托法替布联合柳氮磺吡啶治疗类风湿关节炎的临床研究

Clinical study on tofacitinib combined with sulfasalazine in treatment of rheumatoid arthritis

目的探讨托法替布联合柳氮磺吡啶治疗类风湿关节炎的临床疗效。方法选择2020年6月—2022年6月中国人民解放军空军军医大学第一附属医院收治的118例类风湿关节炎患者,采用随机数字表法分为对照组(59例)和治疗组(59例)。对照组患者口服柳氮磺吡啶肠溶片,4片/次,3次/d。在对照组的基础上,治疗组口服枸橼酸托法替布片,5 mg/次,2次/d。两组患者连续服用药物7周。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,关节疼痛评分(VAS),实验室指标红细胞沉降率(ESR)、肿瘤坏死因子-α(TNF-α)、血清类风湿因子(RF)、C反应蛋白(CRP)水平及不良反应。结果治疗后,治疗组患者总有效率(98.31%)明显高于对照组(83.05%,P<0.05)。治疗后,治疗组出现的关节疼痛、关节肿胀、关节晨僵、食欲减退等症状缓解时间均明显早于对照组(P<0.05)。治疗后,两组VAS评分均明显下降(P<0.05),且治疗组明显低于对照组(P<0.05)。治疗后,两组患者实验室指标ESR、RF、TNF-α、CRP水平均明显低于治疗前(P<0.05),且治疗组患者明显低于对照组(P<0.05)。治疗期间,治疗组患者不良反应发生率为8.47%,明显低于对照组(18.64%,P<0.05)。结论托法替布联合柳氮磺吡啶治疗类风湿关节炎疗效确切,可有效缓解关节炎症状,关节止痛效果较佳,且安全有效。

Objective To study the clinical effect of tofacitinib combined with sulfasalazine in treatment of rheumatoid arthritis.Methods Patients(118 cases) with rheumatoid arthritis in the First Affiliated Hospital of Air Force Medical University from June 2020 to June 2022 were divided into control(59 cases) and treatment(59 cases) group by random number table method. Patients in the control group were po administered with Sulfasalazine Enteric-coated Tablets, 4 tablets/time, three times daily. Patients in the treatment group were po administered with Tofacitinib Citrate Tablets on the basis of the control group, 5 mg/time, twice daily. Patients in two groups were treated for 7 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms,VAS score, the levels of Laboratory indicators ESR, TNF-α, RF, and CRP, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group(98.31%) was significantly higher than that of the control group(83.05%, P < 0.05). After treatment, the relief time of joint pain, joint swelling, joint morning stiffness,loss of appetite and other symptoms in the treatment group was significantly earlier than that in the control group(P < 0.05). After treatment, the VAS score of both groups were significantly decreased(P < 0.05), and which in the treatment group was significantly lower than that of the control group(P < 0.05). After treatment, the levels of ESR, RF, TNF-α, and CRP in two groups were significantly lower than those before treatment(P < 0.05), and which in the treatment group were significantly lower than those in the control group(P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group was 8.47%, which was significantly lower than that in the control group(18.64%, P < 0.05). Conclusion Tofacitinib combined with sulfasalazine have definite curative effect, can effectively relieve the symptoms of arthritis, the effect of joint pain relief is better, and it is safe and effective.