李伟

【摘要】 目的：探討小剂量糖皮质激素在类风湿性关节炎治疗中给药时间不同对于患者疗效影响。方法：本次研究收录2015年3月-2017年3月于笔者所在医院治疗的136例类风湿性关节炎患者作为观察目标，按照其接受治疗的次序分别标定为A组及B组，各68例。两组给药时间不同，A组为晚间用药，B组为晨间给药。两组患者在采取不同时间点用药治疗后，比较其关节压痛数（TJC）、视觉模拟疼痛评分（VAS）、关节肿胀数（SJC）及晨僵时间。比较量组患者的各项临床指标及不良事件发生率。结果：A组患者红细胞沉降率、类风湿因子、抗CCP阳性、C反应蛋白均优于B组患者，差异均有统计学意义（P<0.05）。A组患者关节压痛数、视觉模拟疼痛评分、关节肿胀数及晨僵时间均显著优于B组患者，差异均有统计学意义（P<0.05）。两组患者治疗期间均未出现严重不良反应，且不良反应发生率比较差异无统计学意义（P>0.05）。结论：研究发现对于类风湿性关节炎患者而言，采取小剂量糖皮质激素夜间给药的方式进行治疗其干预效果要好于晨间给药，故而值得在临床治疗中推广使用。

【关键词】 小剂量； 糖皮质激素； 类风湿性关节炎； 给药时间

doi：10.14033/j.cnki.cfmr.2018.24.005 文献标识码 B 文章编号 1674-6805（2018）24-00-03

Analysis of Time Points of Administration of Low-dose Glucocorticoid in Treatment of Rheumatoid Arthritis/LI Wei.//Chinese and Foreign Medical Research，2018，16（24）：-13

【Abstract】 Objective：To investigate the effect of different doses of low-dose glucocorticoids on rheumatoid arthritis in patients.Method：A total of 136 patients with rheumatoid arthritis who were treated in the hospital from March 2015 to March 2017 were selected as the target of observation.According to the order in which they received the treatment，they were labeled as group A and group B，with 68 cases in each group.The time of administration in the two groups was different.Group A was given medication in the evening，and group B was given in the morning.Two groups of patients were treated with medication at different time points，and the joint tenderness （TJC），visual analogue pain score （VAS），joint swelling number （SJC） and morning stiffness time were compared.The clinical indicators and the probability of occurrence of adverse events in the patients in the measurement group were compared.Result：The erythrocyte sedimentation rate，rheumatoid factor and anti CCP positive C reactive protein in group A were significantly higher than those in group B （P<0.05）.The number of joint tenderness， visual analogue pain score，joint swelling and morning stiffness in group A were significantly better than those in group B （P<0.05）.There were no serious adverse reactions in the two groups during the treatment period，and there was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）.Conclusion：The study found that for patients with rheumatoid arthritis， the use of low-dose glucocorticoids for nocturnal delivery has better intervention than morning treatments and is therefore worthy of promotion in clinical treatment.

【Key words】 Small dose； Glucocorticoid； Rheumatoid arthritis； Dosing time

First-authors address：Jingmen City Rehabilitation Hospital，Jingmen 448000，China

类风湿性关节炎归属为自身免疫性疾病，其主要表现为以自身关节为主并累及多系统的炎性症状，且临床实践中发现其具有对称性的特点且呈现多处关节出现炎性病变的特征[1-2]。该病会致患者出现受累关节疼痛、功能下降及肿胀等病症，且由于该病处于一种持续发展的状态，且会多次反复，对患者生活质量及心理状态均产生诸多不良影响。目前，该病在我国的发病率正呈现持续走高趋势，也成为致使患者丧失劳动能力的重要因素。临床实……