青白散联合甲氨蝶呤及美洛昔康治疗类风湿关节炎临床观察

Clinical Observation of the Treatment of Rheumatoid Arthritis with Qingbai Powder Combined with Methotrexate and Meloxicam

目的:观察青白散联合甲氨蝶呤及美洛昔康治疗类风湿关节炎的临床疗效及安全性。方法:将64例类风湿关节炎患者随机分为治疗组34例和对照组30例。对照组给予口服甲氨喋呤每次10 mg,每周1次;美洛昔康每次7.5 mg,每日2次;治疗组在对照组治疗的基础上加用青白散,每次2 g,每日3次,冲服。两组美洛昔康疗程为8周,余药疗程为12周。观察两组患者治疗前,治疗第12周关节症状改善程度及药物不良反应。结果:治疗后,治疗组ACR20、ACR50、ACR70分别为88.24%、70.59%、52.94%,对照组ACR20、ACR50、ACR70分别为73.33%、46.67%、33.33%。两组比较,差异有统计学意义(P<0.05)。治疗组关节肿胀、关节压痛、晨僵时间、红细胞沉降率、DAS28评分等临床和实验室指标改善均优于对照组,差异有统计学意义(P<0.05);两组安全性比较,差异无统计学意义(P>0.05)。结论:青白散联合甲氨蝶呤及美洛昔康治疗类风湿关节炎,能很好地缓解患者的关节症状;且不良反应发生率低,患者依从性高。

Objective：To observe the clinical efficacy and safety of Qingbai Powder combined with methotrexate and meloxicam in treatment of rheumatoid arthritis.Methods：64 cases with rheumatoid arthritis were randomly divided into a treatment group（34 cases）and a control group（30 cases）.The control group were given orally methotrexate,10 mg each time,once a week;and meloxicam,7.5 mg each time, twice a day;while the treatment group,based on the treatment of the control group,were treated with Qingbai Powder,2 g each time,3 times a day.Meloxicam treated 8 weeks,and others 12 weeks.The two groups were observed before and after treatment 12 weeks on the aspects of reactions and joint symptom improvement.Results：After treatment,the ACR20,ACR50 and ACR70 of the treatment group were respectively 88.24%,70.59% and 52.94%,while those of the control group were respectively 73.33%,46.67% and 33.33%.The difference between the two groups was statistically significant（P〈0.05）.The treatment group was better than the control group on the clinical and laboratory indexes such as joint swelling,joint tenderness,morning stiffness time,erythrocyte sedimentation rate and DAS28 score,the difference being statistically significant（P〈0.05）;the difference of safety between the two groups was not significant（P〉0.05）.Conclusion：Qingbai Powder combined with methotrexate and meloxicam can be very good to ease joint symptom in the treatment of rheumatoid arthritis,with low incidence rate of adverse reactions and high dependence of patients.