论文部分内容阅读
目的探讨沙利度胺(THD)联合甲氨蝶呤(MTX)治疗类风湿关节炎(RA)的临床疗效及安全性。方法选取2014年12月—2015年12月新疆医科大学第五附属医院收治的RA患者60例,随机将患者分成MTX+THD组与硫酸羟氯喹(HCQ)+MTX组,各30例。比较两组患者临床疗效、治疗前后视觉模拟评分法(VAS)评分、关节肿胀数、关节压痛数、晨僵时间、C-反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF),观察两组患者不良反应发生情况。结果 MTX+THD组总有效率高于MTX+HCQ组,差异有统计学意义(P<0.05)。治疗前两组患者临床表现及活动指标比较,差异无统计学意义(P>0.05);治疗后MTX+THD组患者VAS评分、关节压痛数、关节肿胀数低于MTX+HCQ组,晨僵时间短于MTX+HCQ组,差异有统计学意义(P<0.05);治疗后两组患者ESR、CRP、RF比较,差异无统计学意义(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 THD联合MTX治疗RA疗效确切,可有效改善患者相关活动指标,且不良反应少。
Objective To investigate the clinical efficacy and safety of thalidomide (THD) combined with methotrexate (MTX) in the treatment of rheumatoid arthritis (RA). Methods Sixty RA patients admitted from the Fifth Affiliated Hospital of Xinjiang Medical University from December 2014 to December 2015 were randomly divided into MTX + THD group and HCQ + MTX group (n = 30). The clinical curative effect, visual analogue scale (VAS) score, joint swelling, joint tenderness, morning stiffness, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor ), Observed two groups of patients with adverse reactions occurred. Results The total effective rate in MTX + THD group was higher than that in MTX + HCQ group, the difference was statistically significant (P <0.05). There were no significant differences in clinical manifestations and activities between the two groups before treatment (P> 0.05). After treatment, VAS score, joint tenderness and joint swelling in MTX + THD group were lower than those in MTX + HCQ group and morning stiffness (P <0.05). There was no significant difference in ESR, CRP and RF between the two groups after treatment (P> 0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). Conclusion THD combined with MTX treatment of RA exact effect, can effectively improve the patient-related activity indicators, and fewer adverse reactions.