白芍总苷 甲氨蝶呤 柳氮磺吡啶联合治疗难治性类风湿关节炎的近期疗效观察

目的探讨白芍总苷(TGP)、甲氨蝶呤(MTX)、柳氮磺吡啶(SASP)联合治疗难治性类风湿关节炎(RA)的疗效和安全性。方法对2002年5月至12月本院风湿科门诊和病房收治28例难治性RA病例,同时应用TGP、MTX及SASP,疗程至少3个月。治疗前及治疗后检测临床及实验室指标,包括晨僵持续时间、关节压痛数、关节压痛指数、类风湿因子(RF)、血沉(ESR)、C反应蛋白(CRP)等指标及双手X线检查,并询问不良反应,记录病人自我评价,疗效判定。结果28例中显效13例(46%),有效12例(43%),无效3例(11%),总有效率89%。治疗前后的关节肿胀指数、关节压痛指数、双手握力、晨僵持续时间均有明显改善(P<0.01);ESR、RF、CRP均降低(P<0.01及P<0.05)。结论联合应用TGP、MTX及SASP取得了较高的总有效率,是一种比较合理的联合治疗方法。

Short-term efficacy of combined use of TGP MTX SASP in the treatment of refractory rheumatoid arthritis

Objective To explore the effects and safety of the combined use of total paeony glucosides (TGP), methotrexate (MTX) and salicylazosulfapyridine (SASP) in patients with refractory rheumatoid arthritis (RRA). Methods TGP, MTX and SASP were used at least for 3 months in 28 RRA patients collected from our outpatient and inpatient departments since May to December 2002. We detected the duration of the morning stiffness,number of the press-painful arthritics, index of the press-painful arthritics, rheumatism factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and the X-ray performance of both hands, and observed the side effects, patients′self evaluations to determine the effects. Results Thirteen of 28 patients had obvious effects, 12 had valid effects and 3 had no effects. Total effective rate was 89%. The number of press-painful arthritics, swell index of the arthritics, grip strength of both hands and the duration of the morning stiffness had all bettered (P<0.01). RF, ESR, CRP had all reduced (P<0.01 及P<0.05) . Conclusion Combined use of TGP, MTX and SASP in patients with RRA has good curative effects, this is a reasonable combined treatment.