目的 探讨糖皮质激素联合抗风湿类药物(DMARD)治疗类风湿关节炎(RA)的疗效.方法 选择医院接受治疗的RA患者107例,随机分为对照组53例和联合组54例,均给予DMARD药物羟氯喹和来氟米特治疗,联合组患者加用小剂量糖皮质激素泼尼松治疗.结果 联合组治疗总有效率为90.74％,明显高于对照组的69.81％(χ2=7.428,P<0.05);联合组患者RA彻底消失及药物治疗总时长均明显短于对照组(P<0.05);两组患者治疗后晨僵时间明显缩短,关节肿胀数、关节压痛数及疾病活动性评分(DAS)均明显减小或降低,且联合组明显优于对照组(P<0.05).结论 相比于单纯DMARD治疗RA,联合糖皮质激素治疗效果更明显,可更快地控制RA的炎性反应,缓解临床症状,有利于患者预后改善及生活质量的提高.%Objective To investigate the clinical effect of glucocorticoid combined with disease modifying antirheumatic drug(DMARD) in treating rheumatoid arthritis(RA) . Methods Totally 107 RA patients admitted to our hospital were randomly divided into the control group ( 53 cases) and the combined group ( 54 cases ) . The patients in the two groups were treated with DMARD, on this basis, the combined group were treated with low dose glucocorticoid. Results The total effective rate of the combined group was 90. 74％ , which was significantly higher than 69. 81％ of the control group( χ2 = 7. 428,P < 0. 05), the complete disappearance time of RA inflammation and the total duration of drug treatment in the combined group were significantly shorter than those in the control group( P < 0. 05) . The time of morning stiffness in the two groups was significantly shortened, the number of swollen joints, the number of tender joints and the disease activity score(DAS) in the two groups were significantly decreased, and the combined group was significantly better than the control group( P < 0. 05). Conclusion Compared with the single use of DMARD, the effect of DMARD combined with glucocorticoid in the treatment of RA is more obvious, it can quickly control the RA inflammatory reaction, alleviate the clinical symptoms, and improve the prognosis and life quality of the patients.
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