Abstract：Objective: To investigate the efficacy of diacreine combined with eramode in the treatment of refractory rheumatoid arthritis (RRA) and the effects on helper T cell 17 (TH17)/regulatory T lymphocyte (Treg) in patients. Methods: A total of 80 patients with RRA admitted to hospital from January 2021 to December 2023 were retrospectively analyzed and divided into single group (40 cases with eramodide alone) and combined group (40 cases with eramodide and diacerein) according to different treatment methods. Serological indexes [interleukin-17 (IL-17), TH17, Treg, TH17/Treg], serum inflammatory factors [C-reactive protein (CRP), tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), interleukin-1 (IL-1)] and immunological indexes were compared between the two groups before and after treatment [Immunoglobulin] M(IgM), immunoglobulin A(IgA), immunoglobulin G(IgG)], laboratory indicators [human endostatin (ES), rheumatoid factor (RF), erythrocyte deposition rate (ESR)], improvement of clinical symptoms (number of joint swelling, morning stiffness time, joint pain (VAS) score), total response rate and the incidence of adverse reactions (leukopenia, nausea and vomiting, pruritus, and rash) after treatment. Results: Compared with the single group, the combination group had lower IL-17, TH17, TH17/Treg, CRP, TNF-α, IL-1β, IL-1, IgM, IgA, IgG, RF, ESR and joint swelling number, VAS score, higher Treg and ES, and shorter morning stiffness time after treatment. The difference was statistically significant (P<0.05). The total effective rate of combination group (97.50%) was higher than that of single group (80.00%), and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of leukopenia, nausea and vomiting, pruritus and rash between the two groups (P>0.05). Conclusion: In the treatment of RRA, the combination of diacrein and eramod has significant efficacy, which is beneficial to further improve inflammatory factors, immunological indicators and laboratory indicators of patients and alleviate symptoms, and can also correct TH17/Treg imbalance with less adverse reactions.
2024, Vol. 30 
冀公网安备13080202000677号