糖皮质激素类药物联合治疗类风湿性关节炎患者的疗效及安全性评价  

Evaluation of efficacy and safety of glucocorticoids combined with other drugs against rheumatoid arthritis

作　　者：熊俊慧[1] 薛静[1] 丁振华[1] 王小冬[1] 陈坚[1] 

机构地区：[1]丽水市人民医院,浙江丽水323000

出　　处：《中国医院药学杂志》2016年第18期1582-1585,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探究糖皮质激素类药物联合治疗在类风湿性关节炎上的临床疗效及安全性。方法:按照治疗方式的不同将某院收治84例类风湿性关节炎患者分为糖皮质激素组(43例)、非糖皮质激素组(41例)。非糖皮质激素组仅采用常规抗风湿病药物进行治疗,糖皮质激素组则在此基础上加入糖皮质激素药物进行治疗。治疗3个月后,统计2组患者的关节压痛数、关节肿胀数及晨僵持续时间,详细记录2组患者的ESR、CR及RF水平,并分别计算2组患者的DAS评分。参照相关临床标准对2组患者的短期治疗效果进行对比性评价,并对2组患者在治疗过程中出现的各类型不良反应进行分析比较。结果:治疗结束后,在晨僵持续时间、关节压痛数、关节肿胀数、DAS 28评分以及ESR、CRP及RF上,2组比较存在巨大差异(P<0.05)。糖皮质激素组的总有效率为88.37%,而非糖皮质激素组为67.44%,糖皮质激素组的起效时间也明显快于非糖皮质激素组,2组患者在总有效率及起效时间上存在显著性差异(P<0.05)。此外,糖皮质激素组在体质量增加、胃肠道不适上的发生率明显大于非糖皮质激素组(P<0.05),而在血压、血糖升高上2组患者之间并无显著性差异,差异无统计学意义(P>0.05)。结论:联合糖皮质激素类药物治疗类风湿性关节炎,能够短时间内有效控制关节炎症,临床疗效得到显著提升,但不良反应发生率偏高,因此在治疗上需注意控制用药时间及用药剂量,尽可能降低不良反应地发生。OBJECTIVE To research efficacy and safety of glucocorticoids combined with other drugs against rheumatoid arthritis.METHODS According to different treatment methods,84 patients with rheumatoid arthritis were divided into glucocorticoids groups（43 cases）and non glucocorticoid group（41 cases）.In non glucocorticoid group,only conventional anti rheumatic drugs were used.In glucocorticoid group,glucocorticoids were additionally added.After 3 months of treatment,number of joint tenderness,number of joint swelling and time of morning stiffness were counted,levels of ESR,CR and RF were recorded,to calculate DAS scores of two groups.Related clinical criteria were referred to compare short-term therapeutic effects in two groups,and analyze different adverse reactions of two groups during treatment.RESULTS After 3 months of treatment,there had huge differences in number of joint tenderness,number of joint swelling,time of morning stiffness,DAS score and ESR,CRP and RF between two groups（P〈0.05）.Total effective rate was 88.37% in glucocorticoid group and67.44%in non glucocorticoid group.Onset time of glucocorticoid group was significantly faster than that of glucocorticoid group.Significant differences were observed in total effective rate and onset time between two groups（P〈0.05）.In addition,glucocorticoid group had higher incidences of weight gain and gastrointestinal discomfort than in non glucocorticoid group（P〈0.05）.Blood pressure or glucose was not significantly different between two groups（P〉0.05）.CONCLUSION Therapy combining glucocorticoid drugs against rheumatoid arthritis can effectively control joint inflammation in a short time,with clinical efficacy significantly improved,though incidence of adverse reactions is high.Therefore,attentions should be paid to control duration of medication and dosage to reduce incidence of adverse reactions.

关 键 词：糖皮质激素 类风湿性关节炎 安全性评价 

分 类 号：R977.1[医药卫生—药品]