目的 观察双氯芬酸联合柳氮磺吡啶治疗类风湿性关节炎的临床疗效。方法 选取2011年10月—2014年10月张家港市中医医院收治的类风湿性关节炎患者114例,随机分为对照组和治疗组,每组各57例。对照组口服柳氮磺吡啶肠溶片,初始剂量4片/次,3次/d,若患者无明显不适可渐增加剂量,6片/次,3次/d,患者症状好转后可减量,2片/次,3次/d。治疗组在对照组的治疗基础上口服双氯芬酸钠缓释胶囊,1粒/次,2次/d。两组均连续治疗6个月。观察两组的临床疗效,同时比较两组症状体征、关节功能分级和X线分级的改善程度。比较两组治疗前后血沉(ESR)、C反应蛋白(CRP)、免疫球蛋白(IgA、IgG、IgM)的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为75.44%、92.98%,两组比较差异具有统计学意义(P< 0.05)。治疗后,两组关节疼痛评分、关节压痛评分、关节肿胀评分、活动障碍评分均显著降低,晨僵时间明显缩短,同组治疗前后差异有统计学意义(P< 0.05);且治疗组的改善程度优于对照组,两组比较差异有统计学意义(P< 0.05)。治疗后,两组ESR、CRP、IgA、IgG、IgM显著降低,同组治疗前后差异有统计学意义(P< 0.05);且治疗组的下降程度优于对照组,两组比较差异有统计学意义(P< 0.05)。治疗后,两组关节功能分级、X线分级有明显改善,治疗组的改善情况明显优于对照组,两组比较差异有统计学意义(P< 0.05)。结论 双氯芬酸钠联合柳氮磺吡啶治疗类风湿性关节炎具有较好的临床疗效,可显著改善患者的症状体征,调节患者免疫力,具有一定的临床推广应用价值。

Objective To explore the clinical effect of Diclofenac Sodium Sustained Release Capsules combined with Sulfasalazine in treatment of rheumatoid arthritis. Methods Patients (114 cases) with rheumatoid arthritis in Zhangjiafang Hospital of Traditional Chinese Medicine from October 2011 to in October 2014 were randomly divided into control and treatment groups, and each group had 57 cases. The patients in the control group were po administered with Sulfasalazine Enteric-coated Tablets, with initial dosage of 4 tablets/time, three times daily. If the patient had no obvious discomfort, the dosage could be gradually increased to 6 tablets/time, three times daily. If symptoms could be improved, the dosage was reduced, 2 tablets/time, three times daily. The patients in the treatment group were po administered with Diclofenac Sodium Sustained Release Capsules on the basis of the control group, 1 grain/time, twice daily. The patients in two groups were treated for 6 months. After treatment, the efficacy was evaluated, and the improvement degree of signs and symptoms, joints functional grading and X-ray classification in two groups were compared. The changes of ESR, CRP, IgA, IgG, and IgM in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 75.44% and 92.98%, respectively, and there were differences between two groups (P < 0.05). After treatment, scores of joint pain, joint tenderness, joint swelling, and activity obstacle were significantly lowered, and morning stiffness time was significantly shortened, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in treatment group were better than those in control group, with significant difference between two groups (P < 0.05). After treatment, ESR, CRP, IgA, IgG, and IgM in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in treatment group were better than those in control group, with significant difference between two groups (P < 0.05). After treatment, joints functional grading and X-ray classification in two groups had significantly improved, and the improvement degree of the treatment group was obviously better than that in the control group, with significant difference between two groups (P < 0.05). Conclusion Diclofenac Sodium Sustained Release Capsules combined with Sulfasalazine has clinical curative effect in treatment of rheumatoid arthritis, and can significantly improve the symptoms and signs, and can adjust the immunity of patients, which has a certain clinical application value.