青藤碱和甲氨蝶呤联合治疗类风湿关节炎

Sinomenine combined with methotrexate in treating rheumatoid arthritis

目的 :观察青藤碱和甲氨蝶呤联合治疗类风湿关节炎的疗效和不良反应。方法 :对照组 32例 (男性 6例、女性 2 6例 ,年龄 4 6a±s3a ,病程 4 .1a± 1.0a) ;青藤碱组 32例 (男性 7例 ,女性 2 5例 ,年龄 4 6a± 4a ,病程 4 .6a± 1.6a)。 2组原有非甾类抗炎药 (吲哚美辛、双氯芬酸 )继续应用。对照组加服甲氨蝶呤 15mg ,qw ;青藤碱组加服青藤碱 2 0mg ,tid +甲氨蝶呤 7.5mg ,qw。 3d后无不良反应 ,青藤碱加至 4 0mg ,tid。 2组于 1mo时非甾类抗炎药减半 ,2mo停用。 3mo为一个疗程。结果 :对照组显效 31% ,有效 56% ,改善 13% ;青藤碱组显效 38% ,有效 59% ,改善 3%。不良反应对照组4 7% ,青藤碱组 12 %。结论 :联合用药可减少治疗类风湿关节炎的用药剂量 。

AIM: To observe the effect and adverse reaction of sinomenine combined with methotrexate in treating rheumatoid arthritis.METHODS : The control group of 32 patients (M 6,F 26; age 46 a±s3 a,course of disease 4.1 a±1.0 a) and sinomenine group of 32 patients (M 7,F 25, age 46 a±4 a, course of disease 4.6 a±1.6 a) were continued to use the non-steroidal anti-inflammatory drugs (indometacin,diclofenac).Control group took methotrexate 15 mg, po qw ,sinomenine group took sinomenine 20 mg,po tid and methotrexate 7.5 mg, po, qw. Three days later, the dosage of sinomenine was increased to 40 mg,tid .After 1 mo the non-steroidal antiinflammatory drug was reduced to half of its original dosage for both groups, and it was stopped after 2 mo.Three months was a course of treatment.RESULTS: In the control group the excellent response rate was 31%, effective rate 56% and the improvement rate 13%;sinomenine group that were 38%,59%,3%,respectively. The rate of adverse reaction was 47% in the control group and 12% in the sinomenine group. CONCLUSION: Sinomenine combined with methotrexate can reduce dosage of the drugs in treating rheamatoid arthritis, increase the appropriateness of patient treatment, and decrease the adverse reaction.