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汉防己甲素联合阿仑膦酸钠治疗类风湿性关节炎合并骨质疏松疗效观察

Therapeutic Effect of Tetrandrine Combined with Alendronate Sodium on Rheumatoid Arthritis with Osteoporosis

DOI：

中文关键词: 汉防己甲素甲氨蝶呤阿仑膦酸钠类风湿性关节炎骨质疏松

英文关键词:Tetrandrine Methotrexate Alendronate sodium Rheumatoid arthritis Osteoporosis

基金项目:

作者	单位
安艳芳1 方立2	浙江省舟山医院 1.药剂科；2.风湿免疫科浙江舟山 316000

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中文摘要:

摘要目的：观察汉防己甲素联合阿仑膦酸钠治疗类风湿性关节炎合并骨质疏松的疗效，并与甲氨蝶呤联合阿仑膦酸钠治疗方案进行对比。方法：类风湿性关节炎合并骨质疏松84例患者随机分为观察组和对照组各42例。观察组采用汉防己甲素片联合阿仑膦酸钠治疗，对照组采用甲氨蝶呤片联合阿仑膦酸钠治疗。两组疗程均为3个月。评价两组临床疗效；比较两组患者治疗前后的疼痛视觉模拟评分(VAS)、关节肿胀指数(SJS)、晨僵时间等关节功能指标；以及血清钙离子浓度、红细胞沉降率(ESR)、骨密度(BMD)等骨质疏松评价指标；观察记录两组药品不良反应。治疗后随访观察，比较两组患者Barthel指数变化。 结果：观察组临床总有效率为95.2%，明显高于对照组(P<0.05)。治疗后两组患者VAS、SJS、晨僵时间，以及血钙、ESR、BMD等各项指标均较治疗前明显改善(P<0.05)，且观察组各项指标均优于对照组(P<0.05)。两组药品不良反应发生率差异无统计学意义（P＞0.05）。治疗后随访，两组患者Barthel指数评分均较治疗前升高(P<0.05)，且观察组高于对照组(P<0.05)。结论：汉防己甲素联合阿仑膦酸钠治疗风湿性关节炎合并骨质疏松疗效显著，能改善患者关节功能，增加骨密度，提高生活质量，效果优于甲氨蝶呤联合阿仑膦酸钠，且安全性好。

英文摘要:

ABSTRACT Objective: To observe the efficacy of tetrandrine combined with alendronate sodium in the treatment of rheumatoid arthritis with osteoporosis, and to compare it with methotrexate combined with alendronate sodium in the treatment of rheumatoid arthritis. Methods:84 patients with rheumatoid arthritis combined with osteoporosis were randomly divided into observation group and control group with 42 cases in each group. The observation group was treated with tetrandrine tablets combined with alendronate sodium, while the control group was treated with methotrexate tablets combined with alendronate sodium. The course of treatment was 3 months in both groups. Evaluate the clinical efficacy of the two groups; compare the pain visual analogue score (VAS), joint swelling index (SJS), morning stiffness time and other joint function indicators before and after treatment; as well as serum calcium concentration, erythrocyte sedimentation rate (ESR), bone mineral density (BMD) and other evaluation indicators of osteoporosis; observe and record the adverse drug reactions of the two groups. The changes of Barthel index were compared between the two groups after treatment. Results:The total clinical effective rate of the observation group was 95.2%, which was significantly higher than that of the control group (P<0.05). After treatment, VAS, SJS, morning stiffness time, blood calcium, ESR, BMD and other indicators of the two groups were significantly improved compared with those before treatment (P<0.05), and the indicators of the observation group were better than those of the control group (P<0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups (P>0.05). After treatment, the Barthel index scores of both groups were higher than before treatment (P<0.05), and the observation group was higher than the control group (P<0.05). Conclusion:Tetrandrine combined with alendronate in the treatment of rheumatoid arthritis with osteoporosis has a significant effect. It can improve the joint function, increase bone mineral density and improve the quality of life of patients. The effect is better than methotrexate combined with alendronate, and the safety is good.

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