阿达木单抗联合甲氨蝶呤治疗类风湿关节炎的疗效研究

目的:评估阿达木单抗(ADA)联合甲氨蝶呤(MTX)治疗类风湿关节炎(RA)的疗效与安全性。方法:选取在我院风湿科治疗的203例RA患者,将患者随机分为MTX单药治疗组(MTX组,n=101)与ADA联合MTX(ADA-MTX组,n=102)治疗组。记录患者的临床资料,检测患者实验室指标,比较患者的临床特征与不良反应发生率。结果:ADA-MTX组患者肿胀减轻、VAS评分降低、压痛减轻的患者比率与总有效率显著高于MTX组,差异有统计学意义(P0.05)。与MTX组比较,ADA-MTX组第12周、24周临床特征(晨僵时间、关节压痛数、关节肿胀数与DAS28评分)显著下降,差异有统计学意义(P0.05)。与MTX组第24周值比较,ADA-MTX组患者的生活质量评分显著提高,差异有统计学意义(P0.05)。ADA-MTX组与MTX组不良反应发生率比较无统计学差异(12.7%vs 14.9%,P=0.651)。结论:阿达木单抗联合甲氨蝶呤可明显改善类风湿关节炎患者实验室指标与临床体征、症状,从而减少患者功能障碍,提高患者生活质量,且具有良好的耐受性与安全性。     

甲氨蝶呤联合羟基氯喹对类风湿关节炎合并糖尿病患者糖化血红蛋白水平的影响

目的:观察类风湿关节炎(rheumatoid arthritis,RA)合并糖尿病(diabetes mellitus,DM)患者使用甲氨蝶呤(methotrexate,MTX)联合羟基氯喹(hydroxychloroquine,HCQ)治疗前后糖化血红蛋白(glycosylated hemoglobin,HbA1C)水平的变化。方法:通过回顾性分析,选取联合使用MTX+HCQ或单独使用MTX治疗的RA合并DM患者,且在治疗前及开始治疗12个月内分别至少有1次HbA1C值,记录其年龄、性别、诊断、体重指数、使用糖皮质激素情况。计算用药前到用药后12个月内HbA1C最低值的变化。结果:40例使用HCQ+MTX和45例使用MTX患者符合入选标准。两组间年龄、性别、体重指数、用药前HbA1C水平相似,MTX+HCQ组糖皮质激素使用比例(40.00%)比HCQ组更多(26.67%)(P=0.25)。MTX+HCQ组治疗后HbA1C有明显下降(0.42%,P=0.00),且MTX+HCQ组HbA1C降低幅度高于MTX组(0.42%,0.12%,P=0.02)。结论:与单独使用MTX相比,RA合并DM患者联合使用HCQ+MTX可明显降低HbA1C水平。     

沙利度胺联合甲氨喋呤与羟氯喹治疗类风湿关节炎的疗效分析

目的:探讨沙利度胺(THD)联合甲氨喋呤(MTX)、羟氯喹(HCQ)治疗类风湿关节炎(RA)的临床疗效。方法:82例RA患者随机分为观察组(n=41)与对照组(n=41),对照组给予MTX治疗,观察组在对照组基础上加用THD与HCQ,对比两组患者临床疗效。结果:观察组有效率为90.2%,显著高于对照组的70.7%(P0.05);治疗前、治疗后1个月两组患者肿胀关节数、压痛关节数、晨僵时间、ESR、CRP、RF、VAS比较差异无统计学意义(P0.05);治疗后2、3、4、5、6个月比较观察组各观察指标均显著优于对照组(P0.05);两组患者治疗过程中血细胞降低、消化道症状、呼吸道感染、月经紊乱、皮疹、ALT升高、头晕嗜睡、口腔溃疡等不良反应发生率比较无统计学差异(P0.05)。结论:沙利度胺联合甲氨喋呤、羟氯喹用于类风湿关节炎患者的治疗,能够有效延缓病情的进展、缓解患者痛苦,同时减少了药物的不良反应,为临床提供了新的治疗方法。     

