[1]尉世同,孙永华,邹巧菲,等.双醋瑞因联合甲氨喋呤治疗类风湿关节炎的临床研究[J].第三军医大学学报,2010,32(19):2112-2114.
 Wei Shitong,Sun Yonghua,Zou Qiaofei,et al.Combined diacerein and methotrexate in treatment of rheumatoid arthritis: report of 120 cases[J].J Third Mil Med Univ,2010,32(19):2112-2114.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
32卷
期数:
2010年第19期
页码:
2112-2114
栏目:
论著
出版日期:
2010-10-15

文章信息/Info

Title:
Combined diacerein and methotrexate in treatment of rheumatoid arthritis: report of 120 cases
作者:
尉世同孙永华邹巧菲张鲁阳卢世涛宗世华
山东省烟台市烟台山医院风湿科
Author(s):
Wei Shitong Sun Yonghua Zou Qiaofei Zhang Luyang Lu Shitao Zong Shihua
Department of Rheumatology, Yantai Yantaishan Hospital, Yantai, Shandong Province, 264001,China
关键词:
双醋瑞因甲氨蝶呤类风湿关节炎细胞因子
Keywords:
diacereinmethotrexaterheumatoid arthritiscytokine
分类号:
R593.22;R976;R979.14
文献标志码:
A
摘要:
目的 探讨双醋瑞因(Diacerein)联合甲氨喋呤(MTX)及单用甲氨蝶呤治疗类风湿关节炎的疗效、细胞因子变化及安全性。  方法   符合纳入及排除标准的类风湿关节炎120例随机数字表法分为单用甲氨喋呤(10 mg/周)组、双醋瑞因联合甲氨喋呤治疗组(Diacerein 50 mg/次,每日2次+MTX 10 mg/周),n=60。总疗程52周,在2、6、26、52周进行疗效、细胞因子变化及安全性评价,以ACR20作为主要疗效指标,ACR50作为次要疗效指标。 结果   治疗2、6、26、52周2组达ACR 20%的患者比例,治疗组:20.3%(12/59)、40.7%(24/59)、81.4%(48/59)、91.5%(54/59),对照组:1.7%(1/59)、22.0%(13/59)、59.3%(35/59)、71.2%(42/59),治疗组明显高于对照组,差异有统计学意义(P<0.05);达ACR 50%的患者比例,治疗组:0%(0/59)、13.6%(8/59)、50.8%(30/59)、83.1%(49/59),对照组:0%(0/59)、0%(0/59)、39.0%(23/59)、59.3%(35/59),治疗组明显高于对照组,自第6周起差异有统计学意义(P<0.01,P<0.05)。52周时双醋瑞因联合甲氨喋呤组疼痛、患者对自身健康状况的总体评估(PGA)、健康评价(HAQ)、血沉(ESR)、C反应蛋白(CRP)、IL-1、IL-6、TNF-α的改善和变化高于单用甲氨喋呤组(P<0.01, P<0.05)。 结论  双醋瑞因联合甲氨喋呤治疗类风湿关节炎能显著改善其症状及实验室指标,疗效明显优于单用甲氨蝶呤组,并且起效快、安全性好,不增加不良反应的发生率。
Abstract:
Objective   To evaluate the clinical efficiency and safety of combined diacerein and methotrexate(MTX) in treatment of rheumatoid arthritis(RA), and the change in cytokines.  Methods   One hundred and twenty RA patients were randomly assigned to receive MTX(10 mg per week) or diacerein (50 mg/bid) plus MTX(10 mg per week) for 52 weeks. Therapeutic efficiency and safety as well as change in cytokines were evaluated after 2, 6, 26, and 52 weeks of treatment respectively, with  ACR20 and ACR50 as the primary and secondary therapeutic efficiency indicators, respectively.  Results   The ACR 20 was 20.3% (35/39), 40.7%(24/59), 81.4%(48/59), and 91.5%(54/59)respectively in diacerein plus MTX group, and was 1.7%(1/59),22.0%(13/59),59.3%(35/59)and 71.2%(42/59)respectively in MTX group after 2,6,26,and 52 weeks of treatment (P<0.05). The ACR 50 was 1.7%(1/59),22.0%(13/59),59.3%(35/59)and 71.2%(42/59)respectively in diacerein plus MTX group, and was 0%(0/59),0%(0/59),39.0%(23/59) and 59.3%(35/59)respectively in MTX group after 2,6,26,and 52 weeks of treatment (P<0.05). Both ACR 20 and ACR 50 were higher in diacerein plus MTX group than in MTX group. The changes in PGA,HAQ,ESR,CRP,IL-1,IL-6 and TNF-α were more significant in diacerein plus MTX group than in MTX group after 52 weeks of treatment(P< 0.05).  Conclusion   Diacerein plus MTX is better than diacerein in improving the signs and symptoms of RA patients, with a rapider efficiency, better safety and lower incidence of adverse events than MTX.

参考文献/References:

尉世同, 孙永华, 邹巧菲, 等. 双醋瑞因联合甲氨喋呤治疗类风湿关节炎的临床研究[J].第三军医大学学报,2010,32(19):2112-2114.

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更新日期/Last Update: 2010-10-08