塞来昔布联合甲氨蝶呤治疗类风湿关节炎的临床疗效及其对关节功能和炎性递质的影响

Clinical efficacy of celecoxib combined with methotrexate in the treatment of rheumatoid arthritis and its influence on joint function and inflammatory transmitters

目的观察塞来昔布联合甲氨蝶呤治疗类风湿关节炎的临床疗效及其对关节功能和炎性递质的影响。方法回顾性选取2020年2月—2022年1月张家港市第一人民医院收治的类风湿关节炎患者80例,按照治疗方法不同分为对照组和联合组,每组40例。对照组予以塞来昔布胶囊,联合组在对照组治疗基础上联合甲氨蝶呤。2组患者均治疗6个月。比较2组临床疗效,治疗前后视觉模拟评分法(VAS)评分、类风湿关节炎病情活动度评价表(DAS28)评分、炎性递质[肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、C反应蛋白(CRP)、前列腺素E_(2)(PGE_(2))、血浆P物质(SP)],不良反应。结果联合组治疗总有效率为97.50%,高于对照组的80.00%(χ^(2)=4.507,P=0.034)。与治疗前比较,2组治疗6个月后VAS评分、DAS28评分降低(P<0.01),且联合组均低于对照组(P<0.01)。与治疗前比较,2组治疗6个月后血清TNF-α、IL-6、CRP、PGE_(2)、SP水平均降低(P<0.01),且联合组低于对照组(P<0.01)。联合组不良反应总发生率为7.50%,低于对照组的25.00%(χ^(2)=4.500,P=0.033)。结论塞来昔布配合甲氨蝶呤治疗类风湿关节炎能有效改善患者关节功能,平衡体内炎性递质水平,从而降低炎性反应,提高疗效,且安全性较高。

Objective To analyze and explore the clinical efficacy of celecoxib combined with methotrexate in the treatment of rheumatoid arthritis and its influence on joint function and inflammatory transmitters.Methods A total of 80 cases of patients with rheumatoid arthritis were selected retrospectively from February 2020 to January 2022 in Zhangjiagang First People′s Hospital,which were randomly divided into control group and combined group according to different treatment methods,with 40 cases in each group.The control group was treated with celecoxib capsules,while the combined group was treated with methotrexate on the basis of the control group.Patients in both groups were treated for 6 months.Clinical efficacy,the VAS score,DAS28 score and inflammatory transmitters(TNF-α,IL-6,CRP,PGE_(2),SP)before and after treatment were compared between the two groups,and the incidence of adverse reactions were observed.Results The total effective rate of combined therapy in combined group was 97.50%,which was higher than 80.00%in control group(χ^(2)=4.507,P=0.034).Compared with those before treatment,VAS score and DAS28 score of the two groups decreased after 6 months of treatment(P<0.01).After 6 months of treatment,the VAS score and DAS28 score of the combined group were lower than those of the control group(P<0.01).Compared with those before treatment,the serum levels of TNF-α,IL-6,CRP,PGE_(2)and SP in both groups decreased after 6 months of treatment(P<0.01);after 6 months of treatment,the serum levels of TNF-α,IL-6,CRP,PGE_(2)and SP in the combined group were lower than those in the control group(P<0.01).The total incidence of adverse reactions in combined group was 7.50%,which was lower than 25.00%in control group(χ^(2)=4.500,P=0.033).Conclusion Celecoxib combined with methotrexate in the treatment of rheumatoid arthritis can effectively improve the patient′s joint function,balance the level of inflammatory transmitters in the body,thereby reducing the inflammatory reaction,improving the efficacy and safety.