肱骨近端锁定接骨板结合抗骨质疏松药物治疗老年骨质疏松性肱骨近端粉碎性骨折的疗效观察

目的:探讨肱骨近端锁定接骨板(LPHP)结合抗骨质疏松药物治疗老年骨质疏松性肱骨近端粉碎性骨折(OP-CFPH)的疗效价值。方法:抽选我院2012年1月-2014年2月收治的45例老年OP-CFPH患者,采用随机分层法分为对照组(n=22例,采用三叶形普通钢板治疗)和观察组(n=23例,采用LPHP+入院后抗骨质疏松治疗),比较两组手术参数、术后肩关节Neer评分及并发症发生率的差异。结果:观察组手术时间、术中出血量、术后引流量及术后骨折愈合时间均显著低于对照组的,组间差异具有统计学意义(P0.05);观察组术后肩关节Neer评分优良率明显高于对照组(P0.05);术后观察组并发症发生率低于对照组,但比较差异无统计学意义(P0.05)。结论:LPHP联合抗骨质疏松治疗老年OP-PHF具有创伤小、疗效好的优点,有利于骨折愈合,是目前治疗该类骨折一种理想的方法。     

康复训练联合阿托伐他汀对SIVD患者认知功能及日常行为能力的影响

目的:研究康复训练联合阿托伐他汀对SIVD患者认知功能及日常行为能力的影响。方法:选取97例确诊为SIVD的患者,根据随机数表法将所有患者分为观察组(n=48)和对照组(n=49),对照组给予口服多奈哌齐,观察组给予口服阿托伐他汀和康复训练。结果:治疗1个月后,观察组和对照组的MMSE、Mo CA、BI评分与治疗前差异均无统计学意义(P0.05);治疗6个月后,观察组的MMSE、Mo CA、BI评分显著高于治疗前(P0.05);观察组的MMSE、Mo CA、BI评分显著高于对照组(P0.001);观察组治疗1个月与6个月后总有效分别为16.6%与87.5%,高于同期对照组的12.24%(x~2=0.363,P=0.547)与53.06%(x~2=27.523,P0.001),差异无统计学意义。结论:康复训练联合阿托伐他汀能有效治疗SIVD,值得在临床中推广。     

SL-R柄人工股骨头置换术与股骨近端防旋髓内钉治疗老年不稳定型骨质疏松性股骨粗隆间骨折的疗效比较研究

目的:探讨股骨近端防旋髓内钉、SL-R柄人工股骨头置换术两种术式治疗老年不稳定型骨质疏松性股骨粗隆间骨折的应用效果。方法:选取2015年1月-2017年6月间于河北医科大学附属秦皇岛市第一医院行手术治疗的老年不稳定型骨质疏松性股骨粗隆间骨折患者98例,以数表法将患者随机均分为对照组(n=49)和观察组(n=49)。其中对照组采用股骨近端防旋髓内钉,观察组采用SL-R柄人工股骨头置换术。比较两组患者临床各项指标、手术前后髋关节功能评分以及术后并发症发生情况。结果:观察组手术时间、术中失血量均高于对照组,但住院时间、开始负重时间则低于对照组(P0.05)。观察组术后并发症发生率为4.08%(2/49),低于对照组的18.37%(9/49)(P0.05)。术后1个月、3个月时患者髋关节各项评分相比术前均有升高,术后3个月的各项评分高于术后1个月(P0.05);观察组术后1个月、3个月各项评分均高于对照组(P0.05)。结论:在老年不稳定型骨质疏松性股骨粗隆间骨折患者治疗过程当中,采用SL-R柄人工股骨头置换术可减少住院时间,疗效确切,无严重并发症,且可改善髋关节各项功能评分。     

