曾远强++张燕辉

[摘要] 目的 比较来氟米特片与美洛昔康片治疗类风湿性关节炎的临床效果及安全性。 方法 按就诊顺序随机将2013年1～12月在本院第一门诊部（东武社区卫生服务站）治疗的100例类风湿性关节炎患者分为治疗组（50例）和对照组（50例）。治疗组口服来氟米特，对照组口服美洛昔康治疗。观察两组患者的临床疗效和不良反应。 结果 治疗组总有效率为80.%%，对照组总有效率为70.0%，治疗组临床疗效显著优于对照组（P<0.05）。治疗后，两组临床症状指标均显著改善，与治疗前比较，差异有统计学意义（P<0.05）；且治疗组临床症状指标改善程度大于对照组（P<0.05）。治疗后，两组的类风湿因子（RF）、红细胞沉降率（ESR）及C-反应蛋白（CRP）含量明显下降（P<0.05）；治疗组RF、ESR及CRP含量下降程度显著大于对照组，差异有统计学意义（P<0.05）。治疗组不良反应率为26.0%，对照组不良反应发生率为25.0%，两组不良反应发生率差异无统计学意义（P>0.05）。 结论 来氟米特治疗类风湿性关节炎疗效优于美洛昔康，两者不良反应发生率相似，但临床症状特点不同。

[关键词] 类风湿性关节炎；来氟米特片；美洛昔康片

[中图分类号] R684.3 [文献标识码] A [文章编号] 1674-4721（2015）02（a）-0094-04

The clinical efficacy and safety of leflunomide and meloxicam in treatment of rheumatoid arthritis

ZENG Yuan-qiang ZHANG Yan-hui

The First Department of Outpatient，Qingyuan Hospital of Traditional Chinese Medicine of Guangdong Provicne，Qingyuan 511500，China

[Abstract] Objective To compare the efficacy and safety of leflunomide and meloxicam in the treatment of rheumatoid arthritis. Methods 100 cases of patients with rheumatoid arthritis treated in the First Department of Outpatient in our hospital from January to December 2013 were selected，and were randomly divided into treatment group and control group，50 cases in each group.Leflunomide was taken to the treatment group，meloxicam was given to the control group.The efficacy and adverse reactions of two groups was observed. Results The total effective rate was 80.0% in the treatment group，the total effective rate was 70.0% in the control group，the effect of treatment group was better than that of control group （P<0.05）.After treatment，clinical indicators of two groups improved compared with before treatment，the difference was significant （P<0.05）；and the treatment group was improved more than that of control group （P<0.05）.Rheumatoid factor （RF），erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） of the groups decreased compared with before treatment，the difference was significant （P<0.05）；and the treatment group was decreased more than that of control group （P<0.05）.The incidence of adverse reaction was 26.0% in the treatment group，the incidence of adverse reactions was 25.0% in the control group，the difference was not significant （P>0.05）. Conclusion The efficacy of leflunomide in the treatment of rheumatoid arthritis is better than that of meloxicam，the adverse reactions rate between leflunomide and meloxicam is similar，but the clinical symptoms is different.

[Key words] Rheumatoid arthritis；Leflunomide；Meloxicam

类风湿性关节炎是一种致畸形自身免疫性疾病，在发病两年内即可出现不可逆的骨关节破坏。类风湿性关节炎给患者的身体和心理造成了严重伤害，严重的可造成患者生活不能自理，给患者的生活带来不便的同时增加了患者的经济负担。类风湿性关节炎的治疗主要是根据急性期和稳定期患者的临床症状选择非甾体类抗炎药、抗风湿药、糖皮质激素及植物药[1]。免疫抑制剂的出现，给类风湿性关节炎患者的治疗提供了新的选择，近年来免疫抑制剂在临床的应用越来越广泛，其临床疗效较为显著。本研究应用来氟米特和美洛昔康治疗类风湿性关节炎，比较其临床疗效与安全性。

1 资料与方法

1.1 一般资料

2013年1～12月在本院第一门诊部（东武社区卫生服务站）就诊的类风湿性关节炎患者100例，男性48例，女性52例。……