甲氨蝶呤与雷公藤多苷分别联合来氟米特治疗类风湿关节炎的效果比较

目的 比较甲氨蝶呤片与雷公藤多苷片分别联合来氟米特片治疗类风湿关节炎的临床效果。方法 选取2016年1月—2018年12月在宿州市立医院就诊的68例类风湿关节炎患者作为研究对象，采用单纯随机分组法将患者分为观察组（n=34）和对照组（n=34）。对照组给予患者口服雷公藤多苷片20 mg，3次/d，同时给予口服来氟米特片20 mg，1次/d。观察组给予患者口服甲氨蝶呤片10 mg，1次/周，同时给予口服来氟米特20 mg，1次/d。两组均连续用药3个月。对比两组患者的临床疗效、临床症状、C反应蛋白（CRP）、红细胞沉降率（ESR）和类风湿因子（RF）水平。结果 治疗后，观察组总有效率为97.06%显著高于对照组的70.59%（P<0.05）。治疗后，观察组临床症状（晨僵时间、关节肿胀数和关节疼痛数）显著少于对照组（P<0.05）。治疗后，CRP、ESR和RF水平均显著低于对照组（P<0.05）。两组不良反应发生分别为8.82%和5.88%，差异无统计学意义（P>0.05）。结论 甲氨蝶呤片联合来氟米特片治疗类风湿关节炎效果优于雷公藤多苷片联合来氟米特来氟米特片，且安全性良好，值得临床推广。

Comparison on efficacy of methotrexate and tripterygium glycosides combined with leflunomide in treatment of rheumatoid arthritis

Objective To compare the clinical effects of Methotrexate Tablets and Tripterygium Glycosides Tablets combined with Leflunomide Tablets in treatment of rheumatoid arthritis. Methods A total of 68 patients with rheumatoid arthritis in Suzhou Municipal Hospital from January 2016 to December 2018 were randomly divided into observation group (n=34) and control group (n=34). Patients in the control group were po administered with Tripterygium Glycosides Tablets 20 mg, three times daily, at the same time, patients were po administered with Leflunomide Tablets 20 mg, once daily. Patients in the observation group were po administered with Methotrexate Tablets 10 mg, once weekly. And treated with Leflunomide Tablets 20 mg, once daily. Patients in two groups were treated for 3 months. Clinical efficacy, clinical symptoms, and the levels of CRP, ESR and RF were compared between two groups. Results After treatment, the total effective rate in the observation was 97.06%, which was significantly higher than 70.59% in the control group (P < 0.05). After treatment, the clinical symptoms (morning stiffness time, joint swelling, and joint pain) in the observation group were significantly less than those in the control group (P < 0.05). After treatment, CRP, ESR and RF levels in the observation group were significantly lower than those in the control group (P < 0.05). Adverse reactions in two groups was 8.82% and 5.88%, there was no significant difference between the two groups. Conclusion The effect of Methotrexate Tablets combined with Leflunomide Tablets in treatment of rheumatoid arthritis is better than that of Tripterygium Glycosides Tablets combined with Leflunomide Tablets, and it is safe and worthy of clinical promotion.