摘要
目的:观察甲氨蝶呤结合白芍总苷治疗幼年类风湿性关节炎(JRA)的临床疗效。方法:以随机抽样法将61例JRA患儿分为2组。对照组(n=30)给予甲氨蝶呤0.25～0.8 mg.kg-1、每周1次口服,布洛芬缓释胶囊(芬必得)每日0.6～1.2 g、分2次口服;治疗组(n=31)在口服上述药物同时加用白芍总苷0.6 g,每日3次口服。4周为1个疗程,连用3个疗程。观察治疗前后的临床症状及体征计分、达到美国风湿病学会标准改善70%(ACR70)、疾病活动性评分及疼痛关节总数;记录实验室检查指标包括血沉(ESR)、类风湿因子(RF)、C反应蛋白(CRP)、免疫球蛋白(IgA、IgG、IgM);观察不良反应。结果:2组患者治疗4、8、12周时,治疗组的总有效率分别为90%、94%、100%,略高于对照组(分别为87%、90%、97%),2组比较差异无统计学意义(P>0.05)。治疗后,治疗组关节疼痛指数、晨僵时间、ACR70、疾病活动性评分与对照组同期相应指标比较,差异有统计学意义(P<0.05)。治疗组治疗后ESR、CRP、IgM与对照组同期相应指标比较,差异有统计学意义(P<0.05)。2组不良反应比较,差异无统计学意义(P>0.05)。结论:甲氨蝶呤与白芍总苷联合治疗幼年类风湿性关节炎疗效肯定,且不良反应较小。
OBJECTIVE ： To evaluate the curative efficacy of methotrexate combined with total glucosides of paeony for juvenile rheumatoid arthritis （JRA）. METHODS ： 61 JRA cases were randomly assigned to either control group （n = 30） receiving methotrexate [ （0. 25-0. 8 ） mg. kg-1 ] once a week orally plus brufen modified release capsule （fenbid） 0. 6-1.2 g daily in two divided oral doses or treatment group （ n = 31 ） receiving add-on total glueosides of paeony 0. 6 g t. i. d orally in addition to the drugs for control group for 3 consecutive courses of treatment, with one course of treatment lasting 4 weeks. The scores for clinical symptoms and signs, American College of Rheumatology response 70 （ ACRT0）, disease activity score and the total number of pain joints, the laboratory tests indices including blood sedimentation, rheumatoid factor, c-reactive protein, immunoglobulins （IgA, IgG and IgM） and the adverse drug reactions in both groups were recorded before and after treatment. RESULTS： At 4, 8 and 12 weeks, the total response rates were 90%, 94% and 100%, respectively for ttle treatment group, as compared with 87%, 90% and 97%, respectively for the control group, showing no statistical difference between the two groups （P 〉 0. 05）. After treatment, the joint pain indices, morning stiffness time, ACR-70 response, disease activity score were statistically different between the treatment group and the control group at the same time point （ P 〈 0. 05 ） ; moreover, the differences in ESR, CRP and IgM were also significant between the treatment group and the control group at the same time point （P 〈 0. 05 ） ; however, the adverse drug reactions were not statistically different between the two groups （P 〉0. 05）. CONCLUSION： Addition of total glucosides of paeony to methotrexate resulted in proved efficacy and mild adverse reactions in treating patients with juvenile rheumatoid arthritis.
出处
《中国医院用药评价与分析》
2012年第8期722-724,共3页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
幼年类风湿性关节炎
甲氨蝶呤
白芍总苷
不良反应
Juvenile rheumatoid arthritis
Methotrexate
Total glucosides of paeony
Adverse reaction
