remission rate of the treatment group were better than that of the control group （P〈0.05）. There was no statistically significance in the difference of adverse reaction rate between the two groups （P〉0.05）. Conclusion The treatment of tripterygium wilfordii combine with small dose of prednisone in patients with senile rheumatoid arthritis can quickly improve the clinical symptoms and laboratory indexes, and has less adverse reactions.