ObjectiveTo investigate the clinical efficacy of methotrexate combined with leflunomide and functional exercise in the treatment of patients with advanced rheumatoid arthritis and its effects on joint function and serum biochemical indexes. Methods120 patients with advanced rheumatoid arthritis treated in our hospital were selected as the research object. The random digital table was used to divide the patients into exercise group and treatment group, with 60 cases in each group. The treatment group were treated with methotrexate and leflunomide, and the exercise group was combined with functional exercise on the basis of the treatment of the treatment group. The clinical efficacy of two groups of patients was observed after 3 months of clinical treatment. Comparison of two groups of patients with clinical curative effect, joint swelling, tenderness, stiffness, grip strength etc. Serum C reactive protein (CRP), serum erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), interleukin-6 (IL-6), interleukin-17 (IL-17), tumor necrosis factor alpha (TNF-alpha) level and incidence of adverse reactions were compared between the two groups. ResultsAfter 3 months of treatment, the total effective rate of the patients in the exercise group was 96.67%, the treatment group was 83.33%, and the difference between the two groups was statistically significant (P＜0.05). Two groups of patients, shorten the time of morning stiffness and joint swelling and tenderness were markedly reduced, significantly improve grip strength. The remission of the patients in the exercise group was significantly better than that in the treatment group (P＜0.01). The joint function of the two groups was significantly improved, and the joint function of the patients in the exercise group was significantly better than that in the treatment group (P＜0.05). The levels of serum CRP, ESR, RF, IL-1 beta, IL-6 and TNF-alpha in the two groups were significantly decreased. The levels of serum CRP, ESR, RF, IL-1 beta, IL-6 and TNF-alpha in the patients in the exercise group were significantly lower than those in the treatment group (P＜0.05 or 0.01). In the course of treatment, the total incidence of adverse reactions was 11.67% in the exercise group and 13.88% in the treatment group, and there was no significant difference between the two groups (P＞0.05). ConclusionThe clinical efficacy of methotrexate combined with leflunomide and functional exercise in the treatment of patients with advanced rheumatoid arthritis is significant. It can obviously alleviate the clinical symptoms, improve the function of joint and reduce the level of inflammatory reaction. It is worth popularizing.

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