甲氨喋呤与美洛昔康联合治疗强直性脊柱炎的临床观察

Methotrexate in conjunction with meloxicam for treating ankylosing spondylit is:a clinical observation of the efficacy and safety

目的观察甲氨喋呤(MTX)与美洛昔康(MLX)联合治疗强直性脊柱炎(AS)的疗效和安全性,探索使用MTX的合理剂量。方法将32例AS患者分成A、B两组,A组14例,B组18例。A组给予MTX(12.3±3.6)mg,口服,次/周,B组给予MTX(21.3±3.2)mg,口服,次/周;两组患者均给予MLX7.5mg/d。共治疗3月。结果两组各项临床指标及实验室指标较治疗前均有改善,A组总有效率为78.6%,B组总有效率为88.9%;不良反应发生率A组50.0%,B组83.3%,总有效率和不良反应发生率均无显著性差异(P>0.05)。结论MTX与MLX联合应用治疗AS,疗效良好;其疗效与MTX剂量不存在相关性,但因不良反应发生率较高,MTX以小剂量为宜;在短时间(3月)内,MLX不增加MTX的毒性作用。

Objective To eval ua te the efficacy and safety of combined use of methotrexate and meloxicam for tre ating of ankylosing spondylitis (AS), and to determine the optimal dosage of me thotrexate. Methods Thirty-two patients with AS were divided into group A (n=14 ) to receive oral methotrexate at the dose of 12.3±3.6 mg once a week and group B (n=18) at the dose of 21.3±3.2 mg once a week. Each of the patients in both groups also took oral meloxicam (7.5 mg) for 3 months. Results After treatment , the clinical indexes and inflammatory parameters of the patients significantly improved in both groups, with a total efficacy of 78.6% in group A and 88.9% i n group B. Conclusions The combination of methotrexate with meloxicam may achie ve satisfactory results in AS treatment, which is not positively related to meth otrexate dosage. In short-term usage, meloxicam does not increase the toxicity of methotrexate.