美洛昔康片联合甲氨蝶呤片治疗类风湿关节炎的临床研究  

Clinical trial of meloxicam combined with methotrexat in the treatment of rheumatoid arthritis

作　　者：李培培[1] 邰宇[2] 黄传兵[3] 张玲玲[2] 

机构地区：[1]安徽中医药大学第一附属医院药学部,合肥230031 [2]安徽医科大学临床药理研究所,抗炎免疫药物教育部重点实验室,合肥230032 [3]安徽中医药大学第一附属医院风湿科,合肥230031

出　　处：《中国临床药理学杂志》2016年第22期2023-2026,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(81473223)

摘　　要：目的观察美洛昔康片联合甲氨蝶呤片对类风湿关节炎临床症状和实验室指标的影响。方法 100例类风湿关节炎患者随机分为对照组和试验组,每组50例。对照组口服来氟米特20 mg,每日1次,睡前服用,甲氨蝶呤5 mg,每周1次;试验组口服美洛昔康15 mg,每日1次,甲氨蝶呤5 mg,每周1次。2组均连续用药24周。观察2组患者治疗前后的临床症状和实验室指标。结果治疗后4,12,24周,试验组晨僵时间分别为(78.13±15.24),(62.00±9.31),(35.93±6.12)min,对照组分别为(83.46±17.73),(65.62±11.11),(45.08±9.32)min,与治疗前相比差异有统计学意义(P<0.05)。治疗后4,12,24周,试验组关节疼痛数分别为15.05±3.46,10.11±2.83,5.94±1.47,对照组分别为14.17±4.03,9.17±3.13,5.61±1.85,与治疗前相比差异有统计学意义(P<0.05)。治疗后4,12,24周,试验组肿胀关节数分别为12.90±3.92,10.00±2.71,5.70±2.41,对照组分别为12.00±3.94,8.33±3.04,4.78±1.72,与治疗前相比差异有统计学意义(P<0.05)。治疗后12,24周,试验组红细胞沉降率分别为(32.70±13.52),(28.57±13.87)mm·h^(-1),对照组为(39.29±18.52),(36.00±16.12)mm·h^(-1),差异有统计学意义(P<0.05)。治疗后4,12,24周,试验组C反应蛋白分别为(16.60±6.88),(14.70±6.76),(13.11±3.73)mg·L^(-1),对照组分别为(17.05±7.15),(15.40±6.50),(15.02±4.64)mg·L^(-1),与治疗前相比差异有统计学意义(P<0.05)。治疗后4,12,24周,试验组抗环瓜氨酸肽抗体分别为(116.96±47.95)(85.31±36.43)(58.82±30.26)U·m L^(-1),对照组分别为(111.37±56.16),(82.66±50.11),(63.24±39.61)U·m L^(-1),与治疗前相比差异有统计学意义(P<0.05)。治疗前后,2组类风湿因子差异均无统计学意义(均P>0.05)。对照组出现皮疹4例,恶心4例,消化不良6例,脱发1例,药物不良反应发生率为30.00%(15/50例);试验组出现腹痛4例,消化不良1例,皮疹5例,血白细胞轻度下降1例,呕吐3例,药物不良反应发生率为28.00%(14/50例)。2组均未出现Objective To observe the clinical symptoms and laboratory index of meloxicam combined with methotrexat in patients with rheuma- toid arthritis（RA）. Methods A total of 100 patients with RA were ran- domly divided into treatment group and control group, each group50 cases. Patients in control group were orally given methotrexat 5 mg, 1 times a week, leftunomide 20 mg, once a day before bed. Patients in treatment group were orally given methotrexat 5 rag, 1 times a week, methotrexat 15 mg once a day. All patients were treated for 24 weeks. The clinical symptoms and laboratory index of the two groups were observed. Results After 4, 12, 24 weeks treatment, the morning stiffness time in treatment group were （78. 13 ± 15. 24 ）, （62. 00 ± 9. 31 ）, （35. 93 ± 6. 12） min, and were （ 83.46 ± 17. 73 ）, （65.62 ±11.11 ）, （45.08 ± 9. 32） min in control group, had significant difference with before treatment （P 〈 0. 05 ）. The joint pain in treatment group after 4, 12, 24 weeks treatment were 15.05± 3.46, 10. 11 ± 2. 83, 5.94 ± 1.47, and were 14. 17 ±4. 03, 9. 17 ± 3. 13, 5. 61 ± 1.85 in control group, had significant difference with before treatment（P 〈 0. 05）. The swelling of the joints in treatment group after 4, 12, 24 weeks treatment were 12. 90 23. 92, 10. 00 22. 71, 5.70 22. 41, and were 12. 00 ±3.94, 8. 33 23.04, 4. 78 ± 1.72 in control group, had significant difference with before treatment（P 〈0. 05）. After 12, 24 weeks treatment, erythrocyte sedimentation rate （ESR） in treatment group were （32. 70 ± 13.52）, （ 28. 57 ±13. 87） mm. h-1, had significant difference with control group, which were （39. 29 ± 18. 52）, （ 36. 00 ± 16. 12） mm . h - 1 （p 〈 0. 05 ）. After 4, 12, 24 weeks treatment, the C reactive protein in treatment group were （16. 60 ± 6. 88 ）, （14. 70 ± 6. 76 ）, （13. 11 ±3. 73）mg . L-1, and were （17.05 ±7. 15）, （15.40 ±6.50）, （15.02 ±4.64） mg. L-1 in control group, had significant difference with

关 键 词：类风湿关节炎 甲氨蝶呤 来氟米特 美洛昔康 

分 类 号：R971.1[医药卫生—药品]