摘要
目的观察小剂量甲泼尼龙联合羟氯喹、甲氨蝶呤治疗类风湿关节炎(RA)的疗效。方法 2011年1月-2013年5月将60例病程≤2年的初治RA患者随机分为对照组和治疗1组,两组各30例;两组均给予羟氯喹、甲氨蝶呤治疗,对照组加用美洛昔康(7.5 mg/次,2次/d),治疗1组加用甲泼尼龙(4 mg/次,2次/d)。另选30例病程≥5年的未曾规范治疗的RA患者为治疗2组,采用和治疗1组同样的治疗方案。所有患者在治疗后1周评估临床症状控制情况,治疗前和治疗后12周均评估临床指标和检测免疫学指标。结果治疗1组和治疗2组临床症状在1周内迅速缓解,疗效较对照组明显(P<0.05);12周后治疗1组和治疗2组在临床症状、28个关节疾病活动指数评分等方面较治疗前明显改善(P<0.05);治疗1组与治疗2组相比临床症状及免疫学检查方面改善更明显。结论小剂量甲泼尼龙联合羟氯喹、甲氨蝶呤可快速有效缓解RA患者的临床症状,病史短者疗效更好。
Objective To observe the efficacy of low-dose methylprednisolone combined with hydroxychloroquine and methotrexate in the treatment of rheumatoid arthritis（RA）. Methods Between January 2011 and May 2013, 60 RA patients on their first treatment with a disease course of less than or equal to 2 years were randomly divided to control group and treatment group Ⅰ with 30 patients in each. Patients in both the two groups were given hydroxychloroquine and methotrexate therapy, while the control group was treated with meloxicam（7.5 mg/time, 2 times/d） in addition, and the treatment group one was given methylprednisolone（4 mg/time, 2 times/d） in addition. Another 30 RA patients with a disease course of more than 5 years with no standardized treatment were designated into the treatment group Ⅱ. They accepted the same treatment scheme as treatment groupⅠ. All the patients were evaluated one week after treatment to assess their clinical symptoms. Twelve weeks before and after treatment, the patients were evaluated on their clinical indicators and immunological indicators. Results The clinical symptoms of patients in treatment group Ⅰ and Ⅱ were rapidly relieved within one week after treatment, and the curative effect was significantly higher than that in the control group（P〈 0.05）. Twelve weeks after treatment, the treatment groups were significantly improved compared with the control group in clinical symptoms and DSA28（P〈 0.05）. The improvement of clinical symptoms and immunological tests in treatment group Ⅰ was more obvious than that in treatment group Ⅱ. Conclusion Low-dose methylprednisolone combined with hydroxyl chloroquine and methotrexate can quickly and effectively relieve the clinical symptoms of the patients with RA, and patients with a shorter course of the disease have better clinical efficacy.
出处
《华西医学》
CAS
2015年第11期2001-2004,共4页
West China Medical Journal
基金
江苏省预防医学课题(Y201315)~~
关键词
甲泼尼龙
羟氯喹
甲氨蝶呤
类风湿关节炎
Methylprednisolone
Hydroxychloroquine
Methotrexate
Rheumatoid arthritis
