中西医结合治疗难治性类风湿关节炎临床观察.DOCVIP

中西医结合治疗难治性类风湿关节炎临床观察 余建华 张 衡 洛阳市第三人民医院风湿免疫科，河南 洛阳 471002 [摘要]目的 探讨桂枝芍药知母汤联合甲氨蝶呤（MTX）和柳氮磺吡啶(SSZ)治疗难治性类风湿关节炎（RA）的疗效和安全性。方法 选择符合纳入标准患者81例，随机分为治疗组和对照组，治疗组40例给予桂枝芍药知母汤、MTX和SSZ治疗，对照组41例给予MTX和SSZ治疗，疗程均为12周。采用美国风湿病学会（ACR）推荐的RA疾病活动评价核心指标对两组治疗前后进行评估。结果 治疗后2组病情活动主要指标评分均有显著降低，治疗前后比较，差异均有非常显著性意义（P＜0.01），治疗组评分降低优于对照组，差异有显著性意义（P＜0.05）。治疗组达到ACR20、ACR50、ACR90疗效标准的分别为：37.5%、32.5%、20%，总有效率90%；对照组达到ACR20、ACR50、ACR90疗效标准的分别为：46.34%、19.51%、4.88%，总有效率70.73%。结论 桂枝芍药知母汤联合MTX和SSZ治疗难治性RA疗效明显优于MTX联合SSZ的疗效，且具有较好的安全性。 [关键词]关节炎，类风湿；桂枝芍药知母汤；甲氨蝶呤；柳氮磺吡啶；中西医结合疗法 Traditional Chinese and Western Medicine Treatment of Refractory rheumatoid arthritis clinical observation. YU Jian-hua,ZHANG Heng. Rheumatism department , Luoyang Third People’s Hospital, Luoyang, 【Abstract】Objective Explore the efficacy and safety of Guizhishaoyaozhimutang combine methotrexate (MTX) and sulfasalazine (SSZ) on refractory rheumatoid arthritis (RA).Methods Select 81 patients met the inclusion criteria Were randomly divided into two groups. Patients in treatment group (n=40) were treated with Guizhishaoyaozhimutang combine methotrexate (MTX) and sulfasalazine (SSZ). Patients in control group (n=41) were treated with methotrexate (MTX) and sulfasalazine (SSZ). The therapeutic course was 12 weeks in both groups. Based on American College of Rheumatology (ACR) recommended evaluation of RA disease activity core set of indicators to assess the two groups before and after treatment.Results After treatment, both groups score major indicators of disease activity were significantly decreased ,before and after treatment the differences were highly statistically significant (P 0.01), the treatment group score lower than the control group, the difference was significant (P 0.05 ). The treatment group achieved ACR20, ACR50, ACR90 efficacy criteria were: 37.5%, 32.5%, 20%, with a total effective rate 90%; the control group achieved ACR20, ACR50, ACR90 efficacy criteria were: 46.34%, 19.51%, 4.88 %, the total efficiency of 70.73%. Co