目的 探讨舒筋活络丸联合硫酸羟氯喹片治疗类风湿性关节炎的临床疗效。方法 选取2020年3月—2022年3月在聊城市第二人民医院诊治的90例类风湿性关节炎患者，依据用药区别分为对照组和治疗组，每组各45例。对照组口服硫酸羟氯喹片，0.1 g/次，4次/d；治疗组在对照组的基础上口服舒筋活络丸，2丸/次，2次/d。两组患者治疗4周。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间，DAS-28评分、HAQ指数、VAS评分和HSS评分，及血清肽聚糖识别蛋白-1（PGLYRP-1）、抗环瓜氨酸多肽抗体（ACCP）、胰岛素样生长因子结合蛋白-6（IGFBP-6）、中粒细胞集落刺激因子（GM-CSF）、白细胞介素-17（IL-17）和金属蛋白酶-3（MMP-3）水平。结果 经治疗，治疗组有效率为97.78%，明显高于对照组（82.22%，P＜0.05）。经治疗，治疗组症状改善时间均早于对照组（P＜0.05）。经治疗，两组患者DAS-28评分、HAQ指数、VAS评分均明显降低，而HSS评分明显升高（P＜0.05），且治疗组评分较对照组改善更明显（P＜0.05）。经治疗，两组患者血清PGLYRP-1、ACCP、IGFBP-6、GM-CSF、IL-17、MMP-3水平均明显下降（P＜0.05），且治疗组患者比对照组降低更明显（P＜0.05）。结论 舒筋活络丸联合硫酸羟氯喹片治疗类风湿性关节炎可有效改善患者症状，减轻患者疼痛，促进细胞因子水平改善。

Objective To explore the clinical effect of Shujin Huoluo Pills combined with hydroxychloroquine sulfate in treatment of rheumatoid arthritis. Methods Patients (90 cases) with rheumatoid arthritis in Liaocheng Second People's Hospital from March 2020 to March 2022 were divided into control and treatment group based on different treatments, and each group had 45 cases. Patients in the control group were po administered with Hydroxychloroquine Sulfate Tablets, 0.1 g/time, four times daily. Patients in the treatment group were po administered with Shujin Huoluo Pills on the basis of the control group, 2 pills/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, and the improvement time of symptom, DAS-28 scores, HAQ indexes, VAS, and HSS scores, the levels of serum PGLYRP-1, ACCP, IGFBP-6, GM-CSF, IL-17 and MMP-3 in two groups before and after treatment were compared. Results After treatment, the effective rate of the treatment group was 97.78%, which was significantly higher than that of the control group (82.22%, P < 0.05). After treatment, the time of symptom improvement in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the DAS-28 score, HAQ index and VAS score of the two groups were significantly decreased, while the HSS score was significantly increased (P< 0.05), and the score of the treatment group improved most significantly (P< 0.05). After treatment, the levels of serum PGLYRP-1, ACCP, IGFBP-6, GM-CSF, IL-17 and MMP-3 were significantly decreased in two groups (P< 0.05), and the decrease in the treatment group was more obvious than that in the control group (P < 0.05). Conclusion Shujin Huoluo Pills combined with hydroxychloroquine sulfate tablets can effectively improve the symptoms of RA, alleviate the pain of patients, and promote the improvement of cytokine levels.

R977

山东省中医药科技项目（2021M030）