双醋瑞因联合来氟米特与甲氨蝶呤治疗难治性类风湿关节炎的临床研究  

THE EFFICACY OF DIACEREIN COMBINED WITH LEFLUNOMIDE AND METHOTREXATE IN THE TREATMENT OF RHEUMATOID ARTHRITIS

作　　者：李燕[1] 于学军[1] 胡俊平[1] 巫婷婷[1] 

机构地区：[1]解放军第452医院(空军成都医院),成都6100001

出　　处：《现代预防医学》2010年第17期3381-3383,3385,共4页Modern Preventive Medicine

摘　　要：[目的]观察双醋瑞因联合来氟米特与甲氨蝶呤治疗难治性类风湿关节炎(RA)患者的临床疗效,为双醋瑞因治疗难治性RA提供理论依据。[方法]把难治性RA活动期患者60例,按奇偶数随机分为两组,对照组服用来氟米特(LEF)10mg,2次/d,甲氨蝶呤(MTX)10mg,1次/周;治疗组在对照组基础上加服双醋瑞因胶囊50mg,2次/d。治疗4、8、12周后观察两组患者的临床病情活动性指标(如晨僵、红细胞沉降率、C反应蛋白、压痛关节数、肿胀关节数、双手平均握力、DAS28评分),并采用目视10cm模拟标尺法(VAS)由患者和医生评估病情的整体变化程度,同时监测患者血常规、尿常规、大便隐血、肝功能、肾功能、血压、心电图、血糖等指标。[结果]到第12周时,治疗组总有效率为93%,对照组总有效率为77%,两组比较差异有统计学意义(χ2=8.587,P﹤0.05);治疗组患者的临床病情活动性指标较对照组明显改善(P﹤0.05);两组患者的不良反应发生率无统计学差异(χ2=0.131,P﹥0.05)。[结论]双醋瑞因联合来氟米特与甲氨蝶呤对难治性RA的疗效优于来氟米特联合甲氨蝶呤。[Objective] To investigate the therapeutic effects of diacerein combined with leflunomide and methotrexate on refractoriness rheumatoid arthritis. [Methods] 60 patients were averagely divided into two groups, the control and the treatment group. All patients were treated with leflunomide 10mg po qd and MTX 10mg po qw for 4, 8, 12 weeks. At the same time, the patients in treated group were given diacerein 50mg po bid. The clinical symptoms, objective signs and laboratory’s data after and before treatment were evaluated between the two groups. [Results] After the 12 weeks of clinical treatment, the effective rate in treatment group was 93%, otherwise in control group was 77%, the effective rate was significantly different between the two groups （χ2 = 8.587, P﹤0.05）. The clinical symptoms and objective signs and laboratory’s data were improved in treatment group, the effective rate was significantly different between the two groups （P﹤0.05）. [Conclusion] The efficacy of diacerein combined with LEF and MTX in the treatment of rheumatoid arthritis is much better than LEF and MTX.

关 键 词：类风湿关节炎 双醋瑞因 甲氨蝶呤 来氟米特 

分 类 号：R593.22[医药卫生—内科学]