戈利木单抗联合雷公藤多甙对甲氨蝶呤治疗反应不佳活动性类风湿关节炎的效果及安全性分析

目的:分析戈利木单抗联合雷公藤多苷对甲氨蝶呤(MTX)治疗反应不佳活动性类风湿关节炎(RA)的临床效果及安全性。方法:选择MTX治疗反应不佳(MTX治疗超3个月,但应答不足)的活动性RA患者66例,按照随机数字表法分为对照组与试验组各33例,对照组单用雷公藤多苷治疗,试验组加用戈利木单抗治疗,测定两组治疗前后血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)水平的变化,记录晨僵时间、关节肿胀数目、关节压痛数目,评定治疗效果,采用视觉模拟评分法(VAS)评定患者关节疼痛程度、患者对疾病总体症状的耐受情况,监测两组不良事件的发生情况。结果:(1)治疗后,两组ESR、CRP、RF均降低,与同组治疗前对比差异有统计学意义(P0.05),试验组ESR、CRP降低幅度高于对照组(P0.05);(2)治疗后,两组晨僵时间减少、关节肿胀及压痛数目均减少,与治疗前对比差异有统计学意义(P0.05),试验组各指标改善幅度均高于对照组(P0.05);(3)治疗后,两组VAS评分均降低,与治疗前对比差异有统计学意义(P0.05),试验组降低幅度高于对照组(P0.05);(4)试验组ACR50、ACR70所占比例均高于对照组(P0.05);(5)试验组、对照组不良反应发生率对比差异无统计学意义(P0.05)。结论:戈利木单抗联合雷公藤多苷治疗MTX反应不佳活动性RA疗效肯定,可下调患者ESR、CRP水平,缩短晨僵时间,显著改善患者症状,减轻关节疼痛程度,且安全性高。     

幽门螺杆菌根除治疗对帕金森病患者运动症状的影响

目的:探讨幽门螺杆菌(HP)根除治疗对帕金森病(PD)患者运动症状的影响及其安全性,为临床治疗提供参考。方法:选取2013年1月-2015年10月医院收治的PD患者120例,根据尿素呼吸试验(UBT)检测结果,将PD患者分为HP组(n=32)和非HP组(n=88),两组均进行抗PD的常规治疗,HP组在此基础上采用HP根除治疗(奥美拉唑+克拉霉素+阿莫西林),采用帕金森病评定量表(UPDRS)评估两组患者治疗前后的运动症状,并对治疗过程中的不良反应进行统计分析。结果:120例PD患者中,HP感染32例占26.67%,经HP根除治疗后,HP检测阴性者26人,成功根除率81.25%。组间比较,治疗前两组UPDRS Ⅳ评分有统计学差异(P0.05),而UPDRS Ⅲ评分、Hoehn-Yahr分级、"开"期和"关"期时间无统计学差异(P0.05);治疗后两组"开"期和"关"期时间存在统计学差异(P0.05),而UPDRS Ⅲ评分、UPDRS Ⅳ评分、Hoehn-Yahr分级无统计学差异(P0.05)。组内比较,治疗后,HP组UPDRS Ⅲ评分和UPDRS Ⅳ评分均较治疗前下降,差异有统计学意义(P0.05),且"开"期时间明显延长,"关"期时间明显缩短,差异均有统计学意义(P0.05),而非HP组治疗前后上述各项指标比较,差异均无统计学意义(P0.05)。HP根除组不良反应发生率与非HP组相比,差异无统计学意义(P0.05)。结论:HP感染与PD的发生有关,HP根除治疗能显著改善PD患者的运动症状,安全有效,值得临床推广使用。     

