来氟米特联合美洛昔康对类风湿关节炎患者病情活动指标的影响

Effect of Combined Use of Leflunomide and Meloxicam on Disease Activity Indicators of Rheumatoid Arthritis Patients

目的探究来氟米特联合美洛昔康治疗对类风湿关节炎（RA）患者病情活动指标的影响。方法选取2014年4-12月广元市中心医院收治的RA患者98例，按抽签法随机分为三组：来氟米特组（口服来氟米特片，每日2次，20mg／d）、美洛昔康组（口服美洛昔康分散片，每日2次，15mg／d）、来氟米特联合美洛昔康组（来氟米特10mg／d，每日1次；美洛昔康7．5mg／d，每日1次）。比较治疗前及治疗后1、2、3、4个月患者的病情活动指标[红细胞沉降率（ESR）、C反应蛋白（CRP）及类风湿因子（RF）]的变化。结果三组患者在治疗1、2、3、4个月后ESR、CRP与RF均呈下降趋势，但来氟米特联合美洛昔康组下降速度更快，三组在组间、时点间、组间·时点间差异有统计学意义（P〈0．05）。三组患者在治疗1、2,3、4个月后关节疼痛程度、关节肿胀指数、晨僵时间等临床症状指标均呈下降趋势，来氟米特联合美洛昔康组下降速度更快，三组在组间、时点间、组间·时点间交互效应差异有统计学意义（P〈0．05）。结论来氟米特联合美洛昔康治疗RA能显著降低其ESR、CRP与RF水平，是治疗RA的有效方法，值得临床推广应用。

Objective To investigate the effect of combined use of leflunomide and meloxicam on dis- ease activity indicators of rheumatoid arthritis（RA） patients. Methods Total of 120 patients diagnosed with RA admitted to Guangyuan Central Hospital from Aug. 2014 to Dec. 2014 were included in the study and divided （according to drawing method） into group I ：treated with leflunomide only （oral tablet,20 mg/d ,2 times/d） ;group U ：treated with meloxicam only （oral tablet, 15 mg/d 2 times/d） ;group 111 ：treated with combined use of leflunomide and meloxicam（ leflunomide 10 mg/d, one time per day;meloxicam 7.5 mg/d both one time per day）. The disease activity indicators [ erythrocyte sedimentation rate （ESR）, C reactive protein （CRP） and rheumatoid factor （RF）] of RA patients before treatment and 1,2,3,4 months after treatment were compared, Results The ESR, CRP and RF of RA patients in three groups all decreased after 1,2,3,4-month of treatment, but the group m showed more significant decline, and the differences between groups, different time points and groups ·different time points among the three groups were statistically sig- nificant （P 〈 O. 05 ）. The clinical symptoms indexes（ the degree of arthralgia,index of arthrocele and morning stiffness） after1,2,3,4-month of treatment in all of the three groups were improved,but the group Ⅲ showed more significant improvement, and the differences between groups, time points and groups · time points among three groups were statistically significant （ P 〈 0. 05 ）. Conclusion The combined use of leflunomide and meloxicam can significantly reduce the ESR, CRP and RF levels in treatment of RA disease, which is an effective method to treat RA and worthy to be promoted.