【摘要】 目的　探讨强直性脊柱炎 (AS)的柳氮磺吡啶 (SASP)、氨甲喋呤 (MTX)、雷公藤多苷 (TⅡ)等慢作用药治疗疗效及其治疗策略。方法　观察单用SASP和 (或 )联用MTX、TⅡ 治疗 2年的AS病人治疗前后的晨僵时间、关节疼痛数、关节肿胀数、扩胸度、Schober’s试验、血沉 (ESR)和C 反应蛋白 (CRP)等指标及X线 /CT骶骼关节表现 ,进行分析。结果　SASP治疗第 1年临床缓解、显效、有效和无效率分别为 46 %、1 9%、1 9 %和 1 6 % ;X线 /CT骶髂关节炎好转、稳定和加重率分别为 2 1 %、65 %和 1 4 %。对SASP治疗 1年疗效不好者改用或联用MTX半年后临床缓解 +显效率 81 %。副作用发生率SASP(2 0 % ) <MTX(32 % ) <TⅡ(50 % )。结论　SASP、MTX、TⅡ 治疗AS安全有效 ;以首选SASP ,次选MTX ,后选TⅡ 为宜 ;治疗应个体化 ,头年单用SASP ,对病情严重的进展性和难治性AS可选择 2种甚至 3种联用更多还原

【Abstract】 Objective To evaluate the efficacy and strategy of the slow acting anti rheumatic drugs such as sulfasalazine(SASP),methotrexate(MTX) and total glycoside of hooks F tripterygium wilfordii(T Ⅱ) in the treatment of ankylosing spondylitis(AS).Methods Eighty nine cases of AS were treated with SASP and/or SASP/MTX/T Ⅱ for 2 years.Data such as morning stiffness,number of join pain and swelling,chest expansion,Schober’s test,ESR,CRP and sacroiliac joint radiography/CT scan before and after treatment were collected and analysed.Results In the first year of SASP therapy,the rate of clinical remission,marked improve,effective,and ineffective was 46%,19%,19%,and 16% respectively.In the ineffective cases with SASP treatment for 1 year,MTX was added(or replaced).And after a half year treatment,the rate of clinical remission and marked effective was 81%.The rate of side effect was SASP(20%)<MTX(32%)<T Ⅱ(50%).Conclusion SASP,MTX and T Ⅱ are safe and effective in the treatment of AS.SASP might be the first choice,MTX the second,and T Ⅱ the last.The treatment should be individualized.For example,SASP might be used in the first year’s therapy.And for the serious or refractory cases MTX/T Ⅱ might be added.更多还原