类风湿关节炎338例药物治疗16年回顾性分析

Clinical analysis on drug therapy of rheumatoid arthritis———a retrospect of 16 years

目的 :了解类风湿关节炎 (RA)药物治疗及治疗方案的远期疗效及安全性。方法 :82例单种使用非甾类消炎药 (NSAIDs) ,2 56例用慢作用抗风湿药 (SAARDs) ,其中 113例为单种SAARDs治疗 ,95例为联合用药 ,4 8例为轮换用药。结果 :1,2 ,3,5a和 10a以上治疗坚持率轮换用药组为 94 % ,77% ,69 % ,4 4 %和 13 %。而联合用药组为 81% ,4 7% ,39% ,19%和 4 % ,单种SAARDs用药组为59 .3 % ,33.6% ,2 2 .1% ,7.0 %和 2 .7% ,NSAIDs组为 13 % ,2 % ,2 % ,0和 0。单种SAARDs用药组、联合用药组和轮换用药组治疗RA临床显效率分别为 33.6% ,34 %和 38%。单种用药组、联合用药组和轮换用药组均无发生严重不良反应。结论 :SAARDs治疗方案坚持率高 ,疗效好 ,不良反应轻。

AIM :Tostudythelong termeffica cyandsafetyofdrugsinthetreatmentofrheumatoid arthritis (RA) . METHODS :Threehundredand thrity eightconsecutivepatientswithRAweretreat edduring 1983- 1998.Inthesepatients ,82 patients hadbeentreatedwithNSAIDsaloneand 2 56patients bySAARDsinwhich 113patientswithSAARDs alone ,95patientsbycombinationtherapyand 4 8pa tientsbysawtooththerapy . RESULTS :Therate ofadheringtotreatmentfor 1,2 ,3,5andover 10a was 94 % ,77% ,69% ,4 4 %and 13 %respec tivelyinthechanging (sawtooththerapy) group .It was 81% ,4 7% ,39% ,19%and 4 %respectively inthecombinationgroup ,andintheSAARDsalone groupitwas 59.3 % ,33.6% ,2 2 .1% ,7.0 %and 2 .7% ,andintheNSAIDsgroupitwas 13 % ,2 % , 2 % ,0and 0respectively .Theeffectiverateof SAARDsalonegroup ,combinationtherapygroupand sawtooththerapygroupwere 33.6% ,34 % ,and 38 %respectively .Therewerenosevereadversereac tioninthesethreegroups . CONCLUSION :Early treatmentwithSAARDsisbeneficialindiseasecon trollingandadheringtotreatment .Theeffectof SAARDsisgoodandtheadversereactionismild .