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目的研究类风湿关节炎活动期,综合治疗与综合加口服激素和综合加得宝松局部注射治疗的疗效及毒副作用对比.探讨激素在类风湿关节炎治疗中的最佳选择。方法对106例 RA 急性活动期住院患者,在口服抗炎止痛药物,静脉滴注甲氨喋呤、活血药物等综合治疗。其中34例加用强的松口服,52例加用得宝松局部注射,余34例坚持综合治疗。结果综合治疗组:关节肿痛缓解慢,胃肠道副作用大,出院时症状控制率低,半年后复发率高,平均住院天数多。综合加强的松组:关节肿痛缓解较快,胃肠道副作用小,但因激素引起的副作用重,出院时症状控制率高,出院后半年后复发率低,平均住院天数少。综合加得宝松治疗组:关节肿痛缓解及时,无明显胃肠道症状及激素副作用,出院时症状控制率高,半年后复发率低,平均住院天数更少。结论综合加得宝松局部注射联合治疗,具有疗效高,毒副作用低的临床优势,是 RA 急性活动期治疗最佳选择方法。
Objective To study the curative effect and side effect of local injection of combined treatment with oral plus hormones and synthetic plus treponez on the active stage of rheumatoid arthritis.Methods The best choice of hormones in the treatment of rheumatoid arthritis was investigated. Methods A total of 106 patients with acute active RA were enrolled in the comprehensive treatment of oral anti-inflammatory and analgesic drugs, intravenous methotrexate and blood-activating drugs. Among them, 34 cases were treated with prednisone, 52 cases were treated with local prednisone, and 34 cases were treated with integrated therapy. The results of the comprehensive treatment group: joint pain relief slow, gastrointestinal side effects, discharge control symptoms low, half a year after the recurrence rate, the average length of stay. Comprehensive strengthening of the pine group: joint swelling and pain relief, gastrointestinal side effects, but due to hormone-induced side effects, discharge control symptoms at high rates, six months after discharge, the recurrence rate is low, the average number of hospital stay less. The combination plus treponemate treatment group: joint swelling and pain relief in time, no obvious gastrointestinal symptoms and hormonal side effects, high rate of symptom control at discharge, half a year after the recurrence rate is low, the average length of stay less. Conclusions Combined Jiade Bussong injection combined with local treatment has the advantages of high curative effect and low toxic and side effects. It is the best choice for the treatment of acute exacerbation of RA.