AZD5069通过抑制中性粒细胞迁移治疗类风湿关节炎的机制研究

目的:探讨CXCR2拮抗剂AZD5069能否通过抑制中性粒细胞迁移治疗类风湿关节炎(RA)。方法:将45只雄性DBA/1J小鼠随机分为对照组(n=15)、模型组(n=15)、AZD5069组(n=15);除对照组外,其余两组均给予牛Ⅱ型胶原蛋白+弗氏佐剂建立胶原诱导型关节炎(CIA)模型。观察记录小鼠关节炎评分。二次免疫后第二天给与药物治疗,治疗3周后处死小鼠检测关节病理、中性粒细胞浸润、外周血炎症因子等指标。结果:与对照组相比,模型组小鼠关节炎发病率明显升高(P0.05);与模型组相比,AZD5069组小鼠关节炎发病率明显降低(P0.05)。与对照组相比,模型组小鼠关节炎评分明显升高(P0.05);与模型相比,AZD5069组小鼠关节炎评分明显降低(P0.05)。对照组小鼠踝关节间隙正常,滑膜无增生,无炎症细胞浸润,软骨面光滑无破坏;模型组小鼠踝关节间隙狭窄,滑膜增生明显,可见大量炎症细胞浸润,软骨侵蚀破坏;与模型组相比,AZD5069组小鼠踝关节间隙未见明显狭窄,滑膜未见明显增生,炎症细胞浸润明显减轻,软骨未见明显破坏。与对照组相比,模型组小鼠血清中炎症因子TNF-α、IL-1β的水平明显升高(P0.05);与模型组相比,AZD5069组小鼠血清中炎症因子TNF-α、IL-1β的水平明显降低(P0.05)。与对照组相比,模型组小鼠踝关节中性粒细胞明显增多,可见大量中性粒细胞浸润;与模型组相比,AZD5069组小鼠踝关节中性粒细胞明显减少,中性粒细胞浸润情况明显减轻。结论:CXCR2拮抗剂AZD5069可通过抑制中性粒细胞迁移治疗类风湿关节炎,为开发新型治疗RA药物提供理论基础。     

活血化瘀汤对髌骨骨折患者膝关节功能及炎症因子的影响

目的:探讨髌骨骨折患者应用活血化瘀汤对患者膝关节功能、炎症因子的影响。方法:选择2015年3月到2017年3月西南医科大学附属中医医院接诊的髌骨骨折患者100例作为研究对象,以随机数表法分为观察组(n=53)和对照组(n=47),两组患者均采用切开复位克氏针张力带内固定,观察组加用活血化瘀汤。比较两组治疗后膝关节优良率、肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)、白细胞介素10(IL-10)、膝关节功能Lysholm评分、视觉模拟评分法(VAS)评分及不良反应发生情况。结果:治疗后,观察组患者优良率为92.45%,显著高于对照组的72.34%(P0.05);治疗前,两组患者TNF-α、IL-6及IL-10水平无显著差异(P0.05);治疗后,两组TNF-α、IL-6及IL-10水平较治疗前均显著改善(P0.05),且观察组TNF-α、IL-6均明显低于对照组,IL-10水平显著高于对照组(P0.05);治疗前,两组患者Lysholm评分、VAS评分无显著差异(P0.05);治疗后,两组Lysholm评分、VAS评分较治疗前均显著改善(P0.05),且观察组Lysholm评分均明显高于对照组,VAS评分显著低于对照组(P0.05);观察组患者不良反应总发生率为1.89%,显著低于对照组的14.89%,差异具有统计学意义(P0.05)。结论:在髌骨骨折患者中使用活血化瘀汤效果显著,可有效改善患者膝关节功能、炎症因子水平,值得推广与运用。     

Low-dose oral prednisone improves clinical and ultrasonographic remission rates in early rheumatoid arthritis: results of a 12-month open-label randomised study

