两种类风湿关节炎治疗方案的疗效及安全性比较

目的比较小剂量激素联合甲氨蝶呤(MTX)及雷公藤多甙方案(TMP方案)和MTX联合来氟米特方案(ML方案)治疗类风湿关节炎(RA)的效果及安全性。方法选择符合1987年诊断标准的类风湿关节炎患者纳入研究。TMP方案选择使用小剂量激素联合甲氨蝶呤及雷公藤多甙;ML方案选择使用甲氨蝶呤联合来氟米特。评估2组治疗4、12周疗效及副反应。结果 2组患者治疗第4、12周的ACR20、ACR50、ACR70组内比较均有显著差异(P0.05)。2组患者治疗4、12周后关节压痛、关节肿胀数、晨僵、血沉、CRP、VAS等指标较用药前显著改善(P0.05)。2组患者不良反应均以肝功能损害为主。结论小剂量激素联合甲氨蝶呤及雷公藤多甙能够显著改善类风湿关节炎患者的症状。

Comparison of efficacy and safety between two therapeutic schemes for rheumatoid arthritis

Objective To compare the efficacy and safety of low-dose hormone combined with methotrexate and tripterygium glycosides (TMP group) and methotrexate combined with leflunomide (ML group) in treatment of rheumatoid arthritis.Methods The patients with active rheumatoid arthritis fulfilling American College of Rheumatology classification criteria of RA in 1987 were selected.The TMP group was conducted with the low-dose of hormone combined with methotrexate and tripterygium,while ML group was given methotrexate combined with leflunomide.Therapeutic effects and side effects were compared 4 and 12 weeks after treatment.Results There were significant differences in the ACR20,ACR50 and ACR70 at the time points of 5 and 12 weeks after treatment in both groups (P ＜0.05).After 4 and 12 weeks of treatment,the joint pain,joint swelling,morning stiffness,ESR,CRP,VAS and other indicators significantly improved in both groups (P ＜ 0.05).Adverse reactions were mainly liver damage in both groups.Conclusion Low-dose of glucocorticoid combined with methotrexate and tripterygium glycosides can significantly improve symptoms of patients with rheumatoid arthritis.