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目的探讨和研究免疫抑制疗法对类风湿关节炎的临床治疗效果。方法选取60例类风湿关节炎患者,随机分成等例数的实验组和对照组,实验组予免疫抑制剂来氟米特治疗,对照组予甲氨蝶呤治疗,疗程24周,在第12周、24周评估治疗效果。结果经过治疗12周后实验组、对照组患者晨僵、关节疼痛、关节肿胀等症状得到改善,实验室检查示ESE、类风湿因子、C反应蛋白显著下降。治疗24周后患者症状及实验室检查指标明显改善。两组患者在治疗过程中,实验组有2例发生皮疹、消化不良、腹泻、耳鸣等不良反应,但无因严重不良反应而停药,对照组有6例发生厌食、恶心、呕吐、头痛、口角糜烂等不良反应,其中有1例因严重消化道反应而短期停药。实验组不良反应发生率(6.67%)低于对照组(20.00%),差别有统计学意义(χ2=4.04,P<0.05)。治疗12周后实验组、对照组总体有效率分别为80.0%、76.67%,差别无统计学意义(χ2=0.098,P>0.05)。治疗24周后实验组、对照组总体有效率分别为86.67%、83.33%,差别无统计学意义(χ2=0.13,P>0.05)。结论免疫抑制疗法对类风湿关节炎有明显的临床治疗效果,且不良反应发生率低,可在临床进一步推广应用。
Objective To investigate and study the clinical effect of immunosuppressive therapy on rheumatoid arthritis. Methods Sixty patients with rheumatoid arthritis were selected and divided into experimental and control groups randomly. The experimental group was treated with leflunomide, the control group was treated with methotrexate for 24 weeks. In section 12 Weeks, 24 weeks to assess the therapeutic effect. Results After 12 weeks of treatment, symptoms such as morning stiffness, joint pain and swollen joints in experimental group and control group were improved. Laboratory tests showed that ESE, rheumatoid factor and C-reactive protein were significantly decreased. After 24 weeks of treatment, symptoms and laboratory tests significantly improved the indicators. Two groups of patients in the course of treatment, experimental group 2 cases of rash, indigestion, diarrhea, tinnitus and other adverse reactions, but no due to serious adverse reactions and withdrawal, the control group, 6 cases of anorexia, nausea, vomiting, headache, Mouth erosion and other adverse reactions, of which 1 case of short-term withdrawal due to severe gastrointestinal reactions. The incidence of adverse reactions in the experimental group (6.67%) was lower than that in the control group (20.00%), the difference was statistically significant (χ2 = 4.04, P <0.05). After 12 weeks of treatment, the overall effective rates of the experimental group and the control group were 80.0% and 76.67%, respectively, with no significant difference (χ2 = 0.098, P> 0.05). After 24 weeks of treatment, the total effective rates of the experimental group and the control group were 86.67% and 83.33%, respectively, with no significant difference (χ2 = 0.13, P> 0.05). Conclusion Immunosuppressive therapy has obvious clinical therapeutic effect on rheumatoid arthritis, and the incidence of adverse reactions is low, which can be further popularized and applied in clinic.