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目的:评价双醋瑞因、甲氨蝶呤和来氟米特三药联用治疗老年类风湿关节炎患者的临床疗效。方法:选取2012年3月—2014年3月间收治的老年类风湿关节炎患者66例,按照数字随机法将其分为观察组患者和对照组患者,每组33例;对照组患者均给予甲氨蝶呤与来氟米特联用治疗,观察组患者在对照组患者基础上加用双醋瑞因治疗,比较两组患者的临床疗效。结果:观察组患者治疗后无效率为6.06%,ACR_(20)率为18.18%,ACR_(50)率为36.36%,ACR_(70)率为39.39%;对照组患者治疗后无效率为33.33%,ACR_(20)率为36.36%,ACR_(50)率为21.21%,ACR_(70)率为9.09%;观察组患者无效率及ACR_(20)率均低于对照组患者(P<0.05);观察组患者ACR_(50)率及ACR_(70)率均高于对照组(P<0.05);观察组患者用药不良反应的发生率为15.15%显著低于对照组为39.39%(P<0.05);观察组患者治疗后类风湿因子、C反应蛋白和红细胞沉降率经检测其结果均低于对照组(P<0.05)。结论:双醋瑞因、甲氨蝶呤和来氟米特联用治疗老年类风湿关节炎患者的临床疗效较显著,且安全性较高。
Objective: To evaluate the clinical efficacy of triacetin, methotrexate and leflunomide in the treatment of elderly patients with rheumatoid arthritis. Methods: Sixty-six elderly patients with rheumatoid arthritis who were admitted to our hospital from March 2012 to March 2014 were randomly divided into observation group and control group, with 33 cases in each group. Patients in control group were given Methotrexate and leflunomide combination therapy, observation group patients in the control group based on the addition of diacerein treatment, the clinical efficacy of the two groups were compared. Results: In the observation group, the inefficiency rate was 6.06%, the ACR 20 rate was 18.18%, the ACR 50 rate was 36.36% and the ACR 70 rate was 39.39%. In the control group, the inefficiency was 33.33% , The rate of ACR 20 was 36.36%, the rate of ACR 50 was 21.21% and the rate of ACR 70 was 9.09%. The rate of ACR 20 and the rate of ACR 20 in the observation group were lower than those in the control group (P 0.05) (P <0.05). The incidence of adverse reactions in the observation group was 15.15%, which was significantly lower than that in the control group (39.39%, P <0.05). The ACR 50 and ACR 70 in the observation group were significantly higher than those in the control group ). The results of rheumatoid factor, C-reactive protein and erythrocyte sedimentation rate in the observation group after treatment were lower than those in the control group (P <0.05). Conclusion: Diacerein, methotrexate and leflunomide combined treatment of elderly patients with rheumatoid arthritis clinical efficacy is more significant and safe.