标题：甲氨蝶呤联合非甾体抗炎药治疗症状性膝关节骨关节炎临床疗效观察

      作者：孔卫红 1，龚志强 2，戴莉萍 1，黄 帼 1，张会昌 1，陈新鹏 1
    （1.深圳市风湿病医院风湿科，广东 深圳 518040；
2.福田区第二人民医院老年科，广东 深圳 518035）

      卷次： 2013年24卷19期

      【摘要】 目的 观察甲氨蝶呤（MTX）联合非甾体抗炎药治疗症状性膝关节骨关节炎（OA）的临床疗效。
方法 62例原发性症状性膝关节OA患者按1:1比例随机双盲分为治疗组和对照组各31例，治疗组接受MTX 10~
15 mg/周和非甾体抗炎药(NSAID)治疗；对照组仅接受NSAID治疗。观察第2、4、8、16周患者膝关节功能评分、
血常规、血沉及肝肾功能等，并记录患者使用NSAID的变化情况。结果 接受治疗第 2周，两组患者VAS和
WOMAC评分较治疗前都有明显下降，下降幅度两组比较差异无统计学意义(P>0.05)；第 4、8、16周，治疗组两
项评分下降幅度明显高于对照组，差异具有统计学意义(P<0.05)。MTX还能更快地帮助患者减少NSAID用
量。结论 MTX联合NSAID治疗可显著缓解患者疼痛和减轻滑膜炎症，并改善患者的关节功能。

      【关键词】 甲氨蝶呤；膝关节骨关节炎；临床疗效

      【中图分类号】 R684.3 【文献标识码】 A 【文章编号】 1003—6350（2013）19—2834—03


Clinical effect of methotrexate combined with non-steroidal anti-inflammatory drugs for the treatment of
symptomatic knee osteoarthritis.
KONG Wei-hong 1, GONG Zhi-qiang 2, DAI Li-pin 1, HUANG Guo 1, ZHANG
Hui-chang 1, CHEN Xin-peng 1. 1. Department of Rheumatism, Shenzhen Fourth People's Hospital Xiangmihu
Rheumatism Hospital, Shenzhen 518040, Guangdong, CHINA; 2. Department of Geriatrics, the Second People's Hospital of
Futian District of Shenzhen, Shenzhen 518035, Guangdong, CHINA

【Abstract】 Objective To investigate the effect of methotrexate (MTX) combined with non-steriodal antiin-
flammatory drugs (NSAIDS) on symptomatic knee osteoarthritis. Methods Sixty-two primary symptomatic knee
OA patients were randomly divided into treatment group (31 cases, administered with MTX 10~15 mg/W and
NSAID) and the control group (31 cases, administered with NSAID). The clinical parameters, including knee joint
function score, blood routine, ESR, liver function, was evaluated after treatment of 2, 4, 8, 16 weeks, and the changes
of patients using NSAID were recorded. Results The VAS and WOMAC score of both groups were decreased after
treatment, and significant difference was not seen between the two groups after treatment of 2 weeks (P>0.05). After
treatment of 4, 8, 16 weeks, the scores of the treatment group were decreased significantly than those of the control
group, with statistically significant difference (P<0.05). After treatment of MTX, the amount of NSAID used was less-
ened significantly. Conclusion After treatment of MTX combined with NSAID, joint pain is relieved, inflammatory
reactions are reduced in patients, and joint functions of the patients are improved.

      【Key words】 Methotrexate; Knee osteoarthritis; Clinical effect
·论 著·doi:10.3969/j.issn.1003-6350.2013.19.1184