正清风痛宁联合甲氨蝶呤治疗老年类风湿关节炎的临床研究  

Clinical study of Zhengqing Fengtongning combined with methotrexate in treatment of elderly rheumatoid arthritis

作　　者：朱芳晓[1] 周润华[1] 石宇红[1] 莫汉有[1] 李宝贞[1] 李丽梅[1] 

机构地区：[1]桂林医学院附属医院风湿科,广西桂林541001

出　　处：《现代预防医学》2013年第15期2944-2946,2949,共4页Modern Preventive Medicine

摘　　要：目的观察正清风痛宁联合甲氨蝶呤(MTX)治疗老年类风湿关节炎(elderly onset rheumatoidarthritis,EORA)疗效及安全性。方法应用临床实验研究方法,按入院顺序采用区组随机分组法将病例分成实验组与对照组,实验组采用正清风痛宁联合甲氨蝶呤方案治疗,对照组采用单纯甲氨蝶呤方案治疗。治疗24周观察2组患者关节压痛指数、关节肿胀指数、晨僵持续时间、血沉(ESR)、(C-反应蛋白,C-reactive protein,CRP),与治疗前比较DAS28评分,将DAS28评分做为疾病活动度及疗效指标进行评估。检测血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV),同时观察2组不良反应发生率。结果治疗24周后实验组与对照组晨僵时间、关节压痛数、关节肿胀数、红细胞沉降率、C-反应蛋白、疾病活动度评分(DAS28)均较治疗前好转,差异有统计学意义(P﹤0.05);实验组上述指标改善情况均优于对照组,差异亦有统计学意义(P﹤0.05)。治疗后两组临床疗效比较差异有统计学意义(P﹤0.05)。两组患者血小板参数水平均降低,但实验组降低水平较对照组显著(P﹤0.05)。不良反应发生率两组比较差异无统计学意义(P﹥0.05)。结论正清风痛宁联合MTX在治疗老年RA,较单纯用MTX更能有效改善症状,控制病情,降低患者异常升高的血小板,从而减少老年RA患者心血管疾病的发生,而不良反应的发生率并未增加,值得临床借鉴应用。OBJECTIVE To evaluate the clinical efficacy and safety of the Zhengqing Fengtongning combined with methotrexate in treatment of elderly onset rheumatoid arthritis. METHODS Cases were equally divided into two groups. The experimental group was treated with the Zhengqing Fengtongning combined with MTX and the controls were treated with MTX only. The treatment lasted 24 weeks. Tender joints count （TJC）, swollen joint count （SJC）, morning stiffness time, erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP） of the patients were observed and compared. Used DAS28 as indicators, evaluated disease activity and efficacy. Detected platelet count （PLT）, platelet hematocrit （PCT）, mean platelet volume and adverse reactions in two groups. RESULTS Tender joints count （TJC）, swollen joint count （SJC）, morning stiffness time, erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, DSA 28 scores of the patients were improved after treatment compared with before treatment and these indictors above in the experimental group were better than in the control group （P﹤0.05）. Platelet parameters in two groups dropped, but the extent of the experimental group decreased more compared with the control group （P﹤0.05）. There were no differences in adverse reactions in two groups （P﹥0.05）. CONCLUSION Zhengqing Fengtongning combined with MTX can significantly improve arthritis symptoms and control development of disease. Meanwhile, it could reduce increased platelet to lower incidence of cardiovascular disease of elderly and do not make adverse reactions increase, which is worthy of clinical applications.

关 键 词：老年类风湿关节炎 正清风痛宁 甲氨蝶呤 

分 类 号：R971.1[医药卫生—药品]