甲氨蝶呤加用雷公藤多甙片治疗类风湿性关节炎的临床效果探析

Clinical effect of methotrexate and Leigong Teng Duo Dai Pian on treatment of rheumatoid arthritis

目的评析类风湿性关节炎给予甲氨蝶呤辅以雷公藤多甙片治疗的临床效果与安全性。方法选取深圳市坪山新区人民医院2013年6月~2014年10月收治的96例类风湿性关节炎患者,依据双盲随机法分为对照组与实验组,对照组48例仅接受甲氨蝶呤治疗,实验组48例在甲氨蝶呤基础上联合雷公藤多甙片进行治疗,疗程均为3个月,比较2组关节肿胀数、关节压痛数、疼痛程度及晨僵时间改善情况,观察红细胞沉降率（erythrocyte sedimentation rate,ESR）与C反应蛋白（C-reaction protein,CRP）变化,比较医生与患者对疾病活动性总体评价的差异,并对药物不良反应进行评析。结果与治疗前相比,治疗后2组患者关节肿胀数、关节压痛数、疼痛程度、晨僵时间均得到缓解,ESR、CRP均显著降低（P〈0.05）,且实验组相关指标较对照组改善更为显著（P〈0.05）。2组患者治疗后医生与患者对疾病活动性总体评价分数均显著降低（P〈0.05）,但实验组分数显著低于对照组（P〈0.05）。对照组不良反应为6.3%,实验组为10.4%,2组比较差异无统计学意义。结论类风湿性关节炎给予甲氨蝶呤辅以雷公藤多甙片治疗有助于纠正关节肿胀、疼痛等临床症状,降低红细胞沉降率和C反应蛋白水平,疗效显著优于单用甲氨蝶呤治疗。

Objective To analyze the clinical effect of methotrexate and Leigong Teng Duo Dai Pian on treatment of patients with rheumatoid arthritis. Methods 96 cases of rheumatoid arthritis from Jun. 2013 to Oct. 2014 were selected and divided into control group and experimental group according to the double blind randomized method. 48 cases in control group, were treated with methotrexate, and 48 eases in experimental group were added with LeigongTeng Duo Dai Plan. After 3 month, number of swollen joints, tender joint count, pain condition and morning stiffness, erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） between two groups were tested and compared. The overall evaluation of disease activity and adverse reaction were compared. Results Compared with pre-treatment, the number of swollen joints, tender joint count, pain condition, morning stiffness of two groups were all relieved, and ESR and CRP levels were all significantly decreased （ P 〈 0. 05 ）, and those indexes of experimental group were all better than control group （ P 〈 0. 05 ）. The overall evaluation of disease activity in two groups were all significantly decreased after treatment （ P 〈 0.05 ）, and the experimental group decreased more （ P 〈 0. 05 ）. Adverse reaction in control group was 6. 3 % , which in experimental group was 10. 4% , the difference wasn＇t significant. Conclusion Methotrexate combined with LeigongTeng Duo Dai Pian can relieve clinical symptoms such as joint swelling, pain of rheumatoid arthritis, and decrease ESR and CRP levels, better than the single use of methotrexate treatment.