小剂量糖皮质激素联合来氟米特及羟氯喹治疗类风湿关节炎的疗效观察

The Curative Effect of Small Dose of Glucocorticoid Combined With Leflunomide and Hydroxychloroquine in the Treatment of Rheumatoid arthritis

目的：观察小剂量激素联合来氟米特及羟氯喹治疗类风湿关节炎（RA）的临床疗效。方法将64例 RA 患者随机分为两组：治疗组：小剂量泼尼松联合来氟米特及羟氯喹组，予以来氟米特30 mg/d，强的松10 mg/d，晨起口服，羟氯喹200 mg，2次/d 口服；对照组：来氟米特联合醋氯芬酸组，予以来氟米特30 mg/d，醋氯芬酸0.1/次、2～3次/日，两组均为32例，疗程为12周。比较两组治疗前后的 ESR、C 反应蛋白指标及关节疼痛改善程度。结果与对照组相比，治疗组的完全缓解率与部分缓解率较高，临床 DAS28评分、ESR、C 反应蛋白水平降低，差异有统计学意义（P ＜0.05）。结论小剂量强的松联合来氟米特及强氯喹治疗类风湿关节炎能有效改善患者关节肿痛症状，明显抑制炎症反应，控制病情进展。

Objective To observe the effect of small dose of lefiunomide combined hormone and hydroxychloroquine in the treatment of rheumatoid arthritis （RA） . Methods 64 cases of RA were randomly divided into two groups： treatment group： small dose of leflunomide combined with prednisone and hydroxychloroquine. Treated with leflunomide 30 mg/d, prednisone 10 mg/d, morning oral hydroxychloroquine, 200 mg, 2 /d orally. Control group： lefiunomide combined with aceclofenac group, to lefiunomide 30 mg/d, aceclofenac 0.1/ times, 2~3 times per day , treatment for 12 weeks. ESR, C reactive protein index, and joint pain improvement were compared in two groups before and aftertreatment. Results Compared with the control group, the complete remission rate of treatment group was higher and the partial remission, the level of clinical scores of DAS28, ESR, C reaction protein decreased, the difference was statistically significant （P〈0.05）. Conclusion A small dose of prednisone combined with lefiunomide and strong chloroquine can effectively improve patients with joint pain symptoms in the treatment of rheumatoid arthritis, inhibiting the infiammatory reaction, control the progress of the disease.