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目的:分析类风湿性关节炎(RA)患者用药情况,为临床合理用药提供参考。方法:从医院信息系统中提取2018年9月～2019年4月于我院就诊的259例RA患者临床资料,统计并分析其基本信息及处方用药。结果:259例患者男女之比约为1∶5.2;患者确诊RA年龄集中在40～55岁;分析治疗RA处方药物,甲氨蝶呤的使用频率为42.08%,远低于来氟米特的使用频率60.23%;非甾体抗炎药(NSAIDs)使用频率超过30%。护胃药物选择主要为质子泵抑制剂。2张处方中患者激素使用量超过10mg/d。15例患者的治疗方案仅植物制剂或植物制剂合用NSAIDs控制病情。14例患者同时服用激素类药物与NSAIDs。结论:RA主要发病人群是中老年女性患者,临床用药中甲氨蝶呤使用率偏低,护胃药选择欠妥,激素及植物制剂应用的合理性有待提高。
Abstract：Objective:To analyze the medication status of rheumatoid arthritis(RA)patients,and to provide reference for clinical rational drug use.Methods:The clinical data of 259 patients with RA in our hospital from September 2018 to April 2019 were extracted from hospital information system,and their basic information and prescription medication were analyzed.Results:The ratio of male to female in 259 cases was 1 to 5.2.The age of diagnosis of RA was mainly from 40 to 55 years old.The useage frequency of methotrexate was 42.08%,far lower than that of leflunomide(60.23%),while non-steroidal anti-inflammatory drugs(NSAIDs)was more than 30%.Proton pump inhibitors were the main choice for gastic protection drugs.There were two prescriptions showed patients taking hormones more than 10 mg/d.There were 15 patients treated with plant preparation only or combined with NSAIDs.There were 14 patients took hormone and NSAIDs simultaneously.Conclusion:The main RA patients are middle-aged and elderly female.The clinical use of methotrexate is low,the choice of stomach protection drug is not appropriate,and the application rationality of hormone and botanical preparation is necessary to be improved.
[1]中华医学会风湿病学分会．类风湿关节炎诊断及治疗指南[J]．中华风湿病学杂志，2010,14(4):265-270．
[2]中华医学会风湿病学分会．2018中国类风湿关节炎诊疗指南[J]．中华内科杂志，2018,57(4):242-251．
[3]葛均波，徐永健．内科学[M].8版．北京：人民卫生出版社，2014:87．
[4]郭文慧，李光韬，李海潮，等．类风湿关节炎继发不同类型肺间质病变临床分析[J]．中国实用内科杂志，2017,37(6):532-536．
[5]Narvez J,Díaz-TornéC,Ruiz J M,et al.Comparative effectiveness of rituximab in combination with either methotrexate or leflunomide in the treatment of rheumatoid arthritis[J].Semin Arthritis Rheum,2011,41(3):401-405．
[6]黄正平，丰帆，李天旺．传统改善病情的抗风湿药对骨代谢的影响[J]．新医学，2018,49(3):155-158．
[7]Chan K O,Seon O J,Seokchan H,et al.Conventional synthetic disease-modifying antirheumatic drugs and bone mineral density in rheumatoid arthritis patients with osteoporosis:possible beneficial effect of leflunomide[J].Clin Exp Rheumatol,2019,37(5):813-819．
[8]宋兴丽，吴鹏．观察艾拉莫德联合甲氨蝶呤对类风湿关节炎（RA）患者临床症状改善状况及实验室检测指标的影响[J]．北方药学，2020,17(5):99-100．
[9]刘巧琼．甲氨蝶呤联合来氟米特与硫酸羟氯喹治疗类风湿关节炎的临床观察[J]．中国现代药物应用，2020,14(17):200-202．
[10]Wang L,Ma L L,Lin Y F,et al.Leflunomide increases hepatic exposure to methotrexate and its metabolite by differentially regulating Mrp2/3/4 transporters via PPARαactivation.[J].Mol Pharmacol,2018,93(6):563-574．
[11]Lin M X,Guo R Y,Su Z J,et al.Combination leflunomide and methotrexate impedes the recovery of liver fibrosis,partly through inhibition of myeloid cell admittance[J].Mol Med Rep,2019,19(3):1622-1628．
[12]中华消化杂志编委会．消化性溃疡病诊断与治疗规范（2013年，深圳）[J]．中华消化杂志，2014,34(2):73-76．
[13]陈秋凤，赖思蓓，林丽君．洛索洛芬与塞来昔布治疗类风湿关节炎对血清TNF-α、IL-37水平的影响研究[J]．北方药学，2019,16(7):124,133．
[14]左橙子，彭文兴．非甾体抗炎药的安全用药与合理选择[J]．中南药学，2017,15(5):639-642．
[15]王宁，秦明照．选择性环氧化酶-2抑制剂与心血管事件风险[J]．心血管病学进展，2013,34(2):170-173．
[16]Huang Y,Wang H,Chen Z,et al.Efficacy and safety of total glucosides of paeony combined with methotrexate and leflunomide for active rheumatoid arthritis:a meta-analysis[J].Drug Des Dev Ther,2019,17(13):1969-1984．
[17]陈前琼，武莉．来氟米特联合白芍总苷治疗类风湿关节炎疗效分析[J]．中国基层医药，2019,26(5):592-595．
[18]李凌汉，麦培根，陈宝红．雷公藤多甙联合免疫抑制剂治疗类风湿关节炎疗效及对炎性因子的影响[J]．现代中西医结合杂志，2017,26(10):1088-1090．
[19]程俊敏，马志毅，李勇，等．痹痛定联合来氟米特对类风湿关节炎患者外周血记忆性CD4~+T细胞表达CXCR4的影响[J]．华南国防医学杂志，2018,32(2):86-90．
[20]王秀茹，苏茵，安媛，等．全国多中心类风湿关节炎患者门诊用药费用的调查[J]．中华风湿病学杂志，2010,14(6):368-372．
[21]梁丹，董惠，赵靓，孟立娜．非甾体消炎药小肠损伤机制以及云母防治作用的研究进展[J]．胃肠病学，2015,20(5):311-313．
[22]金晶，谭诗云，方向明．质子泵抑制药加重非甾体抗炎药所致小肠损伤及其防治措施的文献综述[J]．药物流行病学杂志，2019,28(7):477-482．
[23]马远征，王以朋，刘强，等．中国老年骨质疏松诊疗指南（2018)[J]．中国老年学杂志，2019,39(11):2561-2579.
基本信息:
中图分类号:R593.22
引用信息:
[1]王进军,黄梦,易敏,等.259例类风湿性关节炎患者用药分析[J].巴楚医学,2020,3(04):53-57.
基金信息:
湖北省卫生健康委员会指导性项目（No:WJ2019F035）
2020-12-30
2020-12-30