IntroductionIn early rheumatoid arthritis (RA), low-dose oral prednisone (PDN) co-medication yields better clinical results than monotherapy with disease-modifying anti-rheumatic drugs (DMARDs). In addition, ultrasonography (US) evaluation reveals rapid and significant effects of glucocorticosteroids on subclinical synovitis. No data currently exist that examine the clinical and US results offered by glucocorticoid co-medication over DMARD monotherapy in early RA patients.MethodsTwo hundred and twenty patients with early RA (< 1 year from clinical onset) were treated according to a low disease activity (LDA) targeted step-up protocol including methotrexate (MTX) and, in the active treatment arm, low-dose (6.25 mg/day) oral PDN over 12 months. Clinical disease activity measures were collected at baseline, 2, 4, 6, 9 and 12 months, and US examination of hands was performed at baseline, 6 and 12 months. Grey-scale and power Doppler (PD) synovitis were scored (0 to 3) for each joint. At 12 months, clinical remission according to the disease activity score among 28 joints was defined as the clinical outcome, and a total joint PD score of 0 (PD negativity) as the imaging outcome.ResultsEach group included 110 patients with comparable demographic, clinical, laboratory and US characteristics. At 12 months, the LDA rate was similar in the two groups, whilst the clinical remission rate (risk ratio = 1.61 (95% confidence interval = 1.08, 2.04)) and PD negativity rate (risk ratio = 1.31 (95% confidence interval = 1.04, 1.64)) were significantly higher in the MTX+PDN group.ConclusionIn early RA, despite a similar response rate in terms of LDA, low-dose oral PDN co-medication led to a higher proportion of clinical remission and PD negativity compared with MTX monotherapy, thus ensuring a better disease activity control.

Trial registration number

Current Controlled Trials ISRCTN2486111     

不同剂量甲氨蝶呤联合不同剂量叶酸治疗活动期类风湿关节炎的临床研究

摘要 目的：探讨不同剂量甲氨蝶呤（MTX）联合不同剂量的叶酸治疗活动期类风湿关节炎（RA）的疗效与安全性。方法：选取100例符合纳入、排除标准的RA患者,按照28关节疾病活动指数（DAS28）分为高疾病活动度组（使用MTX 15 mg 每周1次）50例和低疾病活动度组（使用MTX 10 mg 每周1次）50例。高疾病活动度组按叶酸使用10 mg 每周1次 或5 mg 每周1次随机分为两组。低疾病活动度组按叶酸使用5 mg 每周1次或不使用随机分为两组,对比治疗6个月后的临床疗效和安全性。结果：治疗后,高疾病活动度叶酸5 mg组DAS28评分、视觉模拟评分量表（VAS）评分、血沉（ESR）、超敏C反应蛋白（hs-CRP）以及总有效率均优于叶酸10 mg组（P<0.05）,但是两组健康评定问卷（HAQ）评分、不良反应发生率和MTX浓度比较无明显差异（P>0.05）。低疾病活动度叶酸5 mg 组与无叶酸组患者治疗后hs-CRP、ESR、MTX浓度比较差异有统计学意义（P<0.05）,但是两组总有效率和不良反应发生率比较无明显差异（P>0.05）。结论：RA高疾病活动时,使用MTX 15 mg 每周1次联合叶酸5 mg 每周1次疗效更优,且不良反应发生率及MTX浓度变化不明显。RA低疾病活动时,MTX 10 mg 每周1次,与是否使用叶酸在疗效和安全性上无显著差异,但未使用叶酸患者的MTX浓度更高。     

Aldolase predicts subsequent myopathy occurrence in systemic sclerosis

Introduction

In early rheumatoid arthritis (RA), low-dose oral prednisone (PDN) co-medication yields better clinical results than monotherapy with disease-modifying anti-rheumatic drugs (DMARDs). In addition, ultrasonography (US) evaluation reveals rapid and significant effects of glucocorticosteroids on subclinical synovitis. No data currently exist that examine the clinical and US results offered by glucocorticoid co-medication over DMARD monotherapy in early RA patients.

Methods

Two hundred and twenty patients with early RA (< 1 year from clinical onset) were treated according to a low disease activity (LDA) targeted step-up protocol including methotrexate (MTX) and, in the active treatment arm, low-dose (6.25 mg/day) oral PDN over 12 months. Clinical disease activity measures were collected at baseline, 2, 4, 6, 9 and 12 months, and US examination of hands was performed at baseline, 6 and 12 months. Grey-scale and power Doppler (PD) synovitis were scored (0 to 3) for each joint. At 12 months, clinical remission according to the disease activity score among 28 joints was defined as the clinical outcome, and a total joint PD score of 0 (PD negativity) as the imaging outcome.

