摘要
目的探讨沙利度胺(thalidomide,THD)单独及联合甲氨蝶呤(methotrexate,MTX)治疗类风湿关节炎(RA)的临床疗效及安全性。方法 50例RA患者分成THD组23例和THD+MTX组27例,疗程均6个月。每月记录疼痛视觉模拟评分法(VAS)评分、关节压痛指数、关节肿胀指数及晨僵时间,并检查红细胞沉降率(ESR)、C-反应蛋白(CRP)、血常规、肝功能、肾功能。治疗6个月后进行疗效和安全性评价。结果两组治疗前后VAS评分、关节压痛指数、关节肿胀指数、晨僵时间和ESR、CRP比较,差异均有统计学意义(P<0.05);两组疗效比较差异有统计学意义(u=4.71,P<0.05),总有效率比较差异无统计学意义(P>0.05)。两组分别有34.8%和40.7%的患者发生药物不良反应,但差异无统计学意义(P>0.05),且症状较轻,可以耐受。结论 THD治疗类风湿关节炎疗效较好,安全性较好,与MTX联合应用有协同作用。
Objective To investigate the clinical efficacy and safety of Thalidomide in different therapies for rheumatoid arthritis.Methods Fifty patients with rheumatoid arthritis（RA） were randomly divided into 2 groups： Thalidomide group（treated with Thalidomide alone,23 cases） and Thalidomide ＋ Methotrexate（MTX） group（treated with Thalidomide and Methotrexate,27 cases）.For all patients,clinical parameters such as Pain Visual Analog Scale（VAS） score,joint tenderness index,joint swelling index and duration of morning stiffness as well as laboratory parameters such as erythrocyte sedimentation rate,C-reactive protein,blood analyses,liver and renal function were measured monthly.Clinical efficacy and safety of the 2 therapes were evaluated in the sixth month.Results VAS pain score,joint tenderness index,joint swelling index,duration of morning stiffness,erythrocyte sedimentation rate and C-reactive protein significantly improved after treatment in both groups（P0.05）.There was significant difference between the two groups in the efficacy（u=4.71,P0.05）,while not in the total effective rate（P0.05）.The incidences of drug adverse reactions were 34.8% in Thalidomide group and 40.7% in Thalidomide ＋ MTX group（NS,P0.05）.However,all adverse reactions were mild and can be tolerated.Conclusion Our observations suggest that Thalidomide show satisfactory clinical effects and safety as well as a synergistic effect with Methotrexate in the treatment of rheumatoid arthritis.
出处
《实用医院临床杂志》
2011年第5期115-116,共2页
Practical Journal of Clinical Medicine
