中国组织工程研究Issue(52)：9049-9054,6.DOI:10.3969/j.issn.2095-4344.2013.52.018
类风湿关节炎单独甲氨蝶呤与三联疗法治疗的系统评价
System evaluation of methotrexate therapy and triple therapy for rheumatoid arthritis
张磊 1努尔艾•沙吾塔力 1阿依娜孜•巴达力汗 1杨康华 1乌兰拜•唐克杰 1黄勇 1加莎热特•杰力勒1
作者信息
- 1. 新疆医科大学第一附属医院骨科中心显微修复重建外科，新疆维吾尔自治区乌鲁木齐市 830054
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摘要
Abstract
BACKGROUND:At present, it is controversial to choose methotrexate therapy alone or triple therapy in the treatment of rheumatoid arthritis. <br> OBJECTIVE:To systemical y evaluate the efficacy and safety of methotrexate therapy and methopterin+hydroxychloroquine+sulfasalazine triple therapy in the treatment of rheumatoid arthritis. <br> METHODS:Computer retrieval was performed on the Cochrane library, PubMed, EMBASE NRR (http://www.updatesoftware.com/National), CCT (http://www.control ed-trails.com) and the Chinese biomedical literature database. Manual retrieval was performed on Chinese major orthopedic journals. Randomized control ed trials of methotrexate therapy alone and methopterin+hydroxychloroquine+sulfasalazine triple therapy treatment for rheumatoid arthritis were col ected. Methodological quality of the included studies was evaluated. The statistical software Revman 5.0 provided by the Cochrane col aboration was used. <br> RESULTS AND CONCLUSION: A total of four literatures in a randomized control ed trial, a total of 297 cases were included;the methodological quality was al class B. Meta-analysis results showed that blood sedimentation improvements were larger in methotrexate therapy alone than in the triple therapy [mean difference=7.01, 95%confidence interval (CI) (2.82, 11.19), P=0.001). Improvements of joints were better in triple therapy than that in single therapy [OR=0.62, 95%CI (0.41, 0.95), P=0.03). There was no significant difference in adverse events. Meta analysis could not be done in ACR, because literature did not provide detailed data. Compared with the triple therapy treatment, methotrexate therapy alone obviously reduced the sedimentation of rheumatoid arthritis in adults, but in terms of joint function improvement, triple therapy was superior to methotrexate therapy alone. Moreover, on the adverse event, there was no significant difference between the two groups. Because this system evaluation included a less number of cases, it stil needs strict large-sample randomized control ed studies to increase the strength of the evidence.关键词
骨关节植入物/骨与关节循证医学/类风湿关节炎/药物治疗/甲氨蝶呤/羟氯喹/柳氮磺吡啶/血沉/不良反应Key words
arthritis, rheumatoid/methotrexate/hydroxychloroquine/sulfasalazine/blood sedimentation分类
医药卫生引用本文复制引用
张磊,努尔艾•沙吾塔力,阿依娜孜•巴达力汗,杨康华,乌兰拜•唐克杰,黄勇,加莎热特•杰力勒..类风湿关节炎单独甲氨蝶呤与三联疗法治疗的系统评价[J].中国组织工程研究,2013,(52):9049-9054,6.
