Clinical Observation of Methotrexate Combined with Total Glucosides of Paeony for Juvenile Rheumatoid Arthritis

OBJECTIVE:To evaluate the curative efficacy of methotrexate combined with total glucosides of paeony for juvenile rheumatoid arthritis(JRA).METHODS: 61 JRA cases were randomly assigned to either control group(n=30) receiving methotrexate [(0.25-0.8)mg·kg-1] once a week orally plus brufen modified release capsule(fenbid) 0.6-1.2 g daily in two divided oral doses or treatment group(n=31) receiving add-on total glucosides of paeony 0.6 g t.i.d orally in addition to the drugs for control group for 3 consecutive courses of treatment,with one course of treatment lasting 4 weeks.The scores for clinical symptoms and signs,American College of Rheumatology response 70(ACR70),disease activity score and the total number of pain joints,the laboratory tests indices including blood sedimentation,rheumatoid factor,c-reactive protein,immunoglobulins(IgA,IgG and IgM) and the adverse drug reactions in both groups were recorded before and after treatment.RESULTS: At 4,8 and 12 weeks,the total response rates were 90%,94% and 100%,respectively for the treatment group,as compared with 87%,90% and 97%,respectively for the control group,showing no statistical difference between the two groups(P0.05).After treatment,the joint pain indices,morning stiffness time,ACR-70 response,disease activity score were statistically different between the treatment group and the control group at the same time point(P0.05);moreover,the differences in ESR,CRP and IgM were also significant between the treatment group and the control group at the same time point(P0.05);however,the adverse drug reactions were not statistically different between the two groups(P0.05).CONCLUSION: Addition of total glucosides of paeony to methotrexate resulted in proved efficacy and mild adverse reactions in treating patients with juvenile rheumatoid arthritis.