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目的:观察甲氨喋呤(MTX)联合蠲痹胶囊治疗类风湿关节炎(RA)的临床疗效及安全性。方法:符合纳入标准的60例RA患者随机分成2组,对照组30例采用蠲痹胶囊治疗,综合组30例采用蠲痹胶囊联合MTX治疗,疗程均为6月。观察治疗前后疼痛视觉模拟评分法(VAS)评分、关节压痛指数、关节肿胀指数及晨僵时间,并检查红细胞沉降率(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)水平、血常规、肝功能、肾功能。随时观察治疗过程中的不良反应。结果:2组治疗后晨僵时间比较,差异有显著性意义(P<0.05)。2组治疗后ESR、CRP、RF等实验室检查指标比较,差异均有显著性意义(P<0.05)。总有效率综合组为90%,对照组为60%,2组比较,差异有显著性意义(P<0.05)。对照组出现药物不良反应10例,综合组1例。主要表现为消化道症状、疲劳、乏力、嗜睡、下肢轻度浮肿、转氨酶升高,未发现末梢神经病变和深静脉血栓形成,所有患者能耐受,经观察和对症处理后均能完成治疗。结论:蠲痹胶囊联合西药MTX治疗RA疗效、安全性较好,联合应用有协同作用。
Objective: To observe the clinical efficacy and safety of methotrexate (MTX) combined with Weibi capsule in the treatment of rheumatoid arthritis (RA). Methods: Sixty patients with RA who met the inclusion criteria were randomly divided into two groups. Control group, 30 cases were treated with Huibi capsule, while 30 cases in combination group were treated with Huibi capsule combined with MTX. The course of treatment was June. Visual acuity score (VAS), joint tenderness index, joint swelling index and morning stiffness time were observed before and after treatment. The levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rheumatoid factor (RF) Blood, liver, kidney function. Observed at any time during treatment of adverse reactions. Results: There was significant difference in morning stiffness between the two groups after treatment (P <0.05). There was significant difference between the two groups in the laboratory indexes of ESR, CRP and RF after treatment (P <0.05). The total effective rate was 90% in the combined group and 60% in the control group. There was significant difference between the two groups (P <0.05). Control group appeared adverse drug reactions in 10 cases, 1 case of the integrated group. Mainly for gastrointestinal symptoms, fatigue, fatigue, drowsiness, mild edema of lower extremities, elevated transaminases, peripheral neuropathy and deep venous thrombosis were not found, all patients were able to tolerate, after observation and symptomatic treatment can be completed. Conclusion: Tongbi capsule combined with Western medicine MTX treatment of RA, safety is better, the combination of synergistic effect.