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目的探讨雷公藤甲素联合阿达木单抗治疗克罗恩病及其对肠道菌群的影响。方法收集60例克罗恩病(CD)患者,随机分为2组,每组30例。A组给予雷公藤甲素(口服66μg/次,3次/d)联合阿达木[皮下注射80 mg/40 mg(0周/2周),之后40 mg隔周用药]治疗,B组给予阿达木[皮下注射80 mg/40 mg(0周/2周),之后40 mg隔周用药]单体治疗,另取20例健康志愿者记为C组。如未出现症状加剧或需要额外治疗的情况,则在用药当天和20周后,观察A组和B组临床有效性(Mayo评分),检测三组肠道菌群状况。结果用药治疗后,A组的临床有效率显著高于B组(76.67%vs.50.00%,P<0.05),且A组的Mayo评分低于B组,但差异无统计学意义(4.01±2.04 vs.4.83±1.92,P=0.061)。用药治疗后,两组的肠道菌群均发生有益变化,且与健康对照组比较,差异无统计学意义(P>0.05)。结论雷公藤甲素联合阿达木治疗方案可以有效缓解克罗恩病患者的临床症状,并改善其肠道菌群状况。
Objective To investigate the effects of triptolide combined with adalimumab on Crohn’s disease and its effect on intestinal flora. Methods Sixty patients with Crohn ’s disease (CD) were collected and randomly divided into two groups (n = 30 in each group). Triptolide (66 μg / time, 3 times / d) in combination with adalimumab [subcutaneous injection 80 mg / 40 mg (0 weeks / 2 weeks), followed by 40 mg every other week] Wood [subcutaneous injection of 80 mg / 40 mg (0 weeks / 2 weeks), followed by 40 mg every other week] monotherapy, another 20 healthy volunteers recorded as C group. In the absence of exacerbation or additional treatment, the clinical efficacy (Mayo score) of groups A and B was observed on the day of treatment and after 20 weeks, and the intestinal flora of the three groups was examined. Results After treatment, the clinical efficiency of group A was significantly higher than that of group B (76.67% vs. 50.00%, P <0.05), and the Mayo score of group A was lower than that of group B (4.01 ± 2.04 vs 4.83 ± 1.92, P = 0.061). After treatment, the intestinal flora in both groups had beneficial changes, and there was no significant difference between the two groups (P> 0.05). Conclusion Triptolide combined with adalimycin treatment can effectively relieve the clinical symptoms of Crohn’s disease patients and improve their intestinal microflora.