来氟米特联合甲氨蝶呤治疗银屑病关节炎皮肤病变的效果分析  

Effect of leflunomide combined with methotrexate in the treatment of skin lesions caused by psoriatic arthritis

作　　者：史修波 佘冬华 兰小琼[1] Shi Xiubo;She Donghua;Lan Xiaoqiong(Department of Dermatology and Venereology, the Hospital of Chengdu Office of People＇s Government of Tibetan Autonomous Region ,Affiliated to Huaxi Hospital of Sichuan University, Chengdu ,Sichuan 610041, China)

机构地区：[1]四川大学华西医院西藏成办分院皮肤性病科,四川省成都610041

出　　处：《中国基层医药》2018年第4期503-506,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 研究来氟米特联合甲氨蝶呤治疗银屑病关节炎皮肤病变的临床效果.方法 收集90例银屑病关节炎皮肤病变患者临床资料,采用简单随机法分为对照组和观察组,每组45例.对照组给予甲氨蝶呤治疗,观察组在此基础上使用来氟米特进行联合治疗.观察两组患者在治疗前、治疗1个月、治疗2个月、治疗3个月时的皮肤病变、银屑病关节炎症状改善情况、临床效果以及不良反应发生情况.结果 观察组治疗1个月、治疗2个月、治疗3个月皮肤病生活质量指数评分分别为（8.12±2.02）分、（6.55±1.47）分、（3.68±1.21）分,均显著优于对照组（t=2.54、3.92、4.44,P=0.01、0.01、0.01）;观察组治疗1个月、治疗2个月、治疗3个月皮损面积及严重程度指标评分数分别为（7.57±3.22）分、（4.61±1.86）分、（3.11±2.17）分,均较对照组更优（t=3.42、7.81、4.07,P=0.01、0.01、0.01）;观察组总有效率为88.89％,显著高于对照组的68.89％（χ2=5.40,P=0.02）;两组患者均无严重不良反应发生,差异无统计学意义（11.11％比13.33％,χ2=0.10,P=0.75）.结论 来氟米特联合甲氨蝶呤治疗银屑病关节炎皮肤病变,相比单用甲氨蝶呤,效果显著,能够明显改善患者皮肤症状及关节炎症状,更利于减轻患者痛苦.Objective To study the clinical effect of leflunomide combined with methotrexate in the treatment of skin lesions caused by psoriatic arthritis .Methods The clinical data of 90 patients with skin lesions caused by psoriatic arthritis were collected ,and they were divided into control group and observation group by simple random method,45 cases in each group.The control group was treated with methotrexate ,and the observation group was given leflunomide combined with methotrexate .Before treatment and after treatment for one month ,two months ,three months ,the skin lesions , psoriatic arthritis symptoms improvement , clinical effects and adverse reactions were observed in the two groups.Results After treatment for one month,two months,three months,the DLQL index scores in the observation group were （8.12 ±2.02）points,（6.55 ±1.47）points,（3.68 ±1.21）points,respectively,which were significantly better than those in the control group （t=2.54,3.92,4.44,P=0.01,0.01,0.01）.After treatment for one month,two months,three months,the PASI index scores in the observation group were （7.57 ±3.22）points, （4.61 ±1.86）points,（3.11 ±2.17）points,respectively,which were better than those in the control group （t=3.42, 7.81,4.07,P =0.01,0.01,0.01）.The total effective rate of the observation group was 88.89％,which was significantly higher than 68.89％of the control group （χ2 =5.40,P=0.02）.No serious adverse reactions occurred in both two groups,and the difference was not statistically significant （11.11％ vs.13.33％,χ2 =0.10,P=0.75）. Conclusion Compared with methotrexate alone , leflunomide combined with methotrexate in the treatment of skin lesions caused by psoriatic arthritis has obvious effect , and can significantly improve the symptoms of patients with skin and arthritis symptoms ,and it is more conducive to relieve patients＇pain.

关 键 词：关节炎 牛皮癣 皮肤疾病 来氟米特 甲氨蝶呤 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]