艾拉莫德分别联合甲氨蝶呤和双醋瑞因对难治性类风湿关节炎患者相关指标的影响比较  

Comparison of the Effects of Iguratimod Combined with Methotrexate and Diacerein Respectively on Related Indexes of Refractory Rheumatoid Arthritis

作　　者：李连菊[1] 王京旭[1] 

机构地区：[1]邢台市人民医院风湿免疫科,河北邢台054000

出　　处：《中国药房》2017年第6期769-772,共4页China Pharmacy

摘　　要：目的:比较艾拉莫德分别联合甲氨蝶呤和双醋瑞因对难治性类风湿关节炎(RRA)患者相关指标的影响。方法:98例RRA患者随机分为对照组(48例)和观察组(50例)。对照组患者口服艾拉莫德片25 mg,每日2次+甲氨蝶呤片初始剂量10 mg,每周1次,2周后增加至12.5 mg,并于第2个周期加量至15 mg,每周1次。观察组患者口服艾拉莫德片(用法用量同对照组)+双醋瑞因胶囊50 mg,每日2次。两组均以4周为1个周期,共治疗6个周期。观察两组患者治疗前后晨僵时间、28个关节压痛数、28个关节肿胀数、28个关节的疾病活动度(DAS28)评分、红细胞沉降率(ESR)、类风湿因子(RF)、白细胞介素1(IL-1)、血管内皮生长因子(VEGF)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、丙二醛(MDA)、超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)、早期血流峰值(E峰)、左室舒张晚期血流峰值(A峰)、E/A、左室射血分数(LVEF)及不良反应发生情况。结果:治疗后,两组患者晨僵时间、28个关节压痛数、28个关节肿胀数、DAS28评分、ESR、RF、IL-1、TNF-α、CRP、VEGF、MDA、TAOC、A峰均显著低于同组治疗前,且观察组显著低于对照组;两组患者SOD、E峰、E/A、LVEF均显著高于同组治疗前,且观察组显著高于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:艾拉莫德联合双醋瑞因治疗RRA在改善患者心功能、氧化-抗氧化系统失衡及降低炎症反应作用方面均优于艾拉莫德联合甲氨蝶呤,而两者安全性相当。OBJECTIVE：To compare the effects of iguratimod combined with methotrexate and diacerein respectively on related indexes of refractory rheumatoid arthritis（RRA）. METHODS：98 RRA patients were randomly divided into control group（48cases）and observation group（50 cases）. Control group received Iguratimod tablet 25 mg,twice a day＋Methotrexate tablet with initial dose of 10 mg,once a week,increased to 12.5 mg after 2 weeks,increased to 15 mg in the second courses,once a week. Observation group received Iguratimod tablet（the same dosage and usage with control group）＋Diacerein granule 50 mg,twice a day.4-week was a course,they were treated for 6 courses. Morning stiffness time,the numbers of 28 joints tenderness and swelling,28 joint disease activity score（DAS28）,erythrocyte sedimentation rate（ESR）,rheumatoid factor（RF）,IL-1,vascular endothelial growth factor（VEGF）,tumor necrosis factor（TNF）-α,C-reaction protein（CRP）,malondialdehyde（MDA）,superoxide dismutase（SOD）,total antioxidant capacity（TAOC）,early peak flow（peak E）,left ventricular late flow peak flow（peak A）,E/A and left ventricular ejection fraction（LVEF）before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS：Before treatment,morning stiffness time,the numbers of 28 joints tenderness and swelling,DAS28 score,ESR,RF,IL-1,TNF-α,CRP,VEGF,MDA,TAOC and peak A in 2 groups were significantly lower than before treatment,and observation group was significantly lower than control group;SOD,peak E,E/A and LVEF in 2 groups were significantly higher than before treatment,and observation group was significantly higher than control group,with statistical significances（P〈0.05）.And there was no significant difference in the incidence of adverse reactions（P〉0.05）. CONCLUSIONS：Iguratimod combined with diacerein is superior to iguratimod combined with methotrexate in improving cardiac function,oxidation-antioxidant imbalance play and reducing inflammato

关 键 词：难治性类风湿关节炎 艾拉莫德 甲氨蝶呤 双醋瑞因 心功能 炎症反应 安全性 

分 类 号：R684.3[医药卫生—骨科学]