盐酸二甲双胍片联合尼美舒利治疗老年类风湿性关节炎的临床疗效

Clinical efficacy of oral metformin hydrochloride added on nimesulide for analgesia in elderly-onset rheumatoid arthritis

目的探究盐酸二甲双胍片联合尼美舒利治疗老年类风湿性关节炎的临床疗效。方法选择杭州市富阳区第一人民医院2019年9月至2020年12月收治的84例老年类风湿性关节炎患者,对其进行回顾性分析。其中对照组接受尼美舒利片的基础治疗方案(44例),观察组在基础治疗方案的基础上,联合盐酸二甲双胍片治疗(40例)。比较2组治疗方案的临床疗效,将总有效率作为本研究的主要结局事件,次要结局事件包括治疗后患者的临床症状体征、实验室指标以及治疗期间患者的不良反应发生情况,综合评估盐酸二甲双胍片联合尼美舒利治疗老年类风湿性关节炎的临床效果。结果相比于对照组,观察组治疗方案的临床总有效率显著更高。治疗后观察组患者的临床症状体征,包括压痛关节数、肿胀关节数以及晨僵时间均显著低于对照组。观察组患者的实验室指标(红细胞沉降率,C反应蛋白和类风湿因子)改善程度也显著优于对照组。观察组患者治疗期间的不良反应总发生率显著低于对照组。结论相较于单独采用尼美舒利治疗的老年类风湿性关节炎患者,采用盐酸二甲双胍片联合治疗能够有效改善临床疗效,改善患者治疗后的临床症状体征和实验室指标,提升治疗的安全性。

Objective To investigate the clinical efficacy of metformin hydrochloride tablets added on nimesulide for analgesia in treatment of elderly-onset rheumatoid arthritis.Methods Retrospective included were 84 elderly patients with rheumatoid arthritis treated in our center between September 2019 and December2020.Among them,the control group(n=44)received basic therapy with oral nimesulide,while the patients in the study group(n=40)received metformin hydrochloride tablets in addition to the basic therapy.The clinical efficacy in the two groups was evaluated and compared.Using the overall treatment response as primary endpoint,the clinical symptoms and signs,and laboratory findings after treatment,as well as adverse reactions during treatment as secondary endpoints,the clinical benefits of metformin hydrochloride tablets added on nimesulide for analgesia in elderly-onset rheumatoid arthritis were determined.Results Compared with the control group,the overall treatment response was higher in the study group.After treatment,the study group had fewer clinical symptoms and signs,in terms of tender joint count(TJC),swollen joint count(SJC),and duration of morning stiffness.Compared with the control group,the study group also showed greater improvements in laboratory findings(erythrocyte sedimentation rate,C-reactive protein and rheumatoid factor).The overall incidence of adverse reactions during treatment was significantly lower in the study group than that in the control group.Conclusion Compared with elderly rheumatoid arthritis patients on nimesulide alone,additional use of metformin hydrochloride tablets can effectively improve the efficacy,clinical symptoms and signs,and laboratory findings after treatment,with better patient safety.