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目的:观察应用雷公藤多甙联合来氟米特治疗老年类风湿关节炎(RA)的疗效及对血清白细胞介素-1、白细胞介素-6及肿瘤坏死因子-α的影响。方法:选择60例老年RA患者,其中30例应用雷公藤多甙(20 mg,每日3次,起效剂量10 mg)联合来氟米特(10mg,每日1次)治疗,30例单用来氟米特治疗,随访观察6个月后的疗效。结果:联合治疗组起效剂量(其中雷公藤多甙20 mg,每日3次,起效剂量10 mg)血沉、C反应蛋白、类风湿因子、免疫球蛋白G、免疫球蛋白M、免疫球蛋白A、晨僵及关节肿胀指数与压痛指数明显低于治疗前,晨僵时间、血沉、免疫球蛋白M、免疫球蛋白G的改善与单药对照组相比有明显差异,血清白细胞介素-1、白细胞介素-6及肿瘤坏死因子-α水平低于治疗前,其中白细胞介素-1、肿瘤坏死因子-α指标变化与单药对照组比较有显著性差异。结论:雷公藤多甙及来氟米特联合治疗老年RA效果明显,改善患者的预后,通过下调老年RA患者白细胞介素-1、白细胞介素-6及肿瘤坏死因子-α水平增强抗炎效果。
OBJECTIVE: To observe the effects of combination of tripterygium glycosides and leflunomide on senile rheumatoid arthritis (RA) and its effect on serum interleukin-1, interleukin-6 and tumor necrosis factor-α. Methods: Sixty elderly RA patients were selected. Thirty patients were treated with tripterygium glycosides (20 mg, 3 times a day, 10 mg) and leflunomide (10 mg once daily) in 30 patients Used for the treatment of fluorite, followed up for 6 months. Results: The combined treatment group, the effective dose (which tripterygium glycosides 20 mg, 3 times daily, the effective dose of 10 mg) erythrocyte sedimentation rate, C reactive protein, rheumatoid factor, immunoglobulin G, immunoglobulin M, immunoglobulin Protein A, morning stiffness and joint swelling index and tenderness index were significantly lower than before treatment, morning stiffness time, erythrocyte sedimentation rate, immunoglobulin M, immunoglobulin G improved significantly compared with the single drug control group, serum interleukin -1, interleukin-6 and tumor necrosis factor-α were lower than those before treatment, and the change of IL-1 and TNF-α was significantly different from that of single drug control group. Conclusion: The effect of combination of tripterygium glycosides and leflunomide in the treatment of senile RA is obvious and the prognosis of patients is improved. The anti-inflammatory effect is enhanced by down-regulating the levels of interleukin-1, interleukin-6 and tumor necrosis factor-alpha .