甲氨蝶呤联合雷公藤多苷治疗类风湿关节炎的临床效果观察

Clinical effect of methotrexate combined with Tripterygium wilfordii polyglycosides in the treatment of rheumatoid arthritis

目的观察甲氨蝶呤联合雷公藤多苷治疗类风湿关节炎(RA)的临床效果和不良反应,为临床合理用药提供参考。方法将70例RA患者随机分为对照组和观察组,每组35例。对照组口服甲氨蝶呤治疗,观察组在对照组治疗基础上口服雷公藤多苷,2组均持续治疗12周。观察比较2组治疗前后晨僵时间、关节肿胀数、关节压痛数、红细胞沉降率(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)和不良反应发生情况。结果治疗12周后,2组晨僵时间、关节肿胀数、关节压痛数、ESR、CRP、RF水平较治疗前均有明显好转,且观察组上述指标改善幅度大于对照组(P均<0. 05); 2组不良反应发生率比较差异无统计学意义(P> 0. 05)。结论甲氨蝶呤联合雷公藤多苷治疗RA患者的临床效果显著,安全性较高,是治疗RA的较好方案之一。

Objective To observe the clinical effects and adverse reactions of methotrexate combined with Tripterygium wilfordii polyglycosides in the treatment of rheumatoid arthritis,and to provide reference for clinical rational drug use.Methods Seventy patients with RA were randomly divided into observation group and control group,35 cases in each group.The patients in the control group were treated with methotrexate,while the patients in the observation group were treated with Tripterygium wilfordii polyglycosides on the basis of the control group. Both groups were treated continuously for 12 weeks.Morning stiffness time,number of joint swelling,number of joint tenderness,erythrocyte sedimentation rate( ESR),C-reactive protein( CRP),rheumatoid factor( RF) and adverse reactions were observed and compared between the two groups before and after treatment. Results After 12 weeks of treatment,morning stiffness time,number of joint swelling and joint tenderness,ESR,CRP and RF levels in the two groups were better than those before treatment. The improvement of the above indexes in the observation group was greater than that in the control group( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Conclusion Methotrexate combined with Tripterygium wilfordii polyglycosides in the treatment of RA patients with significant clinical effect,high safety,is one of the better treatment of RA.