本文選題：艾拉莫德 + 甲氨蝶呤�。� 參考：《中國(guó)臨床藥理學(xué)雜志》2017年12期

【摘要】：目的觀察艾拉莫德片聯(lián)合甲氨喋呤片治療老年類風(fēng)濕關(guān)節(jié)炎(RA)的臨床療效及對(duì)患者外周血T淋巴細(xì)胞和B淋巴細(xì)胞的影響。方法將120例老年類風(fēng)濕關(guān)節(jié)炎患者隨機(jī)分為對(duì)照組60例和試驗(yàn)組60例。對(duì)照組給予甲氨蝶呤片10 mg,每日1次,口服;試驗(yàn)組在對(duì)照組基礎(chǔ)上給予艾拉莫德片25 mg,每天2次,口服。2組療程均為3個(gè)月。治療后,比較2組患者的臨床療效、關(guān)節(jié)癥狀改善情況、實(shí)驗(yàn)室檢查指標(biāo)變化及外周血T淋巴細(xì)胞、B淋巴細(xì)胞水平。結(jié)果治療后,試驗(yàn)組總有效率為93.34%(56/60例),對(duì)照組為80.00%(48/60例,P0.05)。治療后,試驗(yàn)組關(guān)節(jié)疼痛指數(shù),關(guān)節(jié)壓痛指數(shù),腫脹指數(shù)分別為6.85±3.02,4.21±2.13,4.01±1.03,對(duì)照組分別為10.16±3.26,7.63±3.16,6.15±1.02,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。治療后,試驗(yàn)組和對(duì)照組類風(fēng)濕因子(RF)分別為(9.11±3.02),(15.31±5.24)U·mL~(-1);抗鏈球菌溶血素O抗體(ASO)分別為(112.26±9.54),(143.15±9.25)U·mL~(-1);C-反應(yīng)蛋白(CRP)分別為(3.46±0.07)g·L~(-1),(7.40±1.02)g·L~(-1),差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。治療后,試驗(yàn)組和對(duì)照組外周血T淋巴細(xì)胞CD3水平分別為(66.77±5.42)%,(63.53±5.21)%;CD4水平為(38.31±5.09)%,(33.52±4.23)%;淋巴細(xì)胞分別為(30.71±4.79)%,(38.43±5.24)%;差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。試驗(yàn)組和對(duì)照組CD8水平分別為(27.32±4.48)%,(27.54±4.21)%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組主要藥物不良反應(yīng)包括胃腸道反應(yīng)、白細(xì)胞減少和肝功能異常,藥物不良反應(yīng)發(fā)生率為21.67%(13/60例),對(duì)照組藥物不良反應(yīng)包括胃腸道反應(yīng)和白細(xì)胞減少,藥物不良反應(yīng)發(fā)生率為18.33%(11/60例),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論艾拉莫德聯(lián)合甲氨喋呤是老年類風(fēng)濕關(guān)節(jié)炎的有效治療方案,能夠顯著提高臨床療效,改善關(guān)節(jié)癥狀和實(shí)驗(yàn)室指標(biāo),并且能夠調(diào)節(jié)機(jī)體免疫功能。
[Abstract]:Objective to observe the clinical effect of Ailamod tablet combined with methotrexate tablet in the treatment of senile rheumatoid arthritis (RA) and its effect on T and B lymphocytes in peripheral blood of patients with rheumatoid arthritis. Methods 120 elderly patients with rheumatoid arthritis were randomly divided into control group (n = 60) and experimental group (n = 60). The control group was given 10 mg methotrexate once a day, and the experimental group was given 25 mg of Elamod tablet on the basis of the control group, twice a day for 3 months. After treatment, the clinical efficacy, the improvement of joint symptoms, the changes of laboratory parameters and the level of T lymphocyte B lymphocytes in peripheral blood were compared between the two groups. Results after treatment, the total effective rate of the trial group was 93.34 / 56 / 60 cases, and that of the control group was 80.00% / 48 / 60 cases (P 0.05). After treatment, the joint pain index, joint tenderness index and swelling index were 6.85 鹵3.02 鹵4.21 鹵2.13 鹵4.01 鹵1.03 in the experimental group and 10.16 鹵3.267.63 鹵3.16 鹵6.15 鹵1.02 in the control group, respectively (P 0.05). After treatment, the RFFs of rheumatoid factors in the experimental group and the control group were 15.31 鹵5.24 U / mL and 143.15 鹵9.25 U mL / L ~ (-1), respectively, and there were significant differences (P < 0.05) between the experimental group and the control group (P < 0. 05), and those of the experimental group and the control group were 15. 11 鹵3. 02 鹵5. 24 U / L and 14. 26 鹵9. 54 U / L respectively (P < 0. 05), respectively. After treatment, the levels of CD3 of peripheral blood T lymphocytes in the test group and the control group were 66.77 鹵5.42 and 63.53 鹵5.21, respectively. The levels of CD4 were 38.31 鹵5.09 and 33.52 鹵4.23 respectively, and the lymphocyte levels were 30.71 鹵4.79 and 38.43 鹵5.24, respectively, and the difference was statistically significant (P 0.05). The CD8 levels in the test group and the control group were 27.32 鹵4.48 and 27.54 鹵4.21, respectively. There was no significant difference between the two groups (P 0.05). The main adverse drug reactions in the trial group included gastrointestinal reactions, leukopenia and liver dysfunction. The incidence of adverse drug reactions was 21.67 / 1360 cases, while the control group included gastrointestinal reactions and leukopenia. The incidence of adverse drug reactions was 18.33 / 11 / 60 with no significant difference (P 0.05). Conclusion Elamod combined with methotrexate is an effective treatment for rheumatoid arthritis in the elderly. It can significantly improve the clinical efficacy, improve the joint symptoms and laboratory indicators, and regulate the immune function of the body.
【作者單位】： 新疆醫(yī)科大學(xué)第一附屬醫(yī)院風(fēng)濕免疫科;
【基金】：新疆醫(yī)科大學(xué)第一附屬醫(yī)院2013年院內(nèi)科研基金資助項(xiàng)目
【分類號(hào)】：R593.22

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