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目的比较单独甲氨蝶呤与三联疗法治疗类风湿关节炎的疗效。方法选择2014年7月至2016年6月住院治疗的类风湿关节炎患者共60例,采用随机数字表法随机分为治疗组和对照组,过程期间患者和医生双盲。对照组30例,采取单独甲氨蝶呤治疗;治疗组30例,采用甲氨蝶呤三联疗法,即甲氨蝶呤+羟氯喹+柳氮磺吡啶,。观察比较两组患者治疗前后的血细胞沉降率(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)、s B7-H3、干扰素-γ(INF-γ)、白细胞介素-2(IL-2)的表达水平及关节压痛数、关节肿胀数、晨僵时间的改变情况。结果治疗后,治疗组ESR、CRP、RF、SB7-H3、INF-γ、IL-2、关节压痛数、关节肿胀数、晨僵时间较对照组均显著下降,差异有统计学意义;且两组患者的不良反应发生情况均少,差异未见统计学意义。结论甲氨蝶呤三联疗法能够降低患者血清中ESR、CRP、RF及s B7-H3、INF-γ、IL-2水平,改善类风湿关节炎患者症状和体征,且不增加不良反应发生率,值得临床推广应用。
Objective To compare the efficacy of methotrexate alone and triple therapy in the treatment of rheumatoid arthritis. Methods A total of 60 rheumatoid arthritis patients hospitalized in our hospital from July 2014 to June 2016 were randomly divided into treatment group and control group by random number table method. Patients and doctors were double-blind during the course of the treatment. Thirty patients in control group were treated with methotrexate alone. The treatment group consisted of 30 patients treated with methotrexate triple therapy (methotrexate + hydroxychloroquine + sulfasalazine). The levels of ESR, CRP, RF, s B7-H3, IFN-γ, IL-2 (IL-2) expression and joint tenderness, joint swelling, morning stiffness changes. Results After treatment, the ESR, CRP, RF, SB7-H3, INF-γ, IL-2, joint tenderness, joint swelling and morning stiffness in the treatment group were significantly lower than those in the control group Adverse reactions in the group of patients were less, the difference was not statistically significant. Conclusions Methotrexate triple therapy can reduce the serum levels of ESR, CRP, RF and s B7-H3, INF-γ, IL-2 and improve the symptoms and signs of rheumatoid arthritis patients without increasing the incidence of adverse reactions, Worthy of clinical application.