艾拉莫德联合甲氨蝶呤治疗类风湿性关节炎的临床观察

发布时间：2018-07-03 14:24

本文选题：艾拉莫德 + 甲氨蝶呤　；参考：《中国药房》2017年32期

【摘要】：目的:观察艾拉莫德联合甲氨蝶呤治疗类风湿性关节炎的临床疗效及安全性。方法:选择2015年2月-2016年2月于我院接受治疗的82例类风湿性关节炎患者,采用随机数字表法分为观察组和对照组,各41例。对照组患者给予甲氨蝶呤片10 mg口服,每周1次,2周后逐渐增至15 mg,每周1次。观察组患者在对照组基础上给予艾拉莫德片25 mg餐后口服,bid。两组患者的疗程均为6个月。观察两组患者的临床疗效、不良反应发生情况和治疗前后的关节压痛数、关节肿胀数、晨僵时间;检测两组患者治疗前后的红细胞沉降率、C反应蛋白(CRP)、血小板计数、血清免疫球蛋白(IgG、IgA、IgM)和T淋巴细胞亚群(CD3~+、CD4~+、CD8~+)水平。结果:观察组患者临床总有效率为90.24%,明显高于对照组的78.05%,差异有统计学意义(P0.05)。治疗前,两组患者上述指标水平比较,差异均无统计学意义(P0.05)。治疗后,两组患者的关节压痛数、关节肿胀数明显少于治疗前,晨僵时间明显短于治疗前,红细胞沉降率、CRP、血小板计数、血清免疫球蛋白和T淋巴细胞亚群水平均明显低于治疗前,且观察组均明显低于对照组,差异均有统计学意义(P0.05)。两组患者均未见严重的不良反应发生,组间不良反应发生率比较,差异无统计学意义(P0.05)。结论:艾拉莫德联合甲氨蝶呤较单用甲氨蝶呤更能够提高疗效、缓解患者临床症状、抑制患者免疫功能,从而控制类风湿性关节炎的疾病进展,且安全性较好。
[Abstract]:Objective: to observe the efficacy and safety of iramod combined with methotrexate in the treatment of rheumatoid arthritis. Methods: 82 patients with rheumatoid arthritis who were treated in our hospital from February 2015 to February 2016 were randomly divided into two groups: observation group (n = 41) and control group (n = 41). Patients in the control group were given 10 mg methotrexate orally, and gradually increased to 15 mg once a week after 2 weeks. The patients in the observation group were treated with 25 mg elamod tablets after meal oral administration on the basis of the control group. The course of treatment was 6 months in both groups. The clinical efficacy, adverse reactions, number of joint tenderness, joint swelling and morning stiffness before and after treatment were observed, the erythrocyte sedimentation rate and C-reactive protein (CRP) and platelet count were measured before and after treatment. The levels of serum immunoglobulin (IgG) and T lymphocyte subsets (CD3 ~ + CD4 ~ + CD8 ~) were measured. Results: the total clinical effective rate of the observation group was 90.24, which was significantly higher than that of the control group (78.05). The difference was statistically significant (P0.05). Before treatment, the two groups of patients compared the above indicators, the difference was not statistically significant (P0.05). After treatment, the number of joint tenderness and joint swelling in both groups were significantly less than those before treatment, the time of morning stiffness was significantly shorter than that before treatment, and the erythrocyte sedimentation rate and platelet count were lower than those before treatment. The levels of serum immunoglobulin and T lymphocyte subsets were significantly lower in the observation group than in the control group (P0.05). No serious adverse reactions occurred in the two groups, and there was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: Elamod combined with methotrexate is more effective than methotrexate alone in relieving clinical symptoms and inhibiting the immune function of patients so as to control the progression of rheumatoid arthritis and its safety is better than that of methotrexate alone.
【作者单位】：莱芜市人民医院药剂科;莱芜市人民医院内科;
【分类号】：R593.22

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