小剂量泼尼松联合甲氨蝶呤治疗类风湿关节炎患者的效果观察

Observation of effect by small dose of prednisone combined with methotrexate in the treatment of rheumatoid arthritis patients

目的研究类风湿关节炎患者实施小剂量泼尼松联合甲氨蝶呤进行治疗的临床效果。方法 56例类风湿关节炎患者,随机分为实验组与对照组,各28例。实验组患者给予小剂量泼尼松联合甲氨蝶呤治疗,对照组患者给予甲氨蝶呤联合来氟米特治疗。比较两组患者的炎性细胞抑制与临床症状改善情况。结果实验组患者的ACR20、ACR50及ACR70缓解率分别为71.43%、64.29%、25.00%,均明显高于对照组的42.86%、35.71%、3.57%,差异具有统计学意义(P<0.05)。治疗前,两组患者关节肿胀数、关节压痛数及晨僵时间比较差异无统计学意义(P>0.05);治疗后,实验组患者关节肿胀数、关节压痛数、晨僵时间改善情况均明显优于对照组,差异具有统计学意义(P<0.05)。治疗前,两组患者风湿性关节炎活动度(DAS)评分、视觉模拟评分法(VAS)评分及红细胞沉降率(ESR)比较差异无统计学意义(P>0.05);治疗后,实验组患者DAS评分、VAS评分及ESR改善情况均明显优于对照组,差异具有统计学意义(P<0.05)。结论采用甲氨蝶呤联合小剂量泼尼松治疗类风湿关节炎患者,可有效抑制其炎性细胞因子,临床症状明显改善,效果显著。

Objective To research clinical effect by small dose of prednisone combined with methotrexate in the treatment of rheumatoid arthritis patients. Methods A total of 56 patients with rheumatoid arthritis were randomly divided into experimental group and control group, with 28 cases in each group. The experimental group received small dose of prednisone combined with methotrexate for treatment, and the control group received methotrexate combined with leflunomide for treatment. Comparison was made on inflammatory cells inhibition and improvement of clinical symptoms between the two groups. Results The experimental group had remission rates of ACR20, ACR50 and ACR70 respectively as 71.43%, 64.29% and 25.00%, which were all higher than 42.86%, 35.71% and 3.57% in the control group, and their difference had statistical significance（P〈0.05）. Before treatment, there was no statistically significant difference of arthrocele count, articular pain count and morning stiffness duration between the two groups（P〉0.05）. After treatment, the experimental group had obviously better improvements of arthrocele count, articular pain count and morning stiffness duration than the control group, and the difference had statistical significance（P〈0.05）. Before treatment, there was no statistically significant difference of disease activity score for rheumatoid arthritis（DAS） scores, visual analogue scale（VAS） scores and erythrocyte sedimentation rate（ESR） between the two groups（P〉0.05）. After treatment, the experimental group had all better improvements of DAS score, VAS score and ESR than the control group, and the difference had statistical significance（P〈0.05）. Conclusion Implement of methotrexate combined with small dose of prednisone in treating rheumatoid arthritis patients can effectively inhibit its inflammatory cytokines, along with remarkably improved clinical symptoms and excellent effect.