目的 比較甲氨蝶呤片與雷公藤多苷片分別聯(lián)合來氟米特片治療類風(fēng)濕關(guān)節(jié)炎的臨床效果。方法 選取2016年1月—2018年12月在宿州市立醫(yī)院就診的68例類風(fēng)濕關(guān)節(jié)炎患者作為研究對(duì)象，采用單純隨機(jī)分組法將患者分為觀察組（n=34）和對(duì)照組（n=34）。對(duì)照組給予患者口服雷公藤多苷片20 mg，3次/d，同時(shí)給予口服來氟米特片20 mg，1次/d。觀察組給予患者口服甲氨蝶呤片10 mg，1次/周，同時(shí)給予口服來氟米特20 mg，1次/d。兩組均連續(xù)用藥3個(gè)月。對(duì)比兩組患者的臨床療效、臨床癥狀、C反應(yīng)蛋白（CRP）、紅細(xì)胞沉降率（ESR）和類風(fēng)濕因子（RF）水平。結(jié)果 治療后，觀察組總有效率為97.06%顯著高于對(duì)照組的70.59%（P<0.05）。治療后，觀察組臨床癥狀（晨僵時(shí)間、關(guān)節(jié)腫脹數(shù)和關(guān)節(jié)疼痛數(shù)）顯著少于對(duì)照組（P<0.05）。治療后，CRP、ESR和RF水平均顯著低于對(duì)照組（P<0.05）。兩組不良反應(yīng)發(fā)生分別為8.82%和5.88%，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 甲氨蝶呤片聯(lián)合來氟米特片治療類風(fēng)濕關(guān)節(jié)炎效果優(yōu)于雷公藤多苷片聯(lián)合來氟米特來氟米特片，且安全性良好，值得臨床推廣。

Objective To compare the clinical effects of Methotrexate Tablets and Tripterygium Glycosides Tablets combined with Leflunomide Tablets in treatment of rheumatoid arthritis. Methods A total of 68 patients with rheumatoid arthritis in Suzhou Municipal Hospital from January 2016 to December 2018 were randomly divided into observation group (n=34) and control group (n=34). Patients in the control group were po administered with Tripterygium Glycosides Tablets 20 mg, three times daily, at the same time, patients were po administered with Leflunomide Tablets 20 mg, once daily. Patients in the observation group were po administered with Methotrexate Tablets 10 mg, once weekly. And treated with Leflunomide Tablets 20 mg, once daily. Patients in two groups were treated for 3 months. Clinical efficacy, clinical symptoms, and the levels of CRP, ESR and RF were compared between two groups. Results After treatment, the total effective rate in the observation was 97.06%, which was significantly higher than 70.59% in the control group (P < 0.05). After treatment, the clinical symptoms (morning stiffness time, joint swelling, and joint pain) in the observation group were significantly less than those in the control group (P < 0.05). After treatment, CRP, ESR and RF levels in the observation group were significantly lower than those in the control group (P < 0.05). Adverse reactions in two groups was 8.82% and 5.88%, there was no significant difference between the two groups. Conclusion The effect of Methotrexate Tablets combined with Leflunomide Tablets in treatment of rheumatoid arthritis is better than that of Tripterygium Glycosides Tablets combined with Leflunomide Tablets, and it is safe and worthy of clinical promotion.

R976

南京市衛(wèi)生局青年啟動(dòng)項(xiàng)目（QYK11165）