Menninger H
Rheuma-Zentrum I. Medizinische Klinik, Bad Abbach.
Z Rheumatol. 1998 Feb;57(1):25-30. doi: 10.1007/s003930050054.
Therapy of rheumatoid arthritis with a combination of several disease-modifying drugs aims towards better control of the disease than achievable by monotherapy. Based on a broad variety of clinical studies, revealing more or less positive results, several combinations have been suggested: the inclusion of cyclosporin into combinations with methotrexate, the inclusion of sulfasalazine into combinations with methotrexate, the combined use of two chemotherapeutic substances, including methotrexate, azathioprine and cyclophosphamide, the inclusion of chloroquine derivatives into such or other combinations, and the combination of methotrexate with injectable gold. The validity of some of the studies is affected by high drop out rates and by the unknown influence of concomitant therapy with corticosteroids. Our own beneficial experience with the triple combination of methotrexate with azathioprine and chloroquine in 21 patients with refractory rheumatoid arthritis is summarized.
使用多种改善病情药物联合治疗类风湿性关节炎，旨在比单一疗法更好地控制疾病。基于大量或多或少显示出阳性结果的临床研究，已提出了几种联合用药方案：环孢素与甲氨蝶呤联合、柳氮磺胺吡啶与甲氨蝶呤联合、包括甲氨蝶呤、硫唑嘌呤和环磷酰胺在内的两种化疗药物联合使用、氯喹衍生物加入此类或其他联合用药方案以及甲氨蝶呤与注射用金联合。部分研究的有效性受到高退出率以及皮质类固醇联合治疗未知影响的影响。本文总结了我们自身使用甲氨蝶呤、硫唑嘌呤和氯喹三联疗法治疗21例难治性类风湿性关节炎患者的有益经验。
