雷公藤多苷联合醋酸泼尼松治疗中度活动型系统性红斑狼疮的疗效观察

目的探讨雷公藤多苷治疗中度活动型系统性红斑狼疮的疗效和安全性。方法 79例中度活动型系统性红斑狼疮患者随机分为观察组40例和对照组39例,在应用醋酸泼尼松基础上,观察组给予雷公藤多苷20mg/次,3次/d,口服;对照组给予甲氨蝶呤10mg/次,1次/周,口服。治疗6个月后评定2组疗效及不良反应发生情况,并比较2组治疗前、后24h尿蛋白、补体C3、系统性红斑狼疮疾病活动度（systemic lupus erythematosus disease activity index,SLEDAI）评分。结果观察组总有效率（87.5%）高于对照组（66.7%）（P〈0.05）;观察组治疗后24h尿蛋白、补体C3、SLEDAI评分分别为（0.65±0.12）g、（0.81±0.55）g/L、4.87±1.92,对照组分别为（0.97±0.39）g、（0.79±0.22）g/L、5.29±2.10,与治疗前（（2.16±0.36）g,（0.48±0.37）g/L,12.8±4.15;（2.08±0.21）g,（0.49±0.26）g/L,12.6±5.01）比较差异均有统计学意义（P〈0.05）;观察组治疗后24h尿蛋白水平低于对照组（P〈0.05）;观察组月经紊乱发生率（20.00%）高于对照组（2.56%）（P〈0.05）,恶心呕吐、上呼吸道感染等不良反应发生率比较差异均无统计学意义（P〉0.05）。结论醋酸泼尼松联合雷公藤多苷治疗中度活动型系统性红斑狼疮疗效优于联合甲氨蝶呤,且不良反应轻。

Therapeutic effect of tripterygium glycosides plus prednisone on moderate active systemic lupus erythematosus

Objective To investigate the efficacy and safety of tripterygium glycosides plus prednisone in the treatment of moderate active systemic lupus erythematosus（SLE）.Methods Seventy-nine patients with moderate active SLE were divided into observation group（n=40）and control group（n=39）.Observation group was treated with prednisone plus tripterygium glycosides 20 mg each time,three times a day,orally,while control group was treated with prednisone plus methotrexate 10 mg each time,once a week,orally.The adverse reaction,24-hour urine protein,serum level of C3 and SLE disease activity index（SLEDAI）were recorded after 6-month treatment and compared between two groups.Results The total effective rate was higher in treatment group（87.5%）than that in control group（66.7%）（P0.05）.The level of 24-hour urine protein,C3 level and SLEDAI score were（0.65±0.12）g,（0.81±0.55）g/L and 4.87±1.92 in treatment group,and（0.97±0.39）g,（0.79±0.22）g/L and 5.29±2.10 in control group after treatment,significantly different from those before treatment（（2.16±0.36）g,（0.48±0.37）g/L,12.8±4.15;（2.08±0.21）g,（0.49±0.26）g/L,12.6±5.01）（P0.05）.The 24-hour urine protein was lower in treatment group than that in control group after treatment（P0.05）.While the incidence of menstrual disorders was higher in treatment group（20.00%）than that in control group（2.56%）.There were no significant differences in the incidences of nausea and vomiting and upper respiratory tract infection between two groups（P 〉0.05）.Conclusion Prednisone plus tripterygium glycosides is superior to prednisone plus methotrexate for moderate active SLE,and the adverse reactions are mild.