不同治疗方案对类风湿关节炎效果观察.docVIP

不同治疗方案对类风湿关节炎的效果观察 　　[摘要]目的 探讨不同治疗方案对类风湿关节炎（RA）的效果。方法 选择2014年6月～2015年8月首诊于澄海人民医院风湿科门诊的250例RA患者作为研究对象，按就诊序号随机将其分为甲氨蝶呤（MTX）组、来氟米特（LEF）组、MTX+LEF组、MTX+雷公藤多苷组、MTX+白芍总苷组，各50例，观察五组患者的疗效及不良反应。结果 治疗后2周，五组临床及实验室疗效相近，差异无统计学意义（P0.05）；治疗后4、12及24周，MTX+LEF组、LEF组、MTX+雷公藤多苷组、MTX+白芍总苷组临床及实验室疗效均优于MTX组，差异有统计学意义（P0.05）。MTX+LEF组不良反应发生率（20.00%）明显低于MTX组（38.00%），差异有统计学意义（χ2=3.93，P0.05）。结论 MTX+LEF治疗RA疗效确切、不良反应较少，应在临床重点推荐应用。 　　[关键词]类风湿关节炎；不同方案；疗效；安全性 　　[中图分类号] R684.3 [文献标识码] A [文章编号] 1674-4721（2016）06（a）-0004-05 　　[Abstract]Objective To explore the effects of different treatment program in rheumatoid arthritis（RA）.Methods 250 patients with RA who got first diagnosis in department of rheumatism of Chenghai people′s hospital from June 2014 to August 2015 were selected as study objects.250 RA patients were randomly divided into methotrexate（MTX） group，leflunomide（LEF） group，MTX+LEF group，MTX+tripterygium glycosides group and MTX+total glucoside of paeony group according to the admission order，and each group was 50 cases.The effects adverse and curative effect among five groups were observed.Results Two weeks after followed up treatment，the clinical and laboratory efficacy of the five groups were similar，and the difference had no statistical significance（P0.05）；Four，twelve and twenty-four weeks after followed up，the clinical and laboratory efficacy in MTX+LEF group，LEF group，MTX+tripterygium glycosides group and MTX+total glucoside of paeony group was better than that of MTX group respectively，and the difference was statistical significance（P0.05）.The adverse effects in MTX+LEF group was 20.00%，obvious lower than that was 38.00% in MTX group，and the difference was statistical significance（χ2=3.93，P0.05）.Conclusion The effects of MTX+LEF in treating RA is exact，and with less adverse effects.It should be major recommended use in clinic. 　　[Key words]Rheumatoid arthritis；Different program；Curative effect；Safety 　　类风湿关节炎（rheumatoid arthritis，RA）是一组以关节滑膜炎症为主要特征的慢性、全身性自身免疫系统疾病，随着病情持续进展，可导致关节疼痛、强