甲氨蝶呤、来氟米特、环磷酰胺两两联合治疗类风湿关节炎疗效比较研究

目的探讨周期特异性药物甲氨蝶呤(MTX)、来氟米特(LEF)与周期非特异性药物环磷酰胺(CTX)联合与两种周期特异性药物甲氨蝶呤与来氟米特(MTX+LEF)联合治疗类风湿关节炎(RA)临床疗效和安全性比较。方法将92例活动期RA患者随机分三组,MTX+CTX组36人,LEF+CTX组30人,LEF+MTX组26人。三组均治疗12周。观察三组治疗后的临床疗效和安全性。结果治疗12周后,联合CTX组(MTX+CTX、LEF+CTX)在DAS28、ESR、患者评估的疾病总体状况VAS评分、关节肿胀数、关节压痛数等临床及实验室指标均优于MTX+LEF组,差异均有统计学意义(P<0.05);联合CTX组不良反应少于MTX+LEF组,差异有统计学意义(P<0.05)。结论周期特异性药物(MTX、LEF)与周期非特异性药物(CTX)联合临床疗效好,不良反应小,安全性高。

Methotrexate, leflunomide, cyclophosphamide Comparison between two combined effecs in the treatment of Rheumatiod Arthritis

Objective To compare the efficary and adverse reaction of cycle specific Methotrexate(MTX),Leflunomide(LEF) combining cycle non-specific drugs of drug Cyclophosphamide(CTX) and two cycles MTX and LEF specific drug combination(MTX+LEF) in the treatment of active Rheumatoid arthritis.Method 92 cases were divided into third group.36 partiens of the combination MTX and CTX;30 partiens of the combination LEF and CTX;26 partiens of the combination LEF and MTX.The indexes of the efficiency assessment included DAS28,erythrocyte sedimentation rate(ESR),the overall situation of VAS score,number of joint swelling,joint tenderness.Results Significant differences were found in efficiency assessment indexes between combining CTX groups and MTX plus LEF group after 12 weeks treatment.Conclusions It is more effetive in the treatment of active RA cycle specific Methotrexate(MTX),Leflunomide(LEF) combining cycle non-specific drugs of drug Cyclophosphamide(CTX),few side effects and high compliance.