甲泼尼龙联合甲氨蝶呤治疗RA患者的临床疗效研究

Study of clinical efficacy of treatment with Methylprednisolone combined with Methotrexate in RA patients

目的探究甲泼尼龙联合甲氨蝶呤治疗类风湿关节炎(RA)患者的临床疗效。方法选取2018年8月—2020年6月在周口市中医院骨一科收治的86例RA患者,并采用随机数字表法将其分为观察组(n=43)和对照组(n=43)。对照组采用甲氨蝶呤治疗,观察组采用甲泼尼龙联合甲氨蝶呤治疗。比较两组患者疾病活动性评分(DAS28)、类风湿因子阳性率、炎症因子水平及不良反应。计数资料采用χ^(2)检验进行比较,计量资料采用均数±标准差■表示,比较采用t检验,以P<0.05为差异具有统计学意义。结果治疗前,两组各项指标水平比较均无明显差异(P>0.05);治疗后,两组DAS28评分及类风湿因子阳性率较治疗前均明显降低(P<0.05),且观察组[2.86±0.57分;17(39.53%)]明显低于对照组[3.43±0.76分;27(62.79%)](t=-3.934,χ^(2)=4.654,P<0.05);治疗后,两组肿瘤坏死因子-(TNF-α)、C反应蛋白(CRP)及红细胞沉降率(ESR)水平均明显低于治疗前(P<0.05),且观察组明显低于对照组(t=12.572,-9.949,-9.196,P<0.05);治疗期间,两组患者在均未发生胃部不适、白细胞下降、肝肾功能损害等严重不良反应。结论甲泼尼龙联合甲氨蝶呤治疗RA患者临床疗效显著,可改善患者病情,减轻机体炎症反应,且安全性较好。

Objective To explore the clinical efficacy of methylprednisolone combined with methotrexate in the treatment of patients with rheumatoid arthritis(RA).Methods A total of 86 patients with RA admitted to the Department of Orthopedics,Zhoukou Hospital of Traditional Chinese Medicine from Aug.2018 to Jun.2020 were selected and divided into observation group(n=43)and control group(n=43)by using the random number table method.The control group was treated with methotrexate,and the observation group was treated with methylprednisolone combined with methotrexate.The disease activity score(DAS28),the positive rate of rheumatoid factors and the levels of related inflammatory factors of two groups were compared.Enumeration data were compared by χ^(2) test,measurement data were expressed as mean±standard deviation■test was used for comparison,and P<0.05 indicates that the difference is statistically significant.Results Before treatment,there were no significant differences between the two groups(P>0.05);After treatment,the DAS28 score and the positive rate of rheumatoid factors of the two groups were significantly lower than those before treatment(P<0.05),and the observation group[2.86±0.57 points,17(39.53%)]were significantly lower than those of the control group[3.43±0.76 points,27(62.79%)](t=-3.934,χ^(2)=4.654,P<0.05).After treatment,the levels of tumor necrosis factor-(TNF-α),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in the two groups were significantly lower than those before treatment(P<0.05),and the observation group were significantly lower than those in the control group(t=12.572,-9.949,-9.196,P<0.05);During the treatment,there were no serious adverse reactions such as stomach discomfort,leucocyte decline,liver and kidney function damage in both groups.Conclusion The clinical efficacy of methylprednisolone combined with methotrexate in the treatment of RA patients is significant,which can improve the disease condition of patients,reduce the inflammatory response of body,and the safety is good.