标题：雷公藤多苷治疗强直性脊柱炎的疗效及对患者可溶性白介素-2受体的影响

      作者：吉健华 1，成洁 2    西安市第五医院风湿免疫科 1、风湿免疫骨质疏松科病区 2，陕西 西安 710082

      卷次： 2019年30卷22期

      【摘要】 目的 观察雷公藤多苷治疗强直性脊柱炎的疗效，并探讨其对患者可溶性白介素-2受体(sIL-2R)的影响。方法 选择2016年9月至2018年9月西安市第五医院收治的92例强直性脊柱炎患者为研究对象，按随机数表法将患者分为观察组和对照组，每组46例。对照组患者给予柳氮磺胺吡啶片治疗，观察组在对照组治疗的基础上联合雷公藤多苷片治疗，均连续治疗6个月。比较两组患者的临床疗效、血清 sIL-2R、C反应蛋白(CRP)、红细胞沉积率(ESR)水平，以及Bath强直性脊柱炎疾病活动性指数(BASDAI)、Bath强直性强直性脊柱炎功能指数(BASFI)和不良反应。结果 治疗后，观察组患者的临床治疗总有效率为89.13%，明显高于对照组的71.74%，差异有统计学意义(P<0.05)；观察组和对照组患者的血清 sIL-2R [(0.21±0.05) U/L vs (0.33±0.07) U/L]、CRP [(5.48±1.89) mg/L vs(7.05±2.77) mg/L]、ESR [(9.57±2.50) mm/h vs (13.29±3.07) mm/h]及BASDAI评分[(9.76±2.61)分 vs (15.75±4.80)分]、BASFI评分[(26.86±4.59)分 vs (38.50±7.22)分]比较，观察组明显低于对照组，差异均有统计学意义(P<0.05)；观察组患者的不良反应率为13.04%，与对照组的8.70%比较差异无统计学意义(P>0.05)。结论 雷公藤多苷治疗强直性脊柱炎可明显降低患者的血清 sIL-2R水平，改善病情，且不良反应少，临床治疗效果显著，值得推广应用。
      【关键词】 雷公藤多苷；柳氮磺胺吡啶；强直性脊柱炎；可溶性白介素-2受体；疼痛；疗效
      【中图分类号】 R681.5+1 【文献标识码】 A 【文章编号】 1003—6350（2019）22—2905—04

Therapeutic effect of tripterygium wilfordii polyglycosides on patients with ankylosing spondylitis and its effecton soluble interleukin-2 receptor levels.
JI Jian-hua 1, CHENG Jie 2. Department of Rheumatism and Immunology 1,Department of Rheumatism, Immunology, and Osteoporosis 2, Xi'an No.5 Hospital, Xi'an 710082, Shaanxi, CHINA
【Abstract】 Objective To observe the efficacy of tripterygium wilfordii polyglycosides in the treatment of an-kylosing spondylitis, and to explore its effect on soluble interleukin-2 receptor (sIL-2R) levels. Methods Ninety pa-tients of ankylosing spondylitis who received therapy from September 2016 to September 2018 in Xi'an No.5 Hospitalwere selected as the study subjects. According to the random number table, the patients were divided into the observa-tion group and the control group, with 46 patients in each group. The patients in the control group were treated with sul-fasalazine tablets, while those in the observation group were treated with Tripterygium wilfordii polyglycosides tabletson the basis of sulfasalazine tablets, continuously for 6 months. The clinical efficacy, serum sIL-2R, C-reactive protein(CRP), erythrocyte sedimentation rate (ESR) levels, and Bath ankylosing spondylitis disease activity index (BASDAI),Bath ankylosing spondylitis function index (BASFI), and adverse reactions were compared between the two groups pa-tients. Results After treatment, the total effective rate of clinical treatment was 89.13% in the observation group,which was significantly higher than 71.74% in the control group (P<0.05). The serum sIL-2R, CRP, ESR, BASDAIscores, and BASFI scores in the observation group were significantly lower than those in the control group (P<0.05):(0.21±0.05) U/L vs (0.33±0.07) U/L, (5.48±1.89) mg/L vs (7.05±2.77) mg/L, (9.57±2.50) mm/h vs (13.29±3.07) mm/h,(9.76±2.61) vs (15.75±4.80), (26.86±4.59) vs (38.50±7.22), respectively. The rate of adverse reactions in the observa-tion group was 13.04%, as compared with 8.70% in the control group (P>0.05). Conclusion The tripterygium wil-fordii polyglycosides can significantly reduce the serum sIL-2R levels in patients with ankylosing spondylitis, im-prove the condition, with less adverse reactions and remarkable clinical treatment effect, which is worth popularizingand applying.
      【Key words】 Tripterygium wilfordii polyglycosides; Sulfasalazine; Ankylosing spondylitis; Soluble interleu-kin-2 receptor; Pain; Curative effect