甲氨蝶呤治疗类风湿性关节炎的应用及最佳剂量分析

目的:探讨甲氨蝶呤治疗类风湿性关节炎的应用及最佳剂量。方法:选择2017年4月至2018年2月90例类风湿性关节炎患者,随机分成2组。对照组给予雷公藤多苷片治疗,观察组则给予雷公藤多苷片联合小剂量的甲氨蝶呤治疗。比较两组疗效水平;关节肿胀、关节压痛、晨僵症状消失的时间、实验室指标正常时间;治疗前后患者关节肿胀指数、压痛指数、晨僵持续时间、休息痛评分、握力水平、C反应蛋白、血沉以及RF滴度;治疗不良反应。结果:观察组疗效水平高于对照组,P<0.05;观察组关节肿胀、关节压痛、晨僵症状消失的时间、实验室指标正常时间优于对照组,P<0.05;治疗前两组关节肿胀指数、压痛指数、晨僵持续时间、休息痛评分、握力水平、C反应蛋白、血沉以及RF滴度并无明显差异,P>0.05;治疗后观察组关节肿胀指数、压痛指数、晨僵持续时间、休息痛评分、握力水平、C反应蛋白、血沉以及RF滴度优于对照组,P<0.05。观察组治疗不良反应和对照组无明显差异,P>0.05。结论:雷公藤多苷片联合小剂量的甲氨蝶呤治疗类风湿性关节炎的疗效确切,可有效改善值得推广应用。

Objective: To investigate the application of methotrexate in the treatment of rheumatoid arthritis and the optimal dose. Methods: 90 patients with rheumatoid arthritis were selected from April 2017 to February 2018 and randomly divided into 2 groups. The control group was treated with tripterygium glycosides tablets, and the observation group was treated with tripterygium glycosides tablets in combination with small doses of methotrexate. The therapeutic efficacy levels of the two groups were compared; joint swelling, joint tenderness, time of morning stiffness disappeared, normal time of laboratory indicators; the joint swelling index, tenderness index, morning stiffness duration, rest pain score, grip strength level, C-reactive protein, erythrocyte sedimentation rate and RF titer before and after treatment; adverse reactions were compared. Results: The therapeutic effect of the observation group was higher than that of the control group, P<0.05. Theextinction time of joint swelling, joint tenderness, morning stiffness and the normal time of laboratory indexes in the observation group were better than those in the control group, P<0.05. There was no significant difference in joint swelling index, tenderness index, morning stiffness duration, rest pain score, grip strength level, C-reactive protein, erythrocyte sedimentation rate and RF titer between the two groups before treatment P>0.05. After treatment, the joint swelling index, tenderness index, morning stiffness duration, rest pain score, grip strength level, C-reactive protein, erythrocyte sedimentation rate and RF titer were better than those in the control group, P<0.05. There was no significant difference in the adverse reactions between the observation group and the control group, P>0.05. Conclusion: The efficacy of tripterygium glycosides combined with low-dose methotrexate in the treatment of rheumatoid arthritis is effective and can be effectively improved.