三军丸联合美洛昔康及甲氨蝶呤治疗类风湿关节炎临床观察

Clinical Observation on the Treatment of Rheumatoid Arthritis with Sanjun Pill Combined with Meloxicam and Methotrexate

目的：观察三军丸联合美洛昔康及甲氨蝶呤治疗类风湿关节炎的临床疗效。方法：将62例类风湿关节炎患者随机分为治疗组和对照组,每组31例。对照组予美洛昔康每次7.5 mg,每日2次,甲氨蝶呤每次10 mg,每周1次,口服。治疗组在对照组基础上加用三军丸每次8～10丸,每日2次,口服。观察两组治疗前后临床症状、体征指标及急性炎症指标等,采用疾病活动性评分（DAS28）标准为临床疗效评价指标,并观察不良反应。结果：治疗组显效10例,进步11例,有效5例,无效4例,有效率占86.67%;对照组显效8例,进步10例,有效5例,无效7例,有效率占76.67%。两组疗效比较,差异有统计学意义（P〈0.05）。治疗后,治疗组临床症状、体征指标及DAS28评分、急性炎症指标较治疗前均有改善,差异有统计学意义（P〈0.05或P〈0.01）;其中,关节压痛数、晨僵时间、VAS评分及红细胞沉降率与对照组比较,差异有统计学意义（P〈0.05）.结论：三军丸联合美洛昔康及甲氨蝶呤治疗类风湿关节炎有较好疗效。

Objective：To observe the clinical curative effect ofSanjun Pill combined with meloxicam and methotrexate in the treatment of rheumatoid arthritis.Methods：62 cases of rheumatoid arthritis were randomly and equally divided into a treatment group and a control group.The control group was treated orally with meloxicam, 7.5 mg each time,twice a day,and methotrexate,10 mg each time,once a week.The treatment group was orally given Sanjun Pill based on the treatment of the control group,8 ～ 10 pills each time,twice a day.The two groups were observed before and after treatment on the aspects of clinical symptoms,signs,indexes and acute inflammation index.The disease activity score standard（DAS28） was used as the clinical efficacy evaluation index,observing the adverse reactions.Results：In the treatment group,10 cases were remarkably effective,11 cases were improved, 5 cases were effective,4 cases were invalid,the effective rate accounting for 86.67%;while in the control group, 8 cases were markedly effective,10 cases were improved,5 cases were effective,and 7 cases were invalid,the efifciency accounting for 76.67%.The difference of the efifcacy between the two groups was statistically signiifcant（P〈 0.05）. After treatment,the clinical symptoms,signs index,DAS28 score,and acute inlfammation index were improved than those before the treatment,the difference being statistically signiifcant（P〈 0.05 orP〈 0.01）;the differences of clinical symptoms and signs,tender joint count,time of morning stiffness,VAS score,acute inlfammation indexes and erythrocyte sedimentation rate between the two groups were statistical significant（P〈 0.05）.Conclusion：There are good curative effects ofSanjun Pill combined with methotrexate and meloxicam in the treatment of rheumatoid arthritis.