甲氨蝶呤联合羟氯喹或雷公藤多苷治疗抗环瓜氨酸肽抗体阳性的早期类风湿关节炎的临床研究

目的观察甲氨蝶呤(MTX)联合羟氯喹(HCQ)或雷公藤多苷(TG)治疗抗环瓜氨酸肽抗体(抗CCP)阳性的早期类风湿关节炎疗效及安全性。方法 96例患者随机分为2组。48例接受MTX联合HCQ治疗(MTX 10mg/次,1次/周:HCQ 200mg/次,2次/d)。48例接受MTX联合TG治疗(MTX 10mg/次,1次/周;TG 20mg/次,3次/d)。24周内各药的剂量保持不变。治疗24周时与治疗前比较美国风湿病学会RA缓解标准(ACR50)指标改善情况,同时观察2组不良反应发生率。结果 2组ACR50改善率分别为73%(35/48)和50%(24/48),差异有统计学意义(P<0.05)。2组药物不良反应发生率差异无统计学意义(P>0.05)。结论 MTX联合HCQ在治疗抗CCP阳性的早期RA患者,较MTX联合TG起效更快,更能有效缓解病情,改善关节功能,并且不增加不良反应的发生率。

Clinical Observation of Methopterin ,Hydroxychloroquine or Tripterygium glycosides on the Treatment of early Rheumatoid arthritis with Anticyclic Citrullinated Protein Antibody Positive

Objective To investigate the clinical efficacy and safety of Methopterin,Hydroxychloroquine or Tripterygium glycosides on the Treatment of early Rheumatoid arthritis(RA)with anti cyclic citrullinated protein antibody positive.Methods 96 cases of early Rheumatoid arthritis with CCP antibody positive were randomized into two groups,48 cases in the Methopterin,Hydroxychloroquine treated group,the other 48 cases in the Methopterin,Tripterygium glycosides treated group.The Methopterin,Hydroxychloroquine treated group was orally given Methopterin(10mg,Qw),Hydr oxychloroquine(200mg,Bid) for 24 weeks.Methopterin,Tripterygium glycosides treated group was orally given Methopterin(10mg,Qw),Tripterygium glycosides(20mg,Tid) for 24 weeks.Before and after the study,Such as relieve standard content indexs of American Rheumatology academy in treatment of RA were investigated.as well as side reaction.Results The efficacy of decreasing relieve standard content indexs of American Rheumatology academy in treatment of RA,the Methopterin,Hydroxychloroquine treated group had statistical significance higher than the Methopterin,Tripterygium glycosides treated group(P<0.05).Therew as no significant d ifference in the side reaction in both groups(P>0.05).Conclusion Methopterin,Hydroxychloroquine is more effective in improve arthitis function,and is not increas adverse effect incidence than Methopterin,Tripterygium glycosides on the treatment of early Rheumatoid arthritis with CCP antibody positive.