来氟米特、甲氨蝶呤联合艾拉莫德治疗难治性类风湿性关节炎的近远期效果

Short Term and Short-term and Long-term Efficacy of Methotrexate with Eilamod and Leflunomide in the Treatment of Refractory RA

目的:探讨来氟米特、甲氨蝶呤联合艾拉莫德治疗难治性类风湿性关节炎(rheumatoid arthritis,RA)的近远期临床疗效。方法:选取2019年1月-2020年1月晋江市医院收治的120例难治性RA患者作为研究对象。随机将其分为观察组与对照组,对照组60例予以来氟米特及甲氨蝶呤治疗,观察组60例则采用来氟米特、甲氨蝶呤联合艾拉莫德治疗,评价两组难治性RA治疗效果及症状改善情况。结果:观察组治疗后难治性RA症状改善效果明显优于对照组(P<0.05)。观察组治疗后16、32、64周ESR、CRP、RF、DAS28评分明显低于对照组(P<0.05)。治疗前两组放射学评分及骨密度值比较差异无统计学意义(P>0.05),治疗后64周观察组侵蚀评分及TSS评分明显低于对照组,骨密度明显高于对照组(P<0.05),但治疗后64周两组狭窄评分比较差异无统计学意义(P>0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:采用来氟米特、甲氨蝶呤联合艾拉莫德治疗难治性类风湿性关节炎近远期效果均更为理想,可控制病情活动,有效阻滞病情进展,且治疗安全性好。

Objective:To investigate the short-term and long-term clinical efficacy of Leflunomide,Methotrexate and Eilamod in the treatment of refractory rheumatoid arthritis (RA).Method:A total of 120 patients with refractory RA treated in Jinjiang City Hospital from January 2019 to January 2020 were selected as the research object.They were randomly divided into observation group and control group.60 cases in the control group were treated with Leflunomide and Methotrexate,and 60 cases in the observation group were treated with Leflunomide,Methotrexate and Eilamod.The therapeutic effect and symptom improvement of refractory RA in the two groups were evaluated.Result:The improvement effect of refractory RA symptoms in the observation group was significantly better than that in the control group (P<0.05).The scores of ESR,CRP,RF and DAS28 in the observation group were significantly lower than those in the control group at 16,32 and 64 weeks after treatment (P<0.05).There was no significant difference in radiology score and bone mineral density between the two groups before treatment (P>0.05).64 weeks after treatment,the erosion score and TSS score of the observation group were significantly lower than those of the control group,and the bone mineral density was significantly higher than that of the control group (P<0.05),but there was no significant difference in stenosis score between the two groups at 64 weeks after treatment (P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion:The short-term and long-term effects of Leflunomide,Methotrexate and Eilamod in the treatment of refractory rheumatoid arthritis are more ideal.It can control the disease activity,effectively block the disease progress,and has good treatment safety.