沙利度胺联合甲氨蝶呤与单独沙利度胺治疗类风湿关节炎的临床疗效及安全性观察

目的探讨沙利度胺联合甲氨蝶呤治疗类风湿关节炎的临床疗效及安全性。方法选取2009年10月至2011年4月来我院就诊治疗的类风湿关节炎患者40例,单盲随机分为对照组和治疗组两组,对照组20例采用单纯沙利度胺治疗,治疗组20例采用沙利度胺联合甲氨蝶呤治疗,每位患者均总共治疗6个月,每2周记录患者治疗情况及不良反应状况,并用疼痛模拟评分方法来对患者的疗效进行评分,对比分析两组的总治疗有效率和疗效差异。结果经过6个月的治疗后,对照组的总有效率75.0%,治疗组的总有效率为80.0%,总有效率差异无统计学意义(P>0.05),但两组的治疗疗效差异具有统计学意义(P<0.05),至于不良反应,对照组20例中有6例患者出现不良反应,治疗组20例有7例出现不良反应,差异无统计学意义(P>0.05),但治疗组的不良反应明显较对照组轻微。结论沙利度胺治疗类风湿关节炎效果明显,联合甲氨蝶呤可改善疗效并提高安全性。

Observation of Thalidomide with Methotrexate and Thalidomide Alone in Treatment of Rheumatoid Arthritis About Clinical Efficacy and Safety

Objective To investigate clinical efficacy and safety of thalidomide methotrexate in treatment of rheumatoid arthritis.Methods October 2009 to April 2011,40 patients were selected with rheumatoid arthritis,single-blind randomized control group and two treatment groups,control group of 20 patients with thalidomide alone,the treatment group of 20 patients with thalidomide methotrexate therapy,each patient a total of six months of treatment,patients recorded every 2 weeks and adverse reaction conditions,and with pain analog scale method to the efficacy of the patient score,comparative analysis of two groups of treatment efficiency and the overall difference in efficacy.Results After 6 months of treatment,control group 75.0% of the total efficiency of the treatment group,the total effective rate was 80.0%,the total efficiency was no significant difference（P0.05）,but the difference between two groups of therapy statistically significant（P 0.05）.As for adverse reactions in 20 patients,6 patients had adverse reactions,the treatment group,20 cases of adverse reactions in 7 patients,no statistically significant difference（P0.05）,adverse reactions were the treatment group than the control group slightly.Conclusion Thalidomide treatment of rheumatoid arthritis effect is obvious,methotrexate can improve the efficacy and improve safety.