中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2013年
6期
763-766
,共4页
游运辉%刘诗晴%邓红香%隆眉%赵洪军
遊運輝%劉詩晴%鄧紅香%隆眉%趙洪軍
유운휘%류시청%산홍향%륭미%조홍군
泼尼松/投药和剂量%泼尼松/治疗应用%甲氨蝶呤/投药和剂量%甲氨蝶呤/治疗应用%羟氯喹/投药和剂量%羟氯喹/治疗应用%关节炎,类风湿/药物疗法%药物疗法,联合%治疗结果
潑尼鬆/投藥和劑量%潑尼鬆/治療應用%甲氨蝶呤/投藥和劑量%甲氨蝶呤/治療應用%羥氯喹/投藥和劑量%羥氯喹/治療應用%關節炎,類風濕/藥物療法%藥物療法,聯閤%治療結果
발니송/투약화제량%발니송/치료응용%갑안접령/투약화제량%갑안접령/치료응용%간록규/투약화제량%간록규/치료응용%관절염,류풍습/약물요법%약물요법,연합%치료결과
Prednisone/administration & dosage%Prednisone/therapeutic use%Methotrexate/administration & dosage%Methotrexate/therapeutic use%Hydroxychloroquine/administration & dosage%Hydroxy chloroquine/therapeutic use%Arthritis,rheumatoid/drug therapy%Drug
目的 探讨小剂量泼尼松联合甲氨蝶呤、羟氯喹治疗类风湿关节炎的疗效及安全性.方法 将150例活动性类风湿关节炎患者按随机数字法分2组:泼尼松组(70例)予以泼尼松5 ～10mg/d+甲氨蝶呤10 mg/周+羟氯喹0.2 g/d；对照组(80例)予以美洛昔康7.5 mg/d+甲氨蝶呤10mg/周+来氟米特20 mg/d,疗程12周.观察两组患者主要疗效指标:肿胀、压痛关节数、患者疼痛视觉模拟评分、患者及医师对疾病状况总体评价；次要疗效指标:晨僵持续时间、C-反应蛋白(CRP)、红细胞沉降率(ESR)、健康评价问卷(HAQ)、DAS28评分以及美国风湿病学会疗效评价指标(ACR20,ACP50).结果 治疗12周后,在主要疗效指标方面,与对照组相比,泼尼松组的压痛、肿胀关节数减少,患者疼痛评分和患者及医师总体评价改善[(4.5±2.5)个,(3.2 ±3.36)个,(21±15)分,(24.2±16.4)分,(20.2±10.4)分vs (6.4±5.84)个,(6.6±5.5)个,(46±14)分,(37.9±19.7)分,(34.1±12.4)分,P＜0.05或P＜0.01]；在次要疗效指标方面,与对照组相比,泼尼松组的治疗应答率更高[HAQ评分(0.93 ±0.52)分,CRP(10.2±5.8)mg/L,ESR(30±14) mm/h,晨僵持续时间(32.0 ±32.3)min,DAS 28评分(3.1±0.9)分vs (1.22±0.81)分,(16.3±10.1)mg/L,(33 ±29)mm/h,(54.7±45.4) min,(4.9±1.9)分,P＜0.05或P＜0.01]；两组患者不良事件的发生率相似(43％ vs 49％,P＞0.05).结论 小剂量泼尼松联合甲氨蝶呤、羟氯喹治疗可快速且显著改善RA的症状与体征.
目的 探討小劑量潑尼鬆聯閤甲氨蝶呤、羥氯喹治療類風濕關節炎的療效及安全性.方法 將150例活動性類風濕關節炎患者按隨機數字法分2組:潑尼鬆組(70例)予以潑尼鬆5 ～10mg/d+甲氨蝶呤10 mg/週+羥氯喹0.2 g/d；對照組(80例)予以美洛昔康7.5 mg/d+甲氨蝶呤10mg/週+來氟米特20 mg/d,療程12週.觀察兩組患者主要療效指標:腫脹、壓痛關節數、患者疼痛視覺模擬評分、患者及醫師對疾病狀況總體評價；次要療效指標:晨僵持續時間、C-反應蛋白(CRP)、紅細胞沉降率(ESR)、健康評價問捲(HAQ)、DAS28評分以及美國風濕病學會療效評價指標(ACR20,ACP50).結果 治療12週後,在主要療效指標方麵,與對照組相比,潑尼鬆組的壓痛、腫脹關節數減少,患者疼痛評分和患者及醫師總體評價改善[(4.5±2.5)箇,(3.2 ±3.36)箇,(21±15)分,(24.2±16.4)分,(20.2±10.4)分vs (6.4±5.84)箇,(6.6±5.5)箇,(46±14)分,(37.9±19.7)分,(34.1±12.4)分,P＜0.05或P＜0.01]；在次要療效指標方麵,與對照組相比,潑尼鬆組的治療應答率更高[HAQ評分(0.93 ±0.52)分,CRP(10.2±5.8)mg/L,ESR(30±14) mm/h,晨僵持續時間(32.0 ±32.3)min,DAS 28評分(3.1±0.9)分vs (1.22±0.81)分,(16.3±10.1)mg/L,(33 ±29)mm/h,(54.7±45.4) min,(4.9±1.9)分,P＜0.05或P＜0.01]；兩組患者不良事件的髮生率相似(43％ vs 49％,P＞0.05).結論 小劑量潑尼鬆聯閤甲氨蝶呤、羥氯喹治療可快速且顯著改善RA的癥狀與體徵.
