CAJ | 학술논문

目的：比较药物联合物理治疗与单纯药物治疗类风湿关节炎（RA）的短期临床疗效。方法随机双盲平行试验，纳入72例活动性RA患者，按2：1的比例被随机分配到试验组48和对照组24例。试验组为传统药物（来氟米特20 mg，1次/d+甲氨蝶呤10 mg，1次/周+非甾类抗炎药）联合物理治疗（超声波+微波+电疗）组，对照组为单纯传统药物（来氟米特+甲氨蝶呤+非甾类抗炎药）治疗组。受试者在试验第1周和第2周随访，评价疗效。同时比较两组患者的压痛和肿胀关节数、晨僵时间、疼痛视觉模拟评分(VAS评分)、健康评估问卷(HAQ)以及实验室炎症指标红细胞沉降率(ESR)、C-反应蛋白(CRP)。结果治疗1周及2周后试验组患者ACR20、ACR50缓解的比例都显著高于对照组(P<0.05)；试验组患者疗效指标均较治疗前水平明显降低（P<0.01）；两组患者的实验室炎症指标ESR、CRP均较治疗前水平显著降低（P<0.05）。结论药物联合物理治疗RA的短期疗效明显优于单纯药物治疗，可1周内明显改善各项临床症状、体征，降低实验室炎症指标，提高患者生活质量。
목적：비교약물연합물리치료여단순약물치료류풍습관절염（RA）적단기림상료효。방법수궤쌍맹평행시험，납입72례활동성RA환자，안2：1적비례피수궤분배도시험조48화대조조24례。시험조위전통약물（래불미특20 mg，1차/d+갑안접령10 mg，1차/주+비치류항염약）연합물리치료（초성파+미파+전료）조，대조조위단순전통약물（래불미특+갑안접령+비치류항염약）치료조。수시자재시험제1주화제2주수방，평개료효。동시비교량조환자적압통화종창관절수、신강시간、동통시각모의평분(VAS평분)、건강평고문권(HAQ)이급실험실염증지표홍세포침강솔(ESR)、C-반응단백(CRP)。결과치료1주급2주후시험조환자ACR20、ACR50완해적비례도현저고우대조조(P<0.05)；시험조환자료효지표균교치료전수평명현강저（P<0.01）；량조환자적실험실염증지표ESR、CRP균교치료전수평현저강저（P<0.05）。결론약물연합물리치료RA적단기료효명현우우단순약물치료，가1주내명현개선각항림상증상、체정，강저실험실염증지표，제고환자생활질량。
Objective To compare the short-term effect of medication combined with physiotherapy and on-ly traditional medication on the treatment of active rheumatoid arthritis. Methods Seventy two patients with active rheumatoid arthritis were divided into 2 groups by randomized double-blind parallel test, and 48 cases in observation group were treated with medication (Leflunomide, 20 mg/d, MTX 10 mg/week, and nonsteroidal anti-inflammatory agent) combined with physiotherapy (ultrasonic, microwave, electrotherapy), while the other 24 cases in control group were treated with only traditional medication. All patients were followed in 1 week and 2 weeks after treatment for as-sessment. Activity and efficacy evaluation indexes, including the number of joints with pain, swelling, the time of morning stiffing, visual analog score, health assessment questionnaire, ESR and CRP were evaluated after 2 weeks of treatment. Results 1 week and 2 weeks after treatment, the ACR20 and the ACR50 improvement rates in the observa-tion group were significantly higher than those in the control group (P<0.05). The disease efficacy evaluation indexes and activity indexes significantly decreased (P<0.01, P<0.05). Conclusion Compared with traditional medication, the effect of medication combined with physiotherapy was much better, which can evidently reduce the symptoms, and improve the life-qualify of the RA patients in short-term.