小剂量甲氨蝶呤联合来氟米特治疗类风湿关节炎的临床疗效观察  

Clinical observation of low dose methotrexate combined with leflunomide in treatment of rheumatoid arthritis

作　　者：汤艳华[1] 

机构地区：[1]江西省九江市第一人民医院风湿免疫科,江西九江332000

出　　处：《中国现代医生》2015年第28期65-68,共4页China Modern Doctor

摘　　要：目的分析小剂量甲氨蝶呤联合来氟米特治疗类风湿关节炎的临床效果。方法于2013年6月～2014年7月选取我院确诊为类风湿关节炎患者60例随机分为实验组和对照组，小剂量甲氨蝶呤联合来氟米特作为实验组的治疗方案，小剂量甲氨蝶呤作为对照组的治疗方案，观察两组患者晨僵时间、关节疼痛和肿胀指数、类风湿因子、红细胞沉降率、C反应蛋白、临床疗效有效率和不良反应发生率。结果治疗后。实验组和对照组的晨僵时间、关节疼痛和肿胀指数、类风湿因子滴度、红细胞沉降率、血清c反应蛋白水平比较．差异具有统计学意义（P〈0．05），且实验组各项指标变化的差异较对照组更明显（P〈0．01）。实验组临床有效率96．67％，显著高于对照组（70．33％），差异具有统计学意义（χ2=21．362，P=0．000）；两组不良反应发生率比较，差异无统计学意义（χ2=0．371，P=0．542）。结论小剂量甲氨蝶呤联合来氟米特治疗方案可有效地缓解类风湿关节炎患者的临床症状。Objective To analyze the clinical effcacy of minor dosage methotrexate combined with leflunomide in treat- ment of rheumatoid arthritis. Methods From June 2013 to January 2014,60 patients diagnosed with rheumatoid arthri- tis were divided into two groups in our hospital. In the experiment group,patients were treated with minor dosage methotrexate combined with leflunomide, in the control group,patients were treated with minor dosage methotrexate. Two groups＇ morning stiffness time, indexes of aching and swelling of joints,rheumatoid factor,erythrocyte sedimenta- tion rate, C-reactin protein , rate of clinical efficacy and side effects were observed. Results After treatment, there were significant ly statistical differences in changes of morning stiffness time, indexes of aching and swelling of joints, rheumatoid factor, erythrocyte sedimentation rate, C-reactin protein between two groups（P〈0.05） and the differences in changes of these indexes of the experiment group were more obvious than that of the control group （P〈0.01）. The rate of clinical efficacy in the experimental group was 96.67% ,far higher than that in the control group （70.33%） ,the differ- ence was significant（χ2=21.362,P=0.000）. There were no significantly statistical differences between two groups in rate of side effects（χ2=0.371 ,P=0.542）. Conclusion It is effective to take the treatment of low dose methotrexate combined with leflunomide to relieve clinical symptoms of patients with rheumatoid arthritis.

关 键 词：小剂量甲氨蝶呤 来氟米特 类风湿 关节炎 

分 类 号：R593.22[医药卫生—内科学]