来氟米特联合白芍总苷治疗老年类风湿关节炎的临床疗效及对C反应蛋白和红细胞沉降率的影响

目的：评价来氟米特联合白芍总苷治疗老年类风湿关节炎的临床疗效，探讨其临床适用性。方法选择从2011年3月—2014年3月于该院就诊的96例老年类风湿关节炎患者，简单随机分为试验组48例和对照组48例，对照组患者单用来氟米特治疗，试验组患者采用氟米特联合白芍总苷治疗。观察两组患者的临床治疗疗效及治疗前后相关指标的改善情况，治疗过程中出现的不良反应情况。结果试验组患者的总临床治疗有效率为95.83%，对照组患者的总临床治疗有效率为79.17%，两组患者的总临床治疗有效率比较，差异有统计学意义（χ2=6.10，P〈0.05），两组患者治疗前ESR（血沉）、 CRP（C反应蛋白）、RF（类风湿因子）和VAS 评分比较，差异无统计学意义（P〉0.05），治疗后各项指标明显改善，且试验组患者各项指标的改善情况明显优于对照组患者，差异有统计学意义（P〈0.05）。两组患者治疗过程中无严重感染、血液系统指标异常、骨髓抑制、严重肝功能损害等不良反应发生。其中试验组患者出现恶心、呕吐4例，腹痛、腹泻1例，上呼吸道感染0例，口腔溃疡1例，脱发0例，皮疹0例，肝酶异常0例，共6例，并发症发生率为12.5%，其中对照组患者出现恶心、呕吐2例，腹痛、腹泻1例，上呼吸道感染1例，口腔溃疡1例，脱发1例，皮疹1例，肝酶异常2例，共9例，并发症发生率为18.8%，两组患者不良反应发生率比较，差异无统计学意义（χ2=0.71，P〉0.05）。结论来氟米特联合白芍总苷治疗老年类风湿关节炎临床疗效显著，可以很好的改善类风湿相关因子，且用药不良反应少，安全性高，适合临床长期推广应用。

The Clinical Efficacy of Leflunomide Combined with TGP in the Treatment of Elderly Rheumatoid Arthritis and Its Effect on C-reactive Protein and Erythrocyte Sedimentation Rate

Objective To evaluate the clinical efficacy of leflunomide combined with total glucosides of paeony （TGP） in the treat-ment of elderly rheumatoid arthritis and investigate its clinical applicability. Methods 96 elderly patients with rheumatoid arthritis admitted in our hospital from March 2011 to March 2014 were selected, and they were simply and randomly divided into the test group of 48 cases and the control group of 48 cases. The control group were treated by only leflunomide, while the test group were treated by leflunomide combined with TGP. The clinical efficacy, improvement in related indicators before and after treatment and adverse reactions occurred in the treatment of the two groups were observed. Results The clinical total effective rate of patients in the test group was 95.83%, while it was 79.17%in the control group, the difference was statistically significant （χ2=6.10, P〈0.05）;Before treatment, the differences in erythrocyte sedimentation rate（ESR）, C-reactive protein（CRP）, rheumatoid factors（RF） and VAS scores between two groups of patients were not statistically significant （P〉0.05）; after treatment, the indicators of both groups im-proved significantly, and the improvement of the indicators of the test group was much better than that of the control group, the differences were statistically significant （P〈0.05）. No serious infections, abnormal hematological indexes, bone marrow depression, severe liver function damage and other adverse reactions occurred in both groups during the treatment. In the test group, there were 4 cases with nausea and vomiting, 1 case with abdominal pain and diarrhea, 0 case with upper respiratory tract infection, 1 case with oral ulcer, 0 case with alopecia, 0 case with rash, 0 case with liver enzyme abnormalities, a total of 6 cases had adverse reactions, the incidence of complications was 12.5%. In the control group, there were 2 cases with nausea and vomiting, 1 case with abdominal pain and diarrhea, 1 case with upper respiratory t