Results

Each group included 110 patients with comparable demographic, clinical, laboratory and US characteristics. At 12 months, the LDA rate was similar in the two groups, whilst the clinical remission rate (risk ratio = 1.61 (95% confidence interval = 1.08, 2.04)) and PD negativity rate (risk ratio = 1.31 (95% confidence interval = 1.04, 1.64)) were significantly higher in the MTX+PDN group.

Conclusion

In early RA, despite a similar response rate in terms of LDA, low-dose oral PDN co-medication led to a higher proportion of clinical remission and PD negativity compared with MTX monotherapy, thus ensuring a better disease activity control.

Trial registration number

Current Controlled Trials ISRCTN2486111     

Comparative Effectiveness of Tocilizumab with either Methotrexate or Leflunomide in the Treatment of Rheumatoid Arthritis

Objective

In agreement with EULAR recommendations, a DMARD in combination with a biotherapy is the reference treatment because of the superior long-term clinical and radiographic outcomes. Methotrexate (MTX) is the cornerstone of combination therapy but is in some cases contra-indicated or poorly tolerated. This observational study aimed to compare the effectiveness and safety of TCZ in combination with either MTX or leflunomide (LEF) in the treatment of patients with active rheumatoid arthritis (RA) and an inadequate response to one or more DMARDs and/or biological agents in a real-world setting.

Methods

We performed an ambispective review of 91 patients with active RA who were routinely treated with TCZ plus MTX or LEF. A comparative study between the two combinations of treatment was performed at 6 months of follow-up considering 3 outcomes: improvement of RA disease activity, evolution of functional disability, and tolerability and side effect profile.

Results

Of the 91 patients, 62 received TCZ with MTX and 29 received TCZ with LEF. Eighty-one patients were followed for 6 months, and the remaining 10 patients discontinued treatment due to serious adverse events. At baseline, there were no significant differences between the groups in terms of the main clinical and laboratory data or in the number of previous DMARDs and biological agents used. At 6 months, there were no significant differences between the combinations in terms of disease activity and functional disability. Serious adverse events occurred in 11% and 10% of the patients treated in combination with MTX and LEF, respectively.

Conclusion

Our preliminary data support the argument that LEF is an effective and safe (equivalent) alternative to MTX for combination treatment with TCZ.     

痛敏穴刺血加艾灸疗法治疗类风湿关节炎临床疗效研究

摘要 目的：观察痛敏穴刺血加艾灸疗法治疗类风湿关节炎（RA）患者的临床疗效。方法：选取2019年1月~2022年1月44例类风湿关节炎患者随机分为2组,每组22例。对照组予以来氟米特片和塞来昔布胶囊治疗,观察组在对照组基础上采用痛敏穴刺血加艾灸疗法。两组患者治疗前后采用视觉模拟评分法（VAS）和疾病活动评分（DAS-28）进行评估,并检测类风湿因子(RF)、超敏C反应蛋白（hs-CRP）、血沉(ESR)、类风湿因子（RF）、纤维蛋白原（FIB）、D二聚体水平。结果：两组治疗后VAS评分降低（P<0.05）,而研究组较对照组低（P<0.05）。两组治疗后DAS-28评分降低（P<0.05）,而研究组较对照组低（P<0.05）。两组治疗后RF、hs-CRP、FIB、D二聚体水平均明显下降（P<0.05）,而研究组均明显低于对照组（P<0.05）。观察组总有效率（100.00 %）明显高于对照组（72.73 %）（P<0.05）。结论：痛敏穴刺血加艾灸能够提高RA患者的临床疗效,且能够提高机体的抗炎效应。     

Active immunization to tumor necrosis factor-α is effective in treating chronic established inflammatory disease: a long-term study in a transgenic model of arthritis

Introduction

Chicken type II collagen (CCII) is a protein extracted from the cartilage of chicken breast and exhibits intriguing possibilities for the treatment of autoimmune diseases by inducing oral tolerance. A 24-week, double-blind, double-dummy, randomized, methotrexate (MTX)-controlled study was conducted to evaluate the efficacy and safety of CCII in the treatment of rheumatoid arthritis (RA).

