甲氨蝶呤联合羟氯喹对类风湿性关节炎患者关节肿胀及晨僵症状的影响

Effect of Methotrexate Combined with Hydroxychloroquine on Joint Swelling and Morning Stiffness in Patients with Rheumatoid Arthritis

目的研究甲氨蝶呤联合羟氯喹对类风湿性关节炎患者关节肿胀及晨僵症状的影响。方法选取2019年3月-2022年3月我院诊治的61例类风湿性关节炎患者为研究对象,采用随机数字表法分为对照组(n=30)和观察组(n=31)。对照组采用甲氨蝶呤治疗,观察组在对照组基础上联合羟氯喹治疗,比较两组临床疗效、关节肿胀评分、晨僵时间、疼痛评分(VAS)、超敏C反应蛋白(hs-CRP)和红细胞沉降率(ESR)水平、不良反应发生率。结果观察组治疗总有效率为93.55%,高于对照组的83.33%(P<0.05);两组治疗后关节肿胀评分低于治疗前,且观察组低于对照组(P<0.05);两组治疗后VAS评分均低于治疗前,且观察组低于对照组(P<0.05);两组治疗后晨僵时间均短于治疗前,且观察组短于对照组(P<0.05);两组治疗后hs-CRP、ESR水平均低于治疗前,且观察组低于对照组(P<0.05);观察组不良反应发生率为9.68%,低于对照组的20.00%(P<0.05)。结论甲氨蝶呤联合羟氯喹治疗可减轻类风湿性关节炎患者关节肿胀程度,缩短晨僵时间,减轻患者疼痛度,降低hs-CRP、ESR水平及不良反应发生率,是一种可行、安全、有效的治疗方案。

Objective To study the effect of methotrexate combined with hydroxychloroquine on joint swelling and morning stiffness in patients with rheumatoid arthritis.Methods A total of 61 patients with rheumatoid arthritis diagnosed and treated in our hospital from March 2019 to March 2022 were selected as the research objects.They were divided into control group(n=30)and observation group(n=31)by random number table method.The control group was treated with methotrexate,and the observation group was treated with hydroxychloroquine on the basis of the control group.The clinical efficacy,joint swelling score,morning stiffness time,pain score(VAS),high-sensitivity C-reactive protein(hs-CRP)and erythrocyte sedimentation rate(ESR)levels,and incidence of adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 93.55%,which was higher than 83.33%in the control group(P<0.05).The joint swelling score of the two groups after treatment was lower than that before treatment,and that of the observation group was lower than that of the control group(P<0.05).The VAS score of the two groups after treatment waslower than that before treatment,and that of the observation group was lower than that of the control group(P<0.05).The morning stiffness time of the two groups after treatment was shorter than that before treatment,and that of the observation group was shorter than that of the control group(P<0.05).After treatment,the levels of hs-CRP and ESR in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 9.68%,which was lower than 20.00%in the control group(P<0.05).Conclusion Methotrexate combined with hydroxychloroquine can reduce the degree of joint swelling in patients with rheumatoid arthritis,shorten the time of morning stiffness,reduce the pain of patients,reduce the levels of hs-CRP and ESR and the incidence of adverse reactions.It is a feasible,safe and effective treatment.