甲氨蝶呤、艾拉莫德联合物理疗法对类风湿关节炎患者的疗效及RF、ESR、CRP的影响观察

甲氨蝶呤、艾拉莫德联合物理疗法对类风湿关节炎患者的疗效及RF、ESR、CRP的影响观察

徐建萍,郭粉娥,岳晓琳,王佩,周红敏,李俊芳,王卫远,刘曦

邯郸市中心医院,邯郸市中心医院,邯郸市中心医院,邯郸市中心医院,邯郸市中心医院,邯郸市中心医院,邯郸市中心医院,邯郸市中心医院

收稿日期:2017-08-08 修回日期:2017-09-25 出版日期:2017-10-25

Effects of Methotrexate and Iguratimod Combined with Physiotherapy on Rheumatoid Arthritis and the Effects on RF， ESR and CRP

xujianping,guofene,yuexiaolin,wangpei,zhouhongmin,lijunfang,wangwenyuan and liuxi

zhongxinyiyuan,zhongxinyiyuan,zhongxinyiyuan,zhongxinyiyuan,zhongxinyiyuan,zhongxinyiyuan,zhongxinyiyuan,zhongxinyiyuan

Received:2017-08-08 Revised:2017-09-25 Online:2017-10-25

摘要/Abstract

摘要： 目的：探讨甲氨蝶呤、艾拉莫德联合物理疗法对类风湿关节炎患者的临床疗效，并观察其类风湿因子（RF）、血沉（ESR）、C反应蛋白（CRP）的影响效果。方法：选取我院在2015年12月至2017年4月收治的150例类风湿关节炎患者，采用随机化列表将患者随机分为对照组和试验组，每组75例，选用甲氨蝶呤、艾拉莫德治疗对照组患者，试验组给予甲氨蝶呤、艾拉莫德联合物理治疗，对比两组患者的临床疗效、相关指标及治疗3个月的经济费用。结果：试验组的总有效率高于对照组，差异具有统计学意义（P<0.05）；试验组的关节疼痛指数和关节肿胀指数治疗后均低于对照组，差异具有统计学意义（P<0.05）；治疗后试验组的RF、CRP和ESR均低于对照组，差异具有统计学意义（P<0.05）；试验组和对照组的不良反应发生率无差异，无统计学意义（P>0.05）；治疗3个月，2组患者的经济费用差异不明显，无统计学意义（P>0.05）。结论：甲氨蝶呤、艾拉莫德联合物理疗法对类风湿关节炎患者的治疗效果显著，有效降低患者的RF、CRP和ESR，缓解患者的关节疼痛指数和关节肿胀指数。

Abstract: Objective： To investigate the clinical efficacy of methotrexate and iguratimod combined with physiotherapy in the treatment of rheumatoid arthritis (RA)， and to observe effects on RF，ESR and CRP. Methods：150 cases of rheumatoid arthritis selected from December 2015 to April 2017 in our hospital were randomly divided into control group and experimental group using randomized list， 75 cases in each group. Patients in the control group were treated with methotrexate and iguratimod， and the experimental group were given methotrexate，iguratimod combined with physiotherapy.The clinical efficacy， the economic cost of treatment for 3 months，ESR，RF and CRP changes were compared between the two groups. Results：The total effective rate of experimental group was significantly higher than the control group (P<0.05). Joint pain index and joint swelling index of experimental group after treatment were significantly lower than the control group (P<0.05). After treatment， RF， CRP and ESR were lower than the control group， the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). After 3 months of treatment， there was no significant difference in economic cost between the two groups(P>0.05). Conclusion：The therapeutic effect of methotrexate，iguratimod combined with physiotherapy in patients with rheumatoid arthritis is significant， and can effectively reduce levels of RF， CRP and ESR， decrease joint pain index and joint swelling index.

徐建萍,郭粉娥,岳晓琳,王佩,周红敏,李俊芳,王卫远,刘曦. 甲氨蝶呤、艾拉莫德联合物理疗法对类风湿关节炎患者的疗效及RF、ESR、CRP的影响观察[J]. .

xujianping,guofene,yuexiaolin,wangpei,zhouhongmin,lijunfang,wangwenyuan and liuxi. Effects of Methotrexate and Iguratimod Combined with Physiotherapy on Rheumatoid Arthritis and the Effects on RF， ESR and CRP[J]. .

