药物联合物理疗法治疗类风湿关节炎48例疗效观察

目的比较药物联合物理治疗与单纯药物治疗类风湿关节炎（RA）的短期临床疗效。方法随机双盲平行试验,纳入72例活动性RA患者,按2：1的比例被随机分配到试验组48和对照组24例。试验组为传统药物（来氟米特20 mg,1次/d＋甲氨蝶呤10 mg,1次/周＋非甾类抗炎药）联合物理治疗（超声波＋微波＋电疗）组,对照组为单纯传统药物（来氟米特＋甲氨蝶呤＋非甾类抗炎药）治疗组。受试者在试验第1周和第2周随访,评价疗效。同时比较两组患者的压痛和肿胀关节数、晨僵时间、疼痛视觉模拟评分（VAS评分）、健康评估问卷（HAQ）以及实验室炎症指标红细胞沉降率（ESR）、C-反应蛋白（CRP）。结果治疗1周及2周后试验组患者ACR20、ACR50缓解的比例都显著高于对照组（P〈0.05）;试验组患者疗效指标均较治疗前水平明显降低（P〈0.01）;两组患者的实验室炎症指标ESR、CRP均较治疗前水平显著降低（P〈0.05）。结论药物联合物理治疗RA的短期疗效明显优于单纯药物治疗,可1周内明显改善各项临床症状、体征,降低实验室炎症指标,提高患者生活质量。

Effect of medication combined with physiotherapy on 48 cases of rheumatoid arthritis

Objective To compare the short-term effect of medication combined with physiotherapy and only traditional medication on the treatment of active rheumatoid arthritis. Methods Seventy two patients with active rheumatoid arthritis were divided into 2 groups by randomized double-blind parallel test, and 48 cases in observation group were treated with medication（Leflunomide, 20 mg/d, MTX 10 mg/week, and nonsteroidal anti-inflammatory agent） combined with physiotherapy（ultrasonic, microwave, electrotherapy）, while the other 24 cases in control group were treated with only traditional medication. All patients were followed in 1 week and 2 weeks after treatment for assessment. Activity and efficacy evaluation indexes, including the number of joints with pain, swelling, the time of morning stiffing, visual analog score, health assessment questionnaire, ESR and CRP were evaluated after 2 weeks of treatment. Results 1 week and 2 weeks after treatment, the ACR20 and the ACR50 improvement rates in the observation group were significantly higher than those in the control group（P〈0.05）. The disease efficacy evaluation indexes and activity indexes significantly decreased（P〈0.01, P〈0.05）. Conclusion Compared with traditional medication,the effect of medication combined with physiotherapy was much better, which can evidently reduce the symptoms,and improve the life-qualify of the RA patients in short-term.