목적 탐토소제량발니송연합갑안접령、간록규치료류풍습관절염적료효급안전성.방법 장150례활동성류풍습관절염환자안수궤수자법분2조:발니송조(70례)여이발니송5 ～10mg/d+갑안접령10 mg/주+간록규0.2 g/d；대조조(80례)여이미락석강7.5 mg/d+갑안접령10mg/주+래불미특20 mg/d,료정12주.관찰량조환자주요료효지표:종창、압통관절수、환자동통시각모의평분、환자급의사대질병상황총체평개；차요료효지표:신강지속시간、C-반응단백(CRP)、홍세포침강솔(ESR)、건강평개문권(HAQ)、DAS28평분이급미국풍습병학회료효평개지표(ACR20,ACP50).결과 치료12주후,재주요료효지표방면,여대조조상비,발니송조적압통、종창관절수감소,환자동통평분화환자급의사총체평개개선[(4.5±2.5)개,(3.2 ±3.36)개,(21±15)분,(24.2±16.4)분,(20.2±10.4)분vs (6.4±5.84)개,(6.6±5.5)개,(46±14)분,(37.9±19.7)분,(34.1±12.4)분,P＜0.05혹P＜0.01]；재차요료효지표방면,여대조조상비,발니송조적치료응답솔경고[HAQ평분(0.93 ±0.52)분,CRP(10.2±5.8)mg/L,ESR(30±14) mm/h,신강지속시간(32.0 ±32.3)min,DAS 28평분(3.1±0.9)분vs (1.22±0.81)분,(16.3±10.1)mg/L,(33 ±29)mm/h,(54.7±45.4) min,(4.9±1.9)분,P＜0.05혹P＜0.01]；량조환자불량사건적발생솔상사(43％ vs 49％,P＞0.05).결론 소제량발니송연합갑안접령、간록규치료가쾌속차현저개선RA적증상여체정.
Objective To investigate the efficacy and safety of low-dose prednisone combined with methotrexate (MTX) and hydroxychloroquine (HCQ) in the treatment of rheumatoid arthritis (RA).Methods In this 12-week study,150 patients with active rheumatoid arthritis were randomly divided into two groups:prednisone group (70 cases who were received prednisone 5 ～ 10 mg/d + MTX 10 mg/w +HCQ 0.2 g/d) and control group (80 cases who were treated by Meloxicam 7.5 mg/d + MTX 10 mg/w +Leflunomide (LEF) 20 mg/d).The primary end-points were tender and swollen joint counts,visual analogue scales (VAS),and global physician and patients assessments of disease.The secondary end-points were morning stiffness time,C-reactive protein,erythrocyte sedimentation rate,the Health Assessment Questionnaire (HAQ),DAS28 and ACR20,ACR50.Results After 12 weeks,in terms of primary endpoints,tender and swollen joint counts,VAS and global physician assessments in the prednisone group were improved significantly [(4.5 ± 2.5),(3.2 ± 3.36),(21 ± 15),(24.2 ± 16.4),(20.2 ± 10.4) vs (6.4 ±5.84),(6.6±5.5),(46±14),(37.9±19.7),(34.1±12.4),P ＜0.05orP ＜0.01].In terms of secondary end-points,the prednisone group produced higher response rates [HAQ score (0.93 ± 0.52),CRP(10.2 ± 5.8) mg/L,ESR(30 ± 14) mm/h,morning stiffness time (32.0 ± 32.3) min,DAS 28 score (3.1±0.9) vs (1.22 ±0.81),(16.3±10.1)mg/L,(33±29)mm/h,(54.7±45.4)min,(4.9±1.9),P ＜0.05 orP ＜0.01].The incidence of adverse events was similar between two groups (43％ vs 49％,P ＞ 0.05).Conclusions Low-dose prednisone combined with MTX and HCQ produced rapid and relevant improvements in RA signs and symptoms.
