沙利度胺联合甲氨喋呤与羟氯喹治疗类风湿关节炎的疗效分析

Analysis of the Efficacy of Thalidomide Combined with Methotrexate and Hydroxychloroquine in the Treatment of Rheumatoid Arthritis

目的:探讨沙利度胺(THD)联合甲氨喋呤(MTX)、羟氯喹(HCQ)治疗类风湿关节炎(RA)的临床疗效。方法:82例RA患者随机分为观察组(n=41)与对照组(n=41),对照组给予MTX治疗,观察组在对照组基础上加用THD与HCQ,对比两组患者临床疗效。结果:观察组有效率为90.2%,显著高于对照组的70.7%(P<0.05);治疗前、治疗后1个月两组患者肿胀关节数、压痛关节数、晨僵时间、ESR、CRP、RF、VAS比较差异无统计学意义(P>0.05);治疗后2、3、4、5、6个月比较观察组各观察指标均显著优于对照组(P<0.05);两组患者治疗过程中血细胞降低、消化道症状、呼吸道感染、月经紊乱、皮疹、ALT升高、头晕嗜睡、口腔溃疡等不良反应发生率比较无统计学差异(P>0.05)。结论:沙利度胺联合甲氨喋呤、羟氯喹用于类风湿关节炎患者的治疗,能够有效延缓病情的进展、缓解患者痛苦,同时减少了药物的不良反应,为临床提供了新的治疗方法。

Objective：To discuss the clinical efficacy of thalidomide （THD） combined with methotrexate （MTX） and hydroxychloroquine （HCQ） in the treatment of rheumatoid arthritis （RA）.Methods：82 patients with RA were randomly divided into observation group （n=41） and control group （n=41）.The patients in the control group were treated with MTX,and the patients in the observation group were treated with THD and HCQ on the basis of the control group.Then the clinical efficacy was compared between the two groups.Results：The effective rate in the observation group was 90.2%,which was significantly higher than 70.7% in the control group （P〈0.05）;There was no significant difference in swollen joints number,tender joints number,morning stiffness time,ESR,CRP,RF,and VAS before the treatment and 1 month after the treatment （P〉0.05）,while the observation group was significantly better than the control group 2,3,4,5,6 months after the treatment （P〈0.05）;There was no significant difference in the incidence of the adverse reactions such as ALT elevation,dizziness and sleepiness,digestive tract symptoms,respiratory tract infection,rash,cytopenia,dental ulcer,menstrual disorders （P〉0.05）.Conclusion：THD combined with MTX and HCQ can effectively delay the progress of the disease,relieve the pain of patients,and reduce the adverse drug reaction in the treatment of RA.It provides a new method for clinical treatment of RA.