目的 探讨风湿马钱片联合甲氨蝶呤治疗类风湿关节炎的临床疗效。方法 选取2016年1月-2016年8月在南阳医学高等专科学校第一附属医院诊治的类风湿关节炎患者84例，根据治疗方案的不同分为对照组（42例）和治疗组（42例）。对照组患者口服甲氨蝶呤片，10 mg/次，1次/周。治疗组在对照组的基础上口服风湿马钱片，4片/次，1次/d，1周为1个疗程，两个疗程间隔3 d。两组患者均治疗12周。评价两组患者临床疗效，同时比较治疗前后两组患者临床症状评分和血清学指标改善情况。结果 治疗后，对照组和治疗组总有效率分别为71.43%和90.48%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者关节疼痛、关节肿胀和晨僵等评分均显著下降，同组比较差异具有统计学意义（P<0.05）；且治疗组患者下降比对照组更明显，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血清C反应蛋白（CRP）、白细胞介素-17（IL-17）、肿瘤坏死因子-α（TNF-α）、环氧化酶-2（COX-2）、肿瘤坏死因子样配体1A（TL1A）和血沉（ESR）水平均明显降低，同组比较差异具有统计学意义（P<0.05）；且治疗组患者上述血清学指标显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 风湿马钱片联合甲氨蝶呤治疗类风湿关节炎可有效改善患者临床症状及血清细胞因子水平，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Fengshi Maqian Tablets combined with methotrexate in treatment of rheumatoid arthritis. Methods Patients (84 cases) with rheumatoid arthritis in the First Affiliated Hospital of Nanyang Medical College from January 2016 to August 2016 were divided into control (42 cases) and treatment (42 cases) groups based on different treatment. Patients in the control group were po administered with Methotrexate Tablets, 10 mg/time, once a week. Patients in the treatment group were po administered with Fengshi Maqian Tablets on the basis of the control group, 4 tablets/time, once daily, 1 week for a course of treatment, and two course of treatment was 3 d apart. Patients in two groups were treated for 12 weeks. After treatment, clinical efficacy was evaluated, and the clinical symptoms scores and serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 71.43% and 90.48%, respectively, and there were differences between two groups (P<0.05). After treatment, the clinical symptoms scores of joint pain, joint swelling and stiffness in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the decreased degree in the treatment group was more significant than that in the control group, with significant difference between two groups (P<0.05). After treatment, the CRP, IL-17, TNF-α, COX-2, TL1A and ESR levels in two groups was significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the levels of these serological indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Fengshi Maqian Tablets combined with methotrexate can significantly improve the clinical symptoms and the serum cytokine level in treatment of rheumatoid arthritis, which has a certain clinical application value.