Methods

Five hundred three RA patients were included in the study. Patients received either 0.1 mg daily of CCII (n = 326) or 10 mg once a week of MTX (n = 177) for 24 weeks. Each patient was evaluated for pain, morning stiffness, tender joint count, swollen joint count, health assessment questionnaire (HAQ), assessments by investigator and patient, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) by using the standard tools at baseline (week 0) and at weeks 12 and 24. Additionally, rheumatoid factor (RF) was evaluated at weeks 0 and 24. Measurement of a battery of biochemical parameters in serum, hematological parameters, and urine analysis was performed to evaluate the safety of CCII.

Results

Four hundred fifty-four patients (94.43%) completed the 24-week follow-up. In both groups, there were decreases in pain, morning stiffness, tender joint count, swollen joint count, HAQ, and assessments by investigator and patient, and all differences were statistically significant. In the MTX group, ESR and CRP decreased. RF did not change in either group. At 24 weeks, 41.55% of patients in the CCII group and 57.86% in the MTX group met the American College of Rheumatology 20% improvement criteria (ACR-20) and 16.89% and 30.82%, respectively, met the ACR 50% improvement criteria (ACR-50). Both response rates for ACR-20 and ACR-50 in the CCII group were lower than those of the MTX group, and this difference was statistically significant (P < 0.05). The DAS28 (disease activity score using 28 joint counts) values of the two treatment groups were calculated, and there was a statistically significant difference between the two treatment groups (P < 0.05). Gastrointestinal complaints were common in both groups, but there were fewer and milder side effects in the CCII group than in the MTX group. The incidence of adverse events between the two groups was statistically significant (P < 0.05).

Conclusions

CCII is effective in the treatment of RA and is safe for human consumption. CCII exerts its beneficial effects by controlling inflammatory responses through inducing oral tolerance in RA patients.

Trials Registration

Clinical trial registration number: ChiCTR-TRC-00000093.     

重度烧伤患者应用重组人生长激素治疗的临床效果

目的:研究重组人生长激素对重度烧伤的应用治疗效果。方法:选取重度烧伤患者42例。根据随机数表法,将所有患者分为观察组(n=21)和对照组(n=21),观察组在对照组的基础上给予重组人生长激素治疗。结果:对照组术后24 h血红蛋白及总蛋白水平均低于实验组,差异无统计学意义(P0.05);对照组术后1周血红蛋白水平为(95.57±11.41)g/L,低于实验组的(137.91±14.29)g/L(t=3.726,P0.001);对照组术后2周血红蛋白水平为(80.89±11.38)g/L,低于实验组的(131.28±13.47)g/L(t=3.917,P0.001);实验组术后1周总蛋白水平为(61.47±5.19)g/L,高于对照组的(39.18±2.76)g/L(t=3.927,P0.001);实验组术后2周总蛋白水平为(55.78±6.38)g/L,高于对照组的(36.81±5.17)g/L(t=3.847,P0.001)。实验组术后24h的TNF-α和IL-6高于对照组,差异无统计学意义(P0.05);实验组术后2周的TNF-α、IL-6均明显低于对照组,差异有统计学意义(P0.001);实验组术后2周的TNF-α、IL-6均明显低于对照组,差异有统计学意义(P0.001);观察组的住院时长为(47.82±7.46)天,显著低于对照组的(79.36±8.10)天(t=4.275,P0.001);观察组的供皮区、植皮区、深Ⅱ度痂下愈合时间均显著低于对照组的,差异有统计学意义(P0.001)。结论:rh GH对重度烧伤的疗效非常显著,值得在临床中推广。