目的 探讨尪痹胶囊联合艾拉莫德治疗类风湿关节炎的临床疗效。方法 选取2020年1月—2021年1月郑州市中医院收治的130例类风湿关节炎患者，随机分为对照组（65例）和治疗组（65例）。对照组患者口服艾拉莫德片，25 mg/次，2次/d。治疗组患者在对照组基础上口服尪痹胶囊，5粒/次，3次/d。两组患者均治疗12周。观察两组患者临床疗效，比较治疗前后两组患者主要症状和体征，红细胞沉降率（ESR）、C反应蛋白（CRP）、类风湿因子（RF）和抗环瓜氨酸肽抗体（Anti-CCP）水平，肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和IL-17水平，及Th17比例、Th17/Treg值和Treg细胞比例。结果 治疗后，治疗组总有效率为96.92%，明显高于对照组的87.69%（P<0.05）。治疗后，两组关节疼痛数、关节肿胀数、晨僵时间、VAS评分均较治疗前降低，双手握力上升（P<0.05），且治疗组主要症状和体征明显好于对照组（P<0.05）。治疗后，两组ESR、CRP、RF、Anti-CCP水平均较治疗前降低（P<0.05），且治疗组比对照组降低更显著（P<0.05）。治疗后，两组TNF-α、IL-6、IL-17水平均较治疗前降低（P<0.05），且治疗组较对照组降低更显著（P<0.05）。治疗后，两组Th17比例、Th17/Treg值均降低，而Treg细胞比例均上升（P<0.05），且治疗组免疫功能明显好于对照组（P<0.05）。结论 尪痹胶囊联合艾拉莫德可以提高类风湿关节炎患者疗效，改善患者临床症状和体征，抑制炎症反应，改善免疫功能，安全性高。

Objective To investigate the clinical effect of Wangbi Capsules combined with iguratimod in treatment of rheumatoid arthritis. Methods Patients (130 cases) with rheumatoid arthritis in Zhengzhou TCM Hospital from January 2020 to January 2021 were randomly divided into control (65 cases) and treatment (65 cases) groups. Patients in the control group were po administered with Iguratimod Tablets, 25 mg/time, twice daily. Patients in the treatment group were po administered with Wangbi Capsules, 5 grains/time, twice daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the main symptoms and signs, the levels of ESR, CRP, RF, Anti-CCP, TNF-α, IL-6, IL-17, Th17 ratio, Th17/Treg ratio and Treg cell ratio in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 96.92%, which was significantly higher than 87.69% of the control group (P < 0.05). After treatment, the number of joint pain, joint swelling, morning stiffness time and VAS score of two groups were significantly lower than those before treatment, and the grip strength of both hands increased (P < 0.05), the main symptoms and signs of the treatment group were significantly better than those of the control group (P < 0.05). After treatment, the levels of ESR, CRP, RF, and anti CCP in two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the levels of TNF-α, IL-6, and IL-17 in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the ratio of Th17 and Th17/Treg were significantly decreased, while the ratio of Treg cells was significantly increased (P < 0.05), and the immune function of the treatment group was significantly better than that of the control group (P < 0.05). Conclusion Wangbi Capsules combined with iguratimod can improve the clinical efficacy of patients with rheumatoid arthritis, improve clinical symptoms and signs, inhibit inflammatory reaction, improve immune function, and have high safety.

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