吕英春

[摘要] 目的 探討昆仙胶囊与甲氨蝶呤治疗类风湿关节炎的临床疗效，为临床治疗类风湿关节炎提供理论依据。方法 便利选取该院2017年1月—2019年12月门诊及住院轻、中度类风湿关节炎患者共60例，随机分为对照组和治疗组各30例，对照组应用甲氨喋呤治疗，治疗组应用甲氨喋呤联合昆仙胶囊治疗，观察两组患者治疗效果以及对比分析两组患者不良反应发生情况。结果 治疗组总有效率93.33%，对照组总有效率86.67%，两组数据比较，差异有统计学意义（χ2=4.167，P=0.023 <0.05）;对照组发生骨髓抑制、肝功能损害、肺间质纤维化总不良反应发生率为20.00%，治疗组总不良反应发生率为6.66%，治疗组总不良反应发生率显著低于对照组，差异有统计学意义（P<0.05）。结论 应用甲氨喋呤联合昆仙胶囊治疗轻中度类风湿性关节炎治疗效果显著，患者关节疼痛评分显著改善，关节肿胀程度明显改善，而且患者不良反应较轻。

[关键词] 甲氨喋呤;昆仙胶囊;类风湿关节炎;临床疗效

[中图分类号] R259          [文献标识码] A          [文章编号] 1674-0742（2020）06（a）-0115-03

Comparative Study of Kunxian Capsule and Methotrexate in the Treatment of Rheumatoid Arthritis

LYU Ying-chun

Department of Rheumatology and Immunology， Jilin Provincial People's Hospital， Changchun， Jilin Province， 130021  China

[Abstract] Objective To explore the clinical efficacy of Kunxian capsule and methotrexate in treating rheumatoid arthritis， and to provide theoretical basis for clinical treatment of rheumatoid arthritis. Methods A total of 60 patients with mild and moderate rheumatoid arthritis convenient selection in the hospital from January 2017 to December 2019 were randomly divided into a control group and a treatment group， each with 30 patients. The control group was treated with methotrexate; the treatment group was treated with methotrexate combined with Kunxian capsules. The treatment effects of the two groups were observed and the adverse reactions of the two groups were compared and analyzed. Results The total effective rate in the treatment group was 93.33%， and the total effective rate in the control group was 86.67%. Comparing the data of the two groups， the difference was statistically significant（χ2=4.167，P=0.023 <0.05）; bone marrow suppression and liver function damage occurred in the control group. The incidence of total adverse reactions in pulmonary interstitial fibrosis was 20.00%， the incidence of total adverse reactions in the treatment group was 6.66%， and the incidence of total adverse reactions in the treatment group was significantly lower than that in the control group， the difference was statistically significant（P<0.05）. Conclusion The application of methotrexate combined with Kunxian capsule in the treatment of mild to moderate rheumatoid arthritis is significant， and the joint pain score of the patient is significantly improved， and the degree of joint swelling is significantly improved， and the adverse reactions of the patient are mild.

[Key words] Methotrexate; Kunxian capsule; Rheumatoid arthritis; Clinical efficacy

类风湿关节炎（RA）是一种由各种病因引发的，以炎性滑膜炎为主伴有多出小关节僵直、变形畸形等症状的炎症性免疫疾病[1]。甲氨喋呤是一类叶酸还原酶抑制药，有效抑制嘌呤和嘧啶核甙酸的生物合成，能抑制体液免疫反应。甲氨喋呤直接的抗炎作用对治疗类风湿关节炎见效快，使用方便，有效改善类风湿性关节炎的炎症反应[2]。昆仙胶囊主要由山海棠、枸杞子、菟丝子、淫羊藿等精制而成，具有祛风除湿、清热解毒、温补肾阳、舒筋活络的功效[3]。甲氨蝶呤目前被公认是治疗RA首选的缓解病情药物，但由于其可能发生骨髓抑制、肝功能损害、肺间质病变等不良反应，对很多类风湿关节炎慎用[4]。为了寻找治疗类风湿性关节炎的合适药物，该院2017年1月—2019年12月应用昆仙胶囊和甲氨喋呤联合治疗，收到了较好的疗效，现将报道如下。……