目的 探讨通滞苏润江胶囊联合塞来昔布治疗类风湿性关节炎的临床疗效。方法 选取2018年2月-2020年2月在河南省洛阳正骨医院（河南省骨科医院）就诊的86例类风湿性关节炎患者，随机分为对照组和治疗组，每组各43例。对照组口服塞来昔布胶囊，0.2 g/次，2次/d；治疗组在对照组治疗基础上口服通滞苏润江胶囊，7粒/次，2次/d。两组均经8周治疗。观察两组的临床疗效，比较两组临床症状缓解时间、相关评分和血清学因子的情况。结果 经治疗，治疗组的总有效率是97.67%明显高于对照组81.40%（P<0.05）。经治疗，治疗组晨僵、关节压痛、屈伸不利、关节肿胀、关节发热症状缓解时间均显著短于对照组（P<0.05）。经治疗，两组HAQ指数、DAS28评分、VAS评分均较治疗前显著降低（P<0.05）；治疗后，治疗组HAQ指数、DAS28评分、VAS评分显著低于对照组（P<0.05）。经治疗，两组血清类风湿因子（RF）、抗环瓜氨酸抗体（ACCP）、白细胞介素-1β（IL-1β）、白细胞介素-17（IL-17）、白细胞介素-37（IL-37）水平均显著降低，但骨保护素（OPG）显著升高（P<0.05）；治疗后，治疗组RF、ACCP、IL-1β、IL-17、IL-37水平显著低于对照组，而OPG高于对照组（P<0.05）。结论 通滞苏润江胶囊联合塞来昔布治疗类风湿性关节炎具有较好的临床疗效，可显著改善患者相关症状和细胞因子水平，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Tongzhi Surunjiang Capsules combined with celecoxib in treatment of rheumatoid arthritis. Methods A total of 86 patients with rheumatoid arthritis treated in Luoyang Orthopedic Traumatological of Henan Province (Henan Orthopaedic Hospital) from February 2018 to February 2020 were selected and randomly divided into control group and treatment group, with 43 patients in each group. Patients in the control group were po administered with Celecoxib Capsules, 0.2 g/time, twice daily. Patients in the treatment group were po administered with Tongzhi Surunjiang Capsules on the basis of the control group, 7 granules/time, twice daily. Both groups were treated for 8 weeks. The clinical efficacy of the two groups was observed, and the clinical symptom relief time, relevant scores and serological factors were compared between two groups. Results After treatment, the total effective rate of the treatment group was 97.67%, which was significantly higher than that of the control group (81.40%, P<0.05). After treatment, the remission time of morning stiffness, joint tenderness, adverse flexion and extension, joint swelling and joint fever in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, HAQ index, DAS28 score and VAS score in both groups were significantly decreased compared with that before treatment (P<0.05). After treatment, HAQ index, DAS28 score and VAS score in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, serum levels of rheumatoid factor (RF), anti-cyclic citrulline antibody (ACCP), interleukin-1β (IL-1β), interleukin-17 (IL-17), and interleukin-37 (IL-37) were significantly decreased in both groups, but OPG was significantly increased (P<0.05). After treatment, RF, ACCP, IL-1β, IL-17, IL-37 levels in the treatment group were significantly lower than those in the control group, while OPG levels were higher than those in the control group (P<0.05). Conclusion Tongzhi Surunjiang Capsules combined with celecoxib has good clinical effect in treatment of rheumatoid arthritis, and can significantly improve symptoms and cytokine levels in patients, which has certain clinical application value.

R977

河南省中医药科学研究专项课题（20-21zy1059）