目的 研究金骨莲胶囊联合美洛昔康治疗类风湿性关节炎患者的临床疗效。方法 选择驻马店市中心医院2020年1月—2021年12月收治的70例类风湿性关节炎患者，按照随机数字表法分为对照组和治疗组，每组各35例。对照组口服美洛昔康片，7.5 mg/次，2次/d。治疗组在对照组基础上口服金骨莲胶囊，2粒/次，3次/d。两组患者均治疗1个月。观察两组患者临床疗效，比较治疗前后两组患者临床症状改善情况，以及C反应蛋白（CRP）、类风湿因子（RF）、红细胞沉降率（ESR）、白细胞介素-17（IL-17）、IL-6和肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，治疗组总有效率明显高于对照组（91.43% vs 71.43%），两组比较差异具有统计学意义（P＜0.05）。治疗后，两组DAS28评分、疼痛评分、关节压痛数和关节肿胀数比治疗前均明显下降（P＜0.05），且治疗组DAS28与疼痛评分明显低于对照组，关节压痛数和肿胀数均少于对照组（P＜0.05）。治疗后，两组患者ESR、CRP、RF、IL-17、IL-6和TNF-α水平明显低于治疗前（P＜0.05），且治疗后治疗组ESR、CRP、RF、IL-17、IL-6和TNF-α水平明显低于对照组（P＜0.05）。结论 金骨莲胶囊联合美洛昔康治疗类风湿关节炎的临床效果更好，可改善患者的临床症状，不增加不良反应发生率。

Objective To study the clinical efficacy of Jingulian Capsules combined with and meloxicam in treatment of rheumatoid arthritis. Methods Patients (70 cases) with rheumatoid arthritis in Zhumadian Central Hospital from January 2020 to December 2021 were divided into control and treatment group by the random number table method, and each had 35 cases. Patients in the control group was po administered with Meloxicam Tablets, 7.5 mg/time, twice daily. Patients in the treatment group were po administered with Jingulian Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 1 months. After treatment, the clinical evaluation was evaluated, and the improvement of clinical symptom, and the levels of ESR, CRP, RF, IL-17, IL-6, and TNF-α in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was significantly higher than that of the control group (91.43% vs 71.43%), and there was significant difference between the two groups (P < 0.05). After treatment, the DAS28 score, pain score, joint tenderness, and joint swelling in two groups were significantly lower than those before treatment (P < 0.05), and the DAS28 and pain score in the treatment group were significantly lower than those in the control group, and the number of joint tenderness and swelling in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the expression level of ESR, CRP, RF, IL-17, IL-6, and TNF-α were significantly lower than those before treatment (P < 0.05). After treatment, the levels of ESR, CRP, RF, IL-17, IL-6, and TNF-α in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The clinical effect of Jingulian Capsules combined with and meloxicam in treatment of rheumatoid arthritis is better, which can can improve the clinical symptoms of patients without increasing the incidence of adverse reactions.

R977

中国药学会全国医药信息网项目（CMEI2021KPYJ00145）