美洛昔康的應用結合護理健康教育對類風濕關節炎患者的影響

摘要：目的 評價美洛昔康的應用結合護理健康教育對l老年類風濕關節炎患者的影響。方法 將105例類風濕關節炎老年患者隨機分為實驗組（53例）和對照組（52例），兩組均給予同一廠家生產的美羅昔康片1片/次，1次/d，每片含美洛昔康75mg。實驗組在此基礎上給予規范性綜合護理健康教育，包括飲食指導、心理護理和健康教育，使醫護人員與患者建立良好的護患關系。兩組療程均為24w，在治療0、4、8、12、24w后根據美國風濕病學會（ACR）制定的ACR20，ACR50，ACR70標準來評價療效，并記錄該試驗進行過程中任何不良事件。結果 最終完成試驗的為97例，實驗組50例，對照組47例。相較于治療前兩組患者治療后觸痛關節數、腫脹關節數、患者對疼痛的VAS評分等均有改善，差異有統計學意義（P<0.05），同時實驗組與對照組同期比較，差異有統計學意義（P<0.05），但兩組間不良事件發生率差異無統計學意義（P>0.05）。結論 美洛昔康的應用結合護理健康教育能更有效的改善老年人與類風濕關節炎相關的各項癥狀、體征，提高生活質量。

關鍵詞：類風濕；關節炎；老年人；美洛昔康；護理；健康教育

Abstract：Objective To evaluate the influence of Meloxicam plus nursing health education in ederly patients with active Rheumatoid arthritis（RA）.Methods Totally 105 elderly patients with active RA were randomly assigned to the treatment group（53 cases）and the control group（52 cases）.All patients received Meloxicam pills from the same campany，one tablet once a day，each piece contains Meloxicam 75mg.Besides，patients in the treatment group were provided with normative and synthetic nursing health education including diet guidance，psychological nursing and health education.The whole curse lasted for 24 weeks.The curative effect was statistically evaluated by the Unite States Institute of Rheumatology ACR20、ACR50 and ACR70 improvement criteria at week 0，4，8，12 and 24.Meanwhile，any adverse event was recorded and evaluated.Results Totally 97 completed the trial，50 in treatment group and 47 in control group.Compared with before treatment in the same group，there was some improvement in tender joint number，swollen joint number and visual analogue scale（VAS）and such relative symptoms and signs，showing statistical difference（P<0.05）.Compared with the control group in the same phase，there was still statistical difference between the two groups.There was no statistical differene in the occurrence of adverse events between them.Conclusion The application of Meloxicam plus nursing health education can more effectively improve the signs and symptoms associated with RA and improve their quality of life.

Key words：Rheumatoid；Arthritis；senior people；Meloxicam；Health education

類風濕性關節炎（Rheumatoid arthritis，簡稱RA），是一種由自身免疫障礙引致免疫系統攻擊關節的長期慢性炎癥。這種炎癥會造成關節變形直至殘廢，并會因關節痛楚及磨損而失去部份的活動能力，甚至可能系統性的影響其他關節外的組織器官。類風濕關節炎在各個階段皆可發病，老年性類風濕關節炎多發于60歲以后，發病原因尚不十分明確。長久以來，類風濕關節炎治療的目的在于控制病情[1]，改善關節功能和預后。……