参考文献

参考文献
[1]明荷,谢寒,艾坤.复方丹参注射液联合针灸治疗对类风湿关节炎患者炎性因子和血脂水平的影响[J].中国老年学杂志,2016,36(11):2719-2721.
[2]孟德钎,潘文友,李鞠,等.甲氨蝶呤联合艾拉莫德治疗难治性类风湿关节炎的效果[J].中国医药导报,2016,13(3):137-141.
[3]刘升云,杨璐,张磊,等.甲氨蝶呤联合小剂量泼尼松治疗类风湿关节炎的短期疗效与安全[J].中华内科杂志,2013,52(12):1018.
[4]刘小军,魏琴,冯艳广,等.艾拉莫德治疗类风湿关节炎的临床研究[J].中国药物与临床,2013,13(11):1453.
[5]高泉,周磊,张婷,等.来氟米特与甲氨蝶呤治疗类风湿关节炎的疗效及安全性[J].中国老年学杂志,2012,32(21):4816.
[6]陈思曾,郭永刚.艾拉莫德、吡咯烷二硫代氨基甲酸盐单用和联合治疗恶病质[J].中华实验外科杂志,2011,28(5):720.
[7]Moreland L W，O'Dell J R，Paulus H E，et al． A randomized comparative effectiveness study of oral triple therapy versus etanercept plus methotrexate in early aggressive rheumatoid arthritis: the treatment of Early Aggressive Rheumatoid Arthritis Trial[J]. Arthritis Rheum,2012,64(9):2824.
[8]周卉,朱芸,张滨,等.艾拉莫德联合甲氨蝶呤治疗类风湿关节炎的临床观察[J].中国医学工程,2014,22(5):35-36.
[9]张斌,王宏智,顾娟芳.艾拉莫德治疗类风湿关节炎对骨代谢的影响及临床疗效[J].中华全科医学,2015,13(3):364.
[10]石宇红,周润华,许佳,等.亚甲基四氢叶酸还原酶基因多态性对小剂量甲氨喋呤治疗类风湿关节炎不良反应的影响[J].中国临床新医学,2013,6(3): 211-214.
[11]黄浩,师伯省.艾拉莫德与依托考昔治疗类风湿关节炎的疗效与安全性比较[J].中国药物经济学,2014,1(1): 75-76.
[12]陈楠,王振刚.以甲氨蝶呤为核心的类风湿关节炎的联合药物治疗[J].中国医刊,2013,48(7):5-7.
[13]闫琳毅,陆利.甲氨蝶呤联合雷公藤多甙片治疗类风湿性关节炎疗效及安全性研究[J].中国现代医生,2015,53(8):90.
[14]MUCKE H A. Iguratimod: a new disease-modifying antirheu- matic drug [J]. Drugs Today(Barc), 2012, 48(9): 577-586.
[15]Fleischmann R,Kremer J,Cush J,et al.Placebo － controlled trial of tofacitinib monotherapy in rheumatoid arthritis[J].N Engl J Med,2012,367(6):495.
[16]秦祖杰,唐金钧,庞学丰. 三联疗法治疗类风湿关节炎60 例[J].中国实验方剂学杂志,2012,18(1):223-225.
[17]Sellam J,Hendel Chavez H,Rouanet S，et al.B cell activation biomarkers as predictive factors for the response to rituximab in rheumatoid arthritis: A six month，national，multicenter，open label study[J].Arthritis Rheum,2011,63(4):933.
[18]张源潮,王峰,王威严,等.类风湿关节炎治疗新药艾拉莫德[J].世界临床药物,2013,34(2):65.
[19]熊永梅,范声念,邹亮.艾拉莫德联合甲氨蝶呤治疗对类风湿关节炎患者抗环胍氨酸肽抗体等指标影响的研究[J].临床内科杂志,2015,32(12):833.
[20]孟德钎,王国如,潘文友,等.甲氨蝶呤联合艾拉莫德对难治性类风湿性关节炎的短期临床疗效[J].中国临床研究,2015,28(12):1586-1588.

快速检索引用检索图表检索高级检索