双醋瑞因联合甲氨蝶呤治疗老年类风湿关节炎的临床分析

目的探讨双醋瑞因联合甲氨蝶呤治疗老年类风湿关节炎患者的临床疗效。方法回顾性分析2017年11月-2020年11月在河北北方学院附属第一医院住院治疗的100例老年类风湿关节炎患者的临床资料,根据不同的治疗方法分为试验组(n=50)和对照组(n=50)。对照组采用甲氨蝶呤治疗,试验组采用双醋瑞因联合甲氨蝶呤治疗。2组疗程均为12周。观察并比较2组治疗前后炎性细胞因子[白细胞介素-1(IL-1)、转化生长因子-β(TGF-β)]表达水平、红细胞沉降率(ESR)和类风湿因子(RF)表达水平、相关临床症状指标(关节肿胀个数、关节压痛个数及晨僵持续时间)、关节功能分级及不良反应。结果治疗12周后,2组IL-1、ESR、RF表达水平均较本组治疗前明显下降(P<0.05),TGF-β较本组治疗前明显上升(P<0.05),关节肿胀个数、关节压痛个数及晨僵持续时间较本组治疗前明显降低(P<0.05),且试验组IL-1、ESR、RF表达水平均较对照组明显下降(P<0.05),TGF-β较对照组明显上升(P<0.05),关节肿胀个数、关节压痛个数及晨僵持续时间较对照组明显降低(P<0.05)。2组治疗后关节功能分级差异无统计学意义(P>0.05)。结论双醋瑞因联合甲氨蝶呤可有效的降低老年类风湿关节炎患者炎性水平,恢复自身免疫系统平衡,减少关节疼痛和肿胀,减少晨僵时间,但未能改善已受损的关节功能。

Clinical analysis of diacerein combined with methotrexate in the treatment of rheumatoid arthritis in elderly patients

Objective To investigate the clinical effect of diacerein combined with methotrexate in the treatment of rheumatoid arthritis in elderly patients.Methods 100 elderly patients treated in First Affiliated Hospital of Hebei North University from November 2017 to November 2020 were selected and divided into experimental group(n=50)and control group(n=50)according to different treatment methods.The control group was treated with methotrexate,while the experimental group was treated with diacetarine combined with methotrexate.Both groups were treated for 12 weeks.The expression levels of inflammatory cytokines[interleukin-1(IL-1),transforming growth factor-β(TGF-β)],erythrocyte sedimentation rate(ESR),rheumatoid factor(RF)expression level,related clinical symptoms(number of joint swelling,number of joint tenderness and duration of morning stiffness),classification of joint function and adverse reactions were observed and compared between the two groups before and after treatment.Results After 12 weeks of treatment,the expression levels of IL-1,ESR,and RF in the two groups were significantly lower than those in the same group before treatment(P<0.05),and TGF-βwas significantly higher than that in the same group before treatment(P<0.05),and the number of joint swelling,the number of joint tenderness and the duration of morning stiffness were significantly lower than those in the same group before treatment(P<0.05).Moreover,the expression levels of IL-1,ESR and RF in the experimental group were significantly lower than those in the control group(P<0.05),the expression level of TGF-βwas significantly higher than that in the control group(P<0.05),the number of joint swelling,joint tenderness and the duration of morning stiffness in the treatment group were significantly lower than those in the control group(P<0.05).But there was no significant difference in the classification of joint function between the two groups after treatment(P>0.05).Conclusion Diacerein combined with methotrexate can effectively reduce the inflammatory level of elderly patients with rheumatoid arthritis,restore the balance of the autoimmune system,reduce joint pain and swelling,reduce morning stiffness time,but can not improve the damaged joint function.