帕夫林联用甲氨蝶呤治疗类风湿关节炎的临床观察

Clincal observation on effect of total glucosides of paeony combined with methotrexate on rheumatoid arthritis

目的:探讨治疗类风湿关节炎经济、有效、安全的治疗方案。方法:回顾性总结2005年3月至2006年3月我院门诊及住院115例类风湿关节炎患者的临床疗效及肝肾功能,通过统计学分析比较单用甲氨蝶呤,甲氨蝶呤联合柳氮磺胺吡啶,帕夫林联用甲氨蝶呤三组患者治疗1y的临床疗效、实验室指标,比较三组间肝肾功异常的发生率。结果:甲氨蝶呤组(单联组)、甲氨蝶呤+柳氮磺吡啶对照组(对照组)、甲氨蝶呤+帕夫林组(治疗组)三组病例用药前一般资料无统计学差异(P>0.05),对照组及治疗组的临床疗效明显优于单联组(P<0.01),而治疗组肝肾功异常发生率明显低于单联组和对照组(P<0.01)。结论:帕夫林联用甲氨蝶呤治疗类风湿关节炎1y疗效优于单用甲氨蝶呤,而肝肾功异常的发生率小于单用甲氨蝶呤和甲氨蝶呤联用柳氮磺胺吡啶。

Objective： To evaluate the security, effective and economy therapeutic regimen on rheumatoid arthritis（RA）. Methotis： The clinical efficacy, hepatic and renal function in the patients with RA in our hospital from 2005 to 2006 were summarized retrospectively. Patients were divided into three groups （treatment with single-dose methotrexate （MTX）, MTX plus sulfasalazine （SASP）, MTX plus total glueosides of paeony（TGP）. The clinical effect and laboratory indexs were analyzed by the statistic method one year after treatment to eornpare the incidence of hepatic and renal dysfunction among the three groups. Results： There was no statistieal difference among the three groups before the treatment（P〉0. 05）. The curative effect of the MTX plus SASP group and the MTX plus TGP group was obviously superior to the MTX group and the incidence of hepatic and renal dysfunction in the MTX plus TGP group was lower than that of the MTX and MTX plus SASP group（P〈0.01）. Conclusion： MTX plus TGP treatment was superior in therapeutic effect to that of single using MTX one year after therapy and it＇s incidence of hepatic and renal dysfunetlon was also lower than that of MTX and MTX plus SASP groups.