论文部分内容阅读
目的 观察甲氨蝶呤（ＭＴＸ）、柳氮磺吡啶（ＳＡＳＰ）、金诺芬、雷公藤多甙、糖皮质激素和重组人干扰素－γ不同联合治疗方案对类风湿关节炎（ＲＡ）的远期疗效。方法①对１８９例经冶疗后追踪１～６年的ＲＡ病例进行回顾性分析；②治疗方案：基础治疗方案为ＭＴＸ加ＳＡＳＰ，ＭＴＸ加金诺芬，部分病例合并使用雷公藤多甙、糖皮质激素、重组人干扰素－γ；③观察指标：关节临床表现、实验室检查（ＥＳＲ、ＣＲＰ、ＲＦ滴度）和关节Ｘ线片。结果①全组临床疗效评价：症状缓解１１．１％、基本控制４９．７％、进步２７．０％、反复发作或恶化１２．２％；②Ｘ线评价：１２２例作Ｘ线复查。Ｘ线改善６．９％、无改变７７，８％、进展１７．２ ％；③单纯基础治疗组与加用雷公藤多甙或糖皮质激素组比较，其远期临床疗效和Ｘ线变化，两者差异均无显著性；④并用重组人干扰素－γ组２２例。临床疗效：症状缓解４５．５％、进步４０．９％、反复发作或恶化１３．６％Ｘ线评价：改善１例，余均无改变。结论①对ＲＡ采用综合性治疗可取得较满意的疗效；②在基础治疗上加用雷公藤多甙或糖皮质激素，对远期临床疗效和Ｘ线变化无明显影响；应用重组人干扰素－γ与其他二线药合用在一定程度上有扭转病情发展，取?
Objective To observe the effect of different combinations of methotrexate (MTX), sulfasalazine (SASP), auranofin, tripterygium glycosides, glucocorticoid and recombinant human interferon-γ on rheumatoid arthritis Long-term efficacy. Methods ① A retrospective analysis was performed on 189 cases of RA patients who were followed up 1 to 6 years after treatment. ② The treatment regimen: The basic treatment regimens were MTX plus SASP and MTX plus auranofin. In some cases, the combination of tripterygium glycosides, Corticosteroids, recombinant human interferon-γ; ③ observation indicators: clinical manifestations, laboratory tests (ESR, CRP, RF titers) and joint X-ray. Results ① The clinical efficacy of the whole group was evaluated. The symptom relief was 11.1%, the basic control was 49.7%, the progress was 27.0% and the recurrent or worsening was 12.2%. ② X-ray evaluation: 122 cases were reviewed by X-ray. X-ray improved 6.9%, no change 77.8%, progress 17.2%; ③ simple basic treatment group and plus tripterygium glycosides or glucocorticoid group, its long-term clinical efficacy and X-ray changes, There was no significant difference between the two groups; ④ combined with recombinant human interferon-γ group of 22 patients. Clinical efficacy: 45.5% remission, progressive 40.9%, recurrent or worsening 13.6% X-ray evaluation: to improve in 1 case, I have no change. Conclusion ① The comprehensive treatment of RA can be more satisfactory curative effect; ② in the basic treatment with tripterygium glycosides or glucocorticoid, long-term clinical efficacy and X-ray changes had no effect; the application of recombinant human interferon- γ and other second-line drugs combined to a certain extent, have to reverse the progression of the disease, take?