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目的探讨甲氨蝶呤联合来氟米特治疗类风湿关节炎(RA)的临床疗效及其安全性。方法选取广西体育运动创伤专科医院2013年5月—2015年4月收治的RA患者60例,根据随机双盲法分为对照组和试验组,各30例。对照组患者给予甲氨蝶呤治疗,试验组患者给予甲氨蝶呤联合来氟米特治疗,两组患者均持续治疗3个月。比较两组患者的临床疗效,治疗前后疾病活动度DAS28评分、Sharp评分及健康调查问卷(HAQ)评分,记录比较两组患者治疗期间不良事件发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前,两组患者DAS28评分、Sharp评分及HAQ评分比较,差异无统计学意义(P>0.05)。治疗后,试验组患者DAS28评分低于对照组(P<0.05);两组患者Sharp评分、HAQ评分比较,差异无统计学意义(P<0.05)。两组患者治疗后DAS28评分低于治疗前(P<0.05)。观察组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论甲氨蝶呤联合来氟米特治疗RA临床疗效确切,可有效改善患者关节活动度,且用药安全性。
Objective To investigate the clinical efficacy and safety of methotrexate combined with leflunomide in the treatment of rheumatoid arthritis (RA). Methods 60 cases of RA patients admitted to Guangxi Sports Trauma Hospital from May 2013 to April 2015 were divided into control group and experimental group according to randomized double-blind method, 30 cases in each group. Methotrexate was given to patients in the control group and to methotrexate plus leflunomide in the test group. Both patients were treated for 3 months. The clinical efficacy, DAS28 score, Sharp score and Health Questionnaire (HAQ) scores of disease activity before and after treatment were compared between two groups. The occurrence of adverse events in both groups were compared. Results The clinical efficacy of the observation group was better than that of the control group (P <0.05). Before treatment, there was no significant difference in DAS28 score, Sharp score and HAQ score between the two groups (P> 0.05). After treatment, the score of DAS28 in test group was lower than that in control group (P <0.05). There was no significant difference between the two groups in Sharp score and HAQ score (P <0.05). DAS28 scores of the two groups after treatment were lower than those before treatment (P <0.05). The incidence of adverse reactions in the observation group was no significant difference (P> 0.05). Conclusion Methotrexate combined with leflunomide in the treatment of RA has definite curative effect, which can effectively improve the degree of joint mobility and medication safety.