复方夏天无联合甲氨喋呤治疗类风湿关节炎的临床研究

目的 观察复方夏天无联合甲氨喋呤治疗类风湿关节炎(RA) 的临床疗效和安全性。

Clinical Efficacy of Corydalis Composite Combined with Methotrexate in Treating Rheumatoid Arthritis

Objective To observe the clinical efficacy and safety of Corydalis composite （CDC） combined with methotrexate （MTX） in treating rheumatoid arthritis （RA）. Methods Seventy-six RA patients were randomly assigned to 2 groups, 37 in the treated group received the combined therapy, and the 39 received MTX treatment alone, all were treated for 12 weeks. Efficacy of treatment was evaluated adopting the standard of A- merican College of Rheumatology （ACR）, taking ACR20 as the chief criterion; ACR50, ACR70 as well as the clinical indexes and items in Health Account Questionnaire （HAQ） as the auxiliary criteria, including joint swelling index, joint tenderness index, holding power, morning stiffness time, resting pain, erythrocyte sedimentation rate （ ESR）, C-reactive protein. And the adverse reaction was recorded at the same time, Results After being treated for4, 8 and 12 weeks, the ACR20 response rate reached 35. 14%, 59.46% and 70.27% respectively in pa- tients of the treated group, while that in the control group was 17.95%, 35.90% and 46. 15% respectively, sig- nificant difference between groups was shown in the outcome of week 8 and 12 （P 〈0.05）. ACR50 and ACR70 improving rate at all the time points of observation were increased in the treated group, with the ACR50 improving rate at week 12 higher than that in the control group （43.24% vs 20. 51%, P 〈 0.05）. As compared with the control group, the improvements in all the auxiliary criteria were more significant in the treated group （ P 〈 0.05）. The incidence of adverse reaction was less in the treated group than in the control group （32.43% vs 56.41%, P 〈0.05）, particularly in term of the damage on liver （0 vs 10.26%, P 〈 0.05）. Conclusion CDC combined with MTX is more effective than MTX alone in treating active RA with less adverse reaction.