The Clinical Observation Of High Dose Glucocorticoid Used To The Early Rheumatoid Arthritis

Objective:To evaluate the efficacy,mechanism and the adverse reactions ofglucocorticoid(GC) in the management of early rheumatoid arthritis(RA).Method:(1) 33 patients with early active arthritis were randomly divided into "high dose group" and "low dose group," were given to high and low doses of glucocorticoids,as well as DMARDs,NSAIDs;41 early RA patients were into historical control group randomly,administered DMARDs and NSAIDs.(2) aching joint counts,swollen joint counts,duration of early morning stiffness,ESR,CRP,RF,BMD,Larsen joint scores were assessed before and after 7days,one month,three months and six months(3) compared three groups of patients with various indicators of whether observed differences.Results:(1) The difference of aching joint counts,swollen joint counts,duration of early morning stiffness, ESR,CRP among three groups is statistical(The statistic are F=6.311,P=0.003;F= 8.688,P=0.000;F =4.147,P=0.020;F=2.715,P=0.047;F=2.983,P=0.035).The difference of RF,BMD,Larsenjoint scores no statistical value(F=0.551,P=0.579;F=0.079,P=0.924;F=0.733,P=0.484).(2) The incidence of gastro-intestinal upset occurred in high group was 31.3%,higher than the others(x 2 = 7.833,P= 0.011 ).The incidence of weight gain occurred in high group was 12.5%,lower than the others(x 2 = 10.532, P = 0.005 ).(3)The days which the patients of historical control group took NSAIDs was 51.17 days averagely, longer than the high group(14.16 days) and the low group(26.50 days).The difference is statistical(x 2= 39.954,P=0.000).Conclusions:(1) Glucocorticoid can quickly ease the patient's clinical symptoms and control of the inflammatory response.(2) In addition to the weight of short-term increase in patients did not bring too many side-effects;but the use of NSAIDs can be reduced,thereby reducing the gastrointestinal tract in patients with the incidence of discomfort.