Clinical Evaluation Of Low-dose Of Hormone Combined With Methotrexate And Tripterygium Wilfordii Hook F In Treating Rheumatoid Arthritis

ObjectivesRheumatoid arthritis have more Drug combintion treatment programs now.their pros and cons. Hormone are still widely debated in treating rheumatoid arthritis. This clinical study was to observe the efficacy and safety in the treatment of rheumatoid arthritis used the treatment programs of low-dose hormone combined methotrexate with Tripterygium glycosides,then flexibility to choose the clinical use of drugs.MethodsUsed the databa about patients of rheumatoid arthritis in Subei People’s Hospital Rheumatology outpatient,including patient information,home address, contact information,newly diagnosed cases,treatment and follow-up, etc. all newly diagnosed rheumatoid joints inflammation and subsequent patient follow-up information were included,researched from September2011to September2013, followed-up24weeks and more, selected the clinical efficacy of combination therapy was relatively sure:Methotrexate combined leflunomide.Finally, there were71patients were used screened who used Low-dose hormone combined tripterygium with methotrexate (TMP program),12male patients,59female patients,Age ranged from28to74, Median Age was52.01±10.73,there whe53patients who used Methotrexate combined leflunomide,ll male patients,42female, Age ranged from25to78, Median Age was48.13±12.90. The selected patients met the American College of Rheumatology in1987or2009on the development of RA classification criteria.The two groups required to exclude use of the rest of immunosuppressants, gave non-steroidati-inflammatory drugs,calcium or gave folic acid supplements to protect the gastric mucosa,such as drug therapy in the study area. Respectively,Therapeutic effects and side effects were assessed at baseline and4and12weeks, And observed the follow-up case after24weeks.Results1Evaluation results(1) Impact on specific clinical symptoms:TMP group and the MLgroup could significantly improve the degree of joint pain,swelling and other indicators,there were significant differences after treatment compared with before treatment (P<0.05). Patient self-assessment of the degree of pain,and the degree of Doctor of diseases assessed before and after treatment when compared to the above indicators were statistically significant (P<0.05).(2) After4weeks of treatment and12weeks,TMP group could effectively reduce laboratory parameters such as ESR or CRP,compared with before treatment,there was a significant difference (P<0.05) After treatment,the MLgroup,could effectively reduce the ESR or CRP, was not statistically significant before and after treatment.(3) After4weeks and12weeks of treatment, the proportion reached ACR20, ACR50, ACR70of the two group was similar, the DAS28score of the two groups were declined,The DAS28score of the patients using TMP group therapy at baseline,4weeks of treatment, were statistically significant,the control group, there were significant differences at baseline and4weeks and12weeks.2.Side effectsThe main side effects of experimental group were:abnormal liver function,mouth ulcers, high blood sugar, gastrointestinal discomfort, irregular menstruation;adverse reactions mainly occurred in the control group, abnormal liver function, mouth ulcers, gastrointestinal discomfort, alopecia.After giving the drug to protect the liver function, folic acid tablets, a proton pump inhibitor drugs, symptoms improved after treatment, the incidence was no significant difference between the two groups.3.24weeks of follow-upAfter24weeks of follow-up, the two groups achieved remission rates were similar, and no serious adverse events.Conclusions(1)The TMP program can significantly improve clinical symptoms of rheumatoid arthritis patients, and can effectively improve laboratory parameters. ACR20,ACR50and ACR70were significantly improved. Efficacy of the two groups was similar.24weeks of follow-up, the two groups of patients achieved similar remission rate(2)TMP group was good safety of treating rheumatoid arthritis, serious adverse events was unfound in short-term treatment.(3)The TMP program had the economic effectiveness.(4)the presence of gonadal inhibition in the selection process using objects tend to menopause or postmenopausal women or patients with no fertility requirements circumference.