摘要
目的 探讨甲氨蝶呤联合来氟米特治疗类风湿关节炎的临床疗效.方法 将嵊州市中医院2017年1月至2018年2月收治的类风湿关节炎患者90例按照随机数字表法分为对照组与观察组各45例;对照组采用甲氨蝶呤治疗;观察组采用甲氨蝶呤联合来氟米特治疗.评价两组临床疗效,分别于治疗前、治疗4个月时检测两组抗环瓜氨酸肽抗体（ACCP）、类风湿因子（RF）、C反应蛋白（CRP）水平,记录两组治疗期间不良反应.结果 观察组治疗4个月后临床总有效率为95.56％,明显高于对照组的80.00％（χ2=8.196,P=0.016）;两组患者治疗4个月时ACCP、RF、CRP水平较治疗前明显下降,观察组治疗4个月时ACCP、RF、CRP水平分为（12423.68±174.82）U/L、（6.24±2.14）U/L、（6.69±3.32）mg/L,明显低于对照组的（15421.27±287.33）U/L、（16.58±3.26）U/L、（10.14±5.22）mg/L,t=（59.787、17.786、3.741,P=0.000、0.000、0.000）.观察组不良反应发生率为6.67％,与对照组的4.44％ 比较,差异无统计学意义（χ2=0.211,P=0.645）.结论 甲氨蝶呤联合来氟米特治疗类风湿关节炎可显著提高临床疗效,降低患者血清ACCP、RF、CRP水平,对控制病情有一定意义,同时不会增加不良反应,具有一定安全性.
Objective To investigate the clinical efficacy of methotrexate combined with leflunomide in the treatment of rheumatoid arthritis. Methods From January 2017 to February 2018,90 patients with rheumatoid arthritis in Shengzhou Hospital of Traditional Chinese Medicine were divided into control group and observation group according to the random number table method,with 45 cases in each group. The control group was treated with metho-trexate,the observation group was treated with methotrexate and leflunomide. The clinical efficacy of the two groups was evaluated. The anti - cyclic citrullinated peptide antibody （ACCP）,rheumatoid factor （RF）,and C - reactive protein （CRP） levels were measured before and after 4 months of treatment. The adverse reactions were recorded. Results The total effective rate in the observation group was 95. 56％ after 4 months of treatment,which was signifi-cantly higher than 80. 00％ in the control group （χ2 = 8. 196,P = 0. 016）. The ACCP,RF and CRP levels in the two groups were significantly decreased after treatment for 4 months. The ACCP,RF and CRP levels in the observation group were （12423. 68 ± 174. 82） U/ L,（6. 24 ± 2. 14） U/ L,and （6. 69 ± 3. 32） mg/ L,respectively,which were significantly lower than those in the control group [（15421. 27 ± 287. 33） U/ L,（16. 58 ± 3. 26） U/ L,（10. 14 ± 5. 22）mg/ L,t = 59. 787,17. 786,3. 741,P = 0. 000,0. 000,0. 000]. The incidence rate of adverse reaction in the observation group was 6. 67％ ,which in the control group was 4. 44％ ,the difference between the two groups was not statistically significant （ χ2 = 0. 211, P = 0. 645）. Conclusion Methotrexate combined with leflunomide in the treatment of rheumatoid arthritis can significantly improve the clinical efficacy,reduce the serum ACCP,RF,CRP levels in patients with a certain degree of control of the disease,while not increasing adverse reactions,has certain degree of safety.
作者
陈华
楼宇舫
Chen Hua;Lou Yufang(Department of Pharmacy,Shengzhou Hospital of Traditional Chinese Medicine,Shengzhou,Zhejiang 312400,China;Department of Rheumatology,Shengzhou Hospital of Traditional Chinese Medicine,Shengzhou,Zhejiang 312400,China)
出处
《中国基层医药》
CAS
2018年第22期2931-2934,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
关节炎
类风湿
类风湿因子
抗环瓜氨酸肽抗体
C反应蛋白质
甲氨蝶呤
来氟米特
临床对照试验
Arthritis
rheumatoid
Rheumatoid factor
Anti-cyclic citrullinated peptide antibody
C-reactive protein
Methotrexate
Leflunomide
Controlled clinical trial
