目的 探讨大活络胶囊联合美洛昔康片治疗类风湿性关节炎的临床疗效。方法 选取2018年3月-2019年10月在天津市泰达医院就诊的88例类风湿性关节炎患者作为研究对象，按照随机数字表法将全部患者分为对照组和治疗组，每组各44例。对照组患者口服美洛昔康片，7.5 mg/次，2次/d。治疗组患者在对照组治疗的基础上口服大活络胶囊，1.0 g/次，3次/d。两组患者连续治疗8周。观察两组患者临床疗效，并比较治疗前后两组患者症状体征改善情况、血液流变学指标、血清因子水平、类风湿关节炎患者病情评分（DAS28）。结果 治疗后，治疗组患者的总有效率（93.18%）高于对照组（77.27%），两组比较差异有统计学意义（P<0.05）。治疗后，两组的肿胀关节数、压痛关节数、晨僵时间、VAS评分均明显降低（P<0.05），且治疗组的症状体征改善情况明显低于对照组（P<0.05）。治疗后，两组的高切血液黏度、血浆黏度、血沉（ESR）、纤维蛋白原（FIB）均低于治疗前（P<0.05）；治疗后治疗组的高切血液黏度、血浆黏度、ESR、FIB比对照组低（P<0.05）。治疗后，两组的类风湿因子（RF）、抗链球菌溶血素O（ASO）、C反应蛋白（CRP）、抗环瓜氨酸肽抗体（ACCP）水平均明显低于治疗前（P<0.05）；且治疗组血清因子水平均低于对照组（P<0.05）。治疗后，两组的DAS28评分明显降低（P<0.05），且治疗组DAS28评分降低的更明显（P<0.05）。结论 大活络胶囊联合美洛昔康片可提高类风湿性关节炎的疗效，减轻患者的临床症状体征，降低疼痛程度，改善血流流变学水平，具有重要临床研究价值。

Objective To explore the clinical effect of Dahuoluo capsule combined with Meloxicam Tablets in treatment of rheumatoid arthritis. Methods Patients (88 cases) with rheumatoid arthritis in Tianjin TEDA Hospital from March 2018 to October 2019 were divided into control (44 cases) and treatment (44 cases) groups according to random number table. Patients in the control group were po administered with Meloxicam Tablets, 7.5 mg/time, twice daily. Patients in the treatment group were po administered with Dahuoluo Capsules on the basis of the control group, 1.0 g/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and symptom and sign, hemorheology, serum factors, and DAS28 score in two groups were compared. Results The total effective rate of the treatment group was 93.18%, which was significantly higher than that of the control group (77.27%), and there were differences between two groups (P<0.05). After treatment, the number of swelling joints, tenderness joints, morning stiffness time, and VAS score in the two groups were significantly decreased (P<0.05). And the symptom and signs in the treatment group were significantly lower than those in the control group (P<0.05). The blood viscosity, plasma viscosity, ESR, and FIB in the two groups were significantly decreased (P<0.05). And the hemorheology indexes in the treatment group were significantly lower than those in the control group (P<0.05). RF, ASO, CRP, and ACCP in the two groups were significantly decreased (P<0.05). And the serum factors in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the DAS28 scores in two groups were significantly decreased (P<0.05). And the DAS28 scores in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Dahuoluo capsule combined with Meloxicam Tablets can improve the curative effect of rheumatoid arthritis, reduce the clinical symptoms and signs and pains, and improve the level of hemorheology, which has important clinical research value.

R977

天津市滨海新区卫生局科技项目（2014BWKY013）