艾拉莫德联合依那西普治疗难治性类风湿性关节炎的临床疗效研究

目的 观察艾拉莫德治疗难治性类风湿关节炎(RA)病人的近期临床疗效。 方法 按纳入标准,将2014年6月至2015年10月重庆三峡中心医院收治的60例难治性RA病人采用随机数字表法分为两组,其中艾拉莫德组使用艾拉莫德联合依那西普治疗,甲氨蝶呤组使用甲氨蝶呤联合依那西普治疗,记录两组病人治疗12周后的临床指标,包括DAS28评分、关节疼痛数、关节肿胀数、晨僵时间、类风湿因子、红细胞沉降率和C反应蛋白。 结果 艾拉莫德组总有效率为96.66%,甲氨蝶呤组为93.33%,艾拉莫德组疗效优于甲氨蝶呤组,差异有统计学意义(Uc=4.505,P=0.034)。艾拉莫德组与甲氨蝶呤组在治疗前的DAS28评分、关节疼痛数、关节肿胀数、晨僵时间、类风湿因子、红细胞沉降率和C反应蛋白数值比较差异无统计学意义(P>0.05)。经12周治疗后,两组DAS28评分、关节疼痛数、关节肿胀数、晨僵时间、类风湿因子、红细胞沉降率和C反应蛋白均较治疗前下降,差异有统计学意义(P<0.05)；治疗后艾拉莫德组的DAS28评分、关节疼痛数、关节肿胀数、晨僵时间、类风湿因子、红细胞沉降率和C反应蛋白数值均低于甲氨蝶呤组,差异有统计学意义(P<0.05)。 结论 艾拉莫德联合依那西普对难治性RA病人具有确切的近期疗效,优于甲氨蝶呤联合依那西普治疗方案。

Clinical curative effect of iguratimod combined with etanercept in the treatment of refractory rheumatoid arthritis

Objective To observe the effect of iguratimod combined with etanercept in treating patients with refractory rheumatoid arthritis (RA). Methods According to the inclusion criteria,60 patients with refractory rheumatoid arthritis treated in Chongqing Three Gorges Center Hospital from June 2014 to October 2015 were collected and randomly assigned into iguratimod group and methotrexate group by using the random number table method.The iguratimod group was treated with iguratimod combined with etanercept while the methotrexate group was treated with methotrexate combined with etanercept.After 12 weeks of treatment,the clinical indicators including DAS28 score,number of joint pain and joint swelling,morning stiffness time,rheumatoid factors (RF),erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were recorded and compared between the two groups. Results The total effective rate of iguratimod group was 96.66%,and that of the methotrexate group was 93.33%.The curative effect of the iguratimod group was better than that of the methotrexate group,with statistically significant difference (Uc=4.505,P=0.034).Before treatment,DAS28 score,number of joint pain and joint swelling,morning stiffness time,RF,ESR and CRP of the two groups had no statistically significant differences (P>0.05).After 12 weeks of treatment,DAS28 score,number of joint pain and joint swelling,morning stiffness time,RF,ESR and CRP of the two group were decreased with statistically significant difference(P<0.05).After treatment,DAS28 score,number of joint pain and joint swelling,morning stiffness time,RF,ESR and CRP of iguratimod group were lower than those in the methotrexate group;the differences were statistically significant (P<0.05). Conclusion Iguratimod combined with etanercept in treating patients with refractory rheumatoid arthritis had a definite short-term curative effect,and was superior to methotrexate combined with etanercept.