Weinblatt M E, Maier A L
Arthritis Care Res. 1989 Sep;2(3):S23-32. doi: 10.1002/anr.1790020311.
The management of the rheumatoid patient involves the considered use of pharmacologic agents as therapies to induce symptomatic relief and to reduce disease activity. Aspirin and nonsteroidal antiinflammatory drugs are used initially to lessen the degree of pain and swelling associated with the inflammatory disease process. The aggressive institution of second-line therapy, previously known as disease-modifying antiinflammatory rheumatic drugs, is advocated to modify the disease course itself. These second-line treatments include antimalarials, gold salts, methotrexate, d-penicillamine, and azathioprine. Randomized placebo controlled trials have demonstrated the efficacy of these compounds in this illness. Improvement in standard parameters of disease activity (number of painful and swollen joints, duration of morning stiffness, erythrocyte sedimentation rate) can be related to the therapeutic value of second-line agents. Whether they modify radiographic progression is under rigorous study. Newer therapies under research investigation include sulfasalazine, cyclosporin A, and combination therapy.
类风湿患者的管理涉及谨慎使用药物作为治疗手段，以缓解症状并降低疾病活动度。阿司匹林和非甾体抗炎药最初用于减轻与炎症性疾病过程相关的疼痛和肿胀程度。提倡积极采用二线治疗，以前称为改善病情抗风湿药物，以改变疾病进程本身。这些二线治疗包括抗疟药、金盐、甲氨蝶呤、青霉胺和硫唑嘌呤。随机安慰剂对照试验已证明这些化合物对该疾病有效。疾病活动度标准参数（疼痛和肿胀关节数、晨僵持续时间、红细胞沉降率）的改善与二线药物的治疗价值相关。它们是否能改变影像学进展正在进行严格研究。正在研究的新疗法包括柳氮磺胺吡啶、环孢素A和联合治疗。
