目的 探讨骨瓜提取物注射液联合洛索洛芬钠片治疗类风湿性关节炎的临床疗效。方法 选取2020年7月—2022年10月北京中医医院怀柔医院收治的85例类风湿性关节炎患者，按计算机随机排列将所有患者分为对照组（42例）和治疗组（43例）。对照组患者口服洛索洛芬钠片，60 mg/次，3次/d。治疗组在对照组治疗的基础上静脉滴注骨瓜提取物注射液，50 mg加入250 mL 5%葡萄糖注射液中充分稀释，1次/d。两组患者连续治疗30 d。观察两组的临床疗效，比较两组的晨僵时间、关节压痛数、关节肿胀数、视觉模拟评分法（VAS）评分以及血清类风湿因子（RF）、抗环瓜氨酸肽抗体（抗CCP抗体）、抗突变型瓜氨酸波形蛋白抗体（抗MCV抗体）、中高迁移率族蛋白B1（HMGB1）、基质金属蛋白酶-2（MMP-2）、白细胞介素-33（IL-33）水平。结果 治疗后，治疗组患者的总有效率88.37%明显高于对照组的总有效率69.05%（P<0.05）。治疗后，两组的晨僵时间、关节压痛数、关节肿胀数、VAS评分明显低于治疗前（P<0.05），且治疗组晨僵时间、关节压痛数、关节肿胀数、VAS评分较对照组更低，差异有统计学意义（P<0.05）。治疗后，两组的RF、抗CCP抗体、抗MCV抗体水平均显著降低（P<0.05），治疗组RF、抗CCP抗体、抗MCV抗体水平均较对照组降低更明显，差异具有统计学意义（P<0.05）。治疗后，两组的血清HMGB1、MMP-2、IL-33水平低于治疗前（P<0.05），且治疗组的血清HMGB1、MMP-2、IL-33水平低于对照组，差异有统计学意义（P<0.05）。结论 骨瓜提取物注射液联合洛索洛芬钠片治疗类风湿性关节炎疗效好，能显著减轻患者症状体征，控制病情发展，减轻炎症反应，治疗安全性良好。

Objective To investigate the clinical effect of Gugua Extractives Injection combined with Loxoprofen Sodium Tablets in treatment of rheumatoid arthritis. Methods Patients (85 cases) with rheumatoid arthritis in Beijing Huairou Hospital of Traditional Chinese Medicine from July 2020 to October 2022 were divided into the control group (42 cases) and the treatment group (43 cases) according to the computer random arrangement method. Patients in the control group were po administered with Loxoprofen Sodium Tablets, 60 mg/time, three times daily. Patients in the treatment group were iv administered with Gugua Extractives Injection on the basis of the control group, 50 mg added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacies were evaluated, and the morning stiffness time, joint tenderness number, joint swelling number, VAS score, the levels of RF, anti-CCP antibody, anti-MCV antibody, HMGB1, MMP-2, and IL-33 in two groups were compared. Results After treatment, the total effective rate of 88.37% in the treatment group was significantly higher than that of 69.05% in the control group (P < 0.05). After treatment, the morning stiffness time, joint tenderness number, joint swelling number, and VAS score of two groups were significantly lower than those before treatment (P < 0.05), and the morning stiffness time, joint tenderness number, joint swelling number, and VAS score in the treatment group were lower than those in the control group (P< 0.05). After treatment, the levels of RF, anti-CCP antibody, and anti-MCV antibody in two groups were significantly decreased (P < 0.05), and levels of RF, anti-CCP antibody, and anti-MCV antibody in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of HMGB1, MMP-2, and IL-33 in two groups were lower than those before treatment (P < 0.05). The serum levels of HMGB1, MMP-2, and IL-33 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Gugua Extractives Injection combined with Loxoprofen Sodium Tablets is effective in treatment of rheumatoid arthritis, can significantly reduce the symptoms and signs of patients, control the disease, reduce the inflammatory reaction, with good safety.

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