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目的:评价昆仙胶囊联合小剂量甲氨蝶呤治疗老年类风湿关节炎(RA)的有效性和安全性。方法:选取40例老年RA患者随机分为治疗组20例及对照组20例,治疗组予常规用药同时加用昆仙胶囊联合小剂量甲氨蝶呤治疗,对照组仅用甲氨蝶呤,治疗24 w,比较治疗前后临床症状、体征及实验室指标如血沉、C反应蛋白的变化,观察不良反应。结果:治疗组总有效率85%,对照组为80%,差异无显著性。治疗后两组各项临床及实验室指标均显著改善(P<0.05或P<0.01)。两组比较,治疗组在肿胀关节数、肿胀关节指数、压痛关节数、压痛关节指数、双手平均握力、ESR和CRP等指标方面改善均优于对照组(P<0.05或P<0.01)。治疗组不良反应于对照组。结论:昆仙胶囊联合小剂量甲氨蝶呤治疗老年RA安全有效,是中西医结合治疗老年RA合理的联合治疗方案。
Objective: To evaluate the effectiveness and safety of Kunxian capsule combined with low-dose methotrexate in the treatment of rheumatoid arthritis (RA) in the elderly. Methods: Forty elderly patients with RA were randomly divided into treatment group (n = 20) and control group (n = 20). The treatment group was treated with Kunxian capsule combined with low dose methotrexate, while the control group only methotrexate, Treatment for 24 w, before and after treatment of clinical symptoms and signs and laboratory indicators such as ESR, C-reactive protein changes observed adverse reactions. Results: The total effective rate was 85% in the treatment group and 80% in the control group, with no significant difference. After treatment, the clinical and laboratory indexes of both groups were significantly improved (P <0.05 or P <0.01). The two groups were better than the control group in improving the number of swollen joints, swollen joint index, tender joint count, tender joint index, both hands average grip strength, ESR and CRP (P <0.05 or P <0.01). Treatment group adverse reactions in the control group. Conclusion: Kunxian capsule combined with low-dose methotrexate in the treatment of senile RA is safe and effective. It is a reasonable combination regimen of traditional Chinese and western medicine for senile RA.