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目的观察甲氨蝶呤(MTX)联合来氟米特(LEF)治疗类风湿关节炎(RA)的临床疗效及安全性。方法将82例RA患者随机分为治疗组与对照组,2组同时给予糖皮质激素醋酸泼尼松片10 mg/d,美洛昔康7.5 mg/d。对照组40例应用甲氨蝶呤(MTX)治疗,10 mg,每周1次。治疗组42例在对照组的基础上口服来氟米特(LEF)10 mg,1次/d,疗程均为24周,疗程结束后比较2组临床疗效。结果经24周治疗后,治疗组在临床缓解率、总有效率及各项观察指标改善方面均明显优于对照组,表明治疗组疗效显著,组间差异有统计学意义(P<0.05)。治疗期间2组均出现谷丙转氨酶升高,白细胞减少、恶心、上腹部不适等不良反应。不良反应发生率分别为治疗组21.43%;对照组20.00%,2组相比较,差异无统计学意义(P>0.05)。结论甲氨蝶呤联合来氟米特治疗RA可明显改善患者的临床症状和实验室指标,疗效确切。
Objective To observe the clinical efficacy and safety of methotrexate (MTX) combined with leflunomide (LEF) in the treatment of rheumatoid arthritis (RA). Methods Eighty-two RA patients were randomly divided into treatment group and control group. Both groups were given glucocorticoid prednisone acetate 10 mg / d and meloxicam 7.5 mg / d. Control group, 40 cases of methotrexate (MTX) treatment, 10 mg, once a week. The treatment group 42 patients in the control group based on oral leflunomide (LEF) 10 mg, 1 / d, the course of treatment were 24 weeks after the end of the course of treatment were compared two groups. Results After 24 weeks of treatment, the treatment group was significantly better than the control group in clinical remission rate, total effective rate and the improvement of various indicators, indicating that the treatment group had a significant effect (P <0.05). During treatment, both groups showed elevated alanine aminotransferase, leukopenia, nausea, abdominal discomfort and other adverse reactions. Adverse reaction rates were 21.43% in the treatment group and 20.00% in the control group, respectively, with no significant difference between the two groups (P> 0.05). Conclusion Methotrexate combined with leflunomide in the treatment of RA patients can significantly improve the clinical symptoms and laboratory indicators, the exact effect.