白芍总苷联合甲氨蝶呤治疗难治性类风湿关节炎效果观察

Effect of total glucosides of paeony and methotrexate on refractory rheumatoid arthritis

目的探讨白芍总苷联合甲氨蝶呤治疗难治性类风湿关节炎的效果和安全性。方法 80例难治性类风湿关节炎患者,随机分为观察组和对照组各40例。对照组口服甲氨蝶呤片,10mg/次,1次/周,第1~2周;12.5mg/次,2次/周,第3~4周;15mg/次,1次/周,第5~24周。观察组在对照组治疗基础上口服白芍总苷胶囊0.3g/次,3次/d,连续24周。记录2组治疗前、后晨僵时间及关节肿胀度、关节疼痛度评分,比较2组疗效及不良反应发生率。结果观察组治疗后关节肿胀度评分[(3.78±1.01)分]、关节疼痛度评分[(0.81±0.33)分]低于治疗前[(6.33±1.39)分、(2.89±0.55)分],晨僵时间[(17.64±8.43)min]较治疗前[(28.42±8.22)min]缩短(P<0.05);对照组治疗后关节肿胀度评分[(4.32±0.89)分]、关节疼痛度评分[(1.09±0.72)分]低于治疗前[(6.39±1.49)分、(2.91±0.78)分],晨僵时间[(22.58±9.86)min]较治疗前[(28.11±7.89)min]缩短(P<0.05);治疗后观察组晨僵时间较对照组短,关节肿胀度、关节疼痛度评分较对照组低(P<0.05);观察组治疗总有效率(95.0%)高于对照组(75.0%)(P<0.05),不良反应发生率(12.5%)与对照组(22.5%)比较差异无统计学意义(P>0.05)。结论白芍总苷联合甲氨蝶呤治疗难治性类风湿关节炎效果确切,不良反应轻。

Objective To investigate the efficacy and safety of total glucosides of paeony and methotrexate in the treatment of refractory rheumatoid arthritis. Methods Eighty patients with refractory rheumatoid arthritis were randomly divided into observation group and control group,with 40 patients in each group.Control group was treated with oral administration of methotrexate,10 mg once,once a week,in the first two weeks,and 12.5mg once,twice a week,in the 3rd to 4th week,15 mg once,once a week,in the 5th to 24th week.Observation group was treated with oral administration of total paeoniflorin capsules,0.3g once,3times a day,totally for 24 weeks in addition to the therapy in control group.The morning stiffness duration,joint swelling score and joint pain score were recorded before and after treatment,and the curative effect and the incidence of adverse reactions were compared between two groups.Results The joint swelling score(3.78±1.01)and joint pain score(0.81±0.33)were significantly lower,and morning stiffness duration((17.64±8.43)min)was significantly shorter after treatment than those before treatment(6.33±1.39,2.89±0.55,(28.42±8.22)min)in observation group(P<0.05),and were significantly lower and shorter after treatment(4.32±0.89,1.09±0.72,(22.58±9.86)min)than those before treatment(6.39±1.49,2.91±0.78,(28.11±7.89)min)in control group(P<0.05),which were more significant in observation group than in control group after treatment(P<0.05).The total effective rate was significantly higher in observation group(95.0%)than that in control group(75.0%)(P<0.05),and there was no significant difference in the incidence of adverse reactions between observation group and control group(12.5%,22.5%)(P>0.05).Conclusion The effect of total glucosides of paeony combined with methotrexate is significant for refractory rheumatoid arthritis and the adverse reaction is mild.