甲氨蝶呤联合雷公藤多甙片治疗类风湿性关节炎疗效及安全性的研究.docVIP

甲氨蝶呤联合雷公藤多甙片治疗类风湿性关节炎疗效及安全性的研究 　　[摘要] 目的 探讨甲氨蝶呤联合雷公藤多甙片治疗类风湿性关节炎的临床效果。 方法 将我院2013年1月～2014年12月期间收治的77例类风湿性关节炎患者分为两组，对照组38例单独给予甲氨蝶呤治疗，观察组39例采用甲氨蝶呤联合雷公藤多甙片治疗，比较两组患者的病情改善情况、晨僵、关节肿痛数、关节压痛数、患者对疾病活动性的总体评价、医生对疾病活动性的总体评价、ESR、CRP等临床指标差异。 结果 治疗后观察组和对照组晨僵时间、关节肿胀数、关节压痛数及疼痛程度评分、ESR、CRP水平、患者总体评价、医生总体评价得分均低于治疗前，观察组治疗后低于对照组治疗后，有统计学差异（P0.05）。 结论 甲氨蝶呤联合雷公藤多甙片治疗类风湿性关节炎疗效确切，明显比单独应用甲氨蝶呤治疗有效更显著，安全性高，可在临床推广应用。 　　[关键词] 类风湿性关节炎；甲氨蝶呤；雷公藤多甙片 　　[中图分类号] R593.22 [文献标识码] B [文章编号] 1673-9701（2015）08-0090-03 　　[Abstract] Objective To investigate the clinical effects of rheumatoid arthritis treated with MTX and tripterygium. Methods A total of 77 cases of rheumatoid arthritis patients admitted to our hospital from January 2013 to December 2014 were divided into two groups，there were 38 cases in the control group， they were given methotrexate alone， 39 cases in the observation group， they used methotrexate combined with tripterygium. The patients condition of improvement， morning stiffness， joint swelling number of joint tenderness， patient overall assessment of disease activity， physicians overall assessment of disease activity， ESR， CRP of two groups were compared. Results The duration of morning stiffness， joint swelling number of joint tenderness and pain severity score surgery， ESR， CRP levels， the overall evaluation of the patient， the doctor treating the overall evaluation scores of the observation group and the control group after treatment were lower than before treatment， the observation group was lower than the control group after treatment， there was a significant difference（P0.05）. Conclusion Tripterygium methotrexate treatment of rheumatoid arthritis is effective， clear and effective than methotrexate alone more significant safe， can be applied in clinical practice. 　　[Key words] Rheumatoid arthritis； Methotrexate； Tripterygium 　　类风湿关节炎（RA）是一种原因未明的慢性、以炎性滑膜炎为主的系统性疾病，以多关节受累为主要临床表现，尤其好发于小关节，对称分布，病程长，反复发作，进行性发展，严重的可导致关节畸形及功能丧失[1]；RA有关节肿胀伴疼痛或晨僵等症状，晚期可导致多系统、多器官病变，严重影响患者正常工作和生活，降低生活质量[2]，