目的 探讨复方小活络丸联合托法替布治疗类风湿关节炎的临床疗效。方法 选取2021年7月—2023年7月天津市北辰医院骨科收治的128例类风湿关节炎患者，按照随机数字法分为对照组和治疗组，每组各64例。对照组口服枸橼酸托法替布片，1片/次，2次/d。治疗组在对照组治疗基础口服复方小活络丸，温开水送服1丸/次，2次/d。两组均连续治疗7周。观察两组的临床疗效和症状改善时间，比较两组治疗前后视觉模拟评分法（VAS）评分、白细胞介素-6（IL-6）、抗环瓜氨酸肽抗体（anti-CCP）、B细胞趋化因子CXC配体13（CXCL13）、肿瘤坏死因子-α（TNF-α）的变化情况。结果 治疗后，治疗组总有效率是98.44%，显著高于对照组的84.38%（P＜0.05）。治疗后，治疗组关节疼痛、关节肿胀、关节晨僵、关节屈伸不利改善时间均显著短于对照组（P＜0.05）。治疗后，两组VAS疼痛评分均较同组治疗前显著降低（P＜0.05）；治疗后，治疗组VAS疼痛评分低于对照组（P＜0.05）。治疗后，两组血清IL-6、anti-CCP、CXCL13、TNF-α水平均较同组治疗前显著降低（P＜0.05）；治疗后，治疗组IL-6、anti-CCP、CXCL13、TNF-α水平均低于对照组（P＜0.05）。结论 复方小活络丸联合托法替布治疗类风湿关节炎具有较好的临床疗效，能缩短症状改善时间，降低VAS疼痛评分和血清炎性因子水平，值得借鉴应用。

Objective To investigate the therapeutic effect of Compound Xiaohuoluo Pills combined with tofacitinib in treatment of rheumatoid arthritis. MethodsA total of 128 patients with rheumatoid arthritis admitted to the Department of Orthopedics of Tianjin Beicchen Hospital from July 2021 to July 2023 were selected and divided into control group and treatment group according to random number method, with 64 cases in each group. Patients in the control group were po administered with Tofacitinib Citrate Tablets, 1tablet/time, twice daily. Patients in the treatment group were po administered with Compound Xiaohuoluo Pills on the basis of the control group, 1 pill/time with warm water, twice daily. Both groups were treated continuously for 7 weeks. The clinical efficacy and symptom improvement time of two groups were observed, and the changes of visual analogue scale (VAS) score, interleukin-6 (IL-6), anti-cyclic citcitine peptide antibody (anti-CCP), B-cell chemokine CXC ligand 13 (CXCL13), and tumor necrosis factor-α (TNF-α) before and after treatment were compared. ResultsAfter treatment, the total effective rate of the treatment group was 98.44%, which was significantly higher than that of the control group (84.38%, P < 0.05). After treatment, the improvement time of joint pain, joint swelling, joint stiffness, and joint flexion and extension in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, VAS pain scores in both groups were significantly lower than those before treatment (P < 0.05). After treatment, the VAS pain score of treatment group was lower than that of the control group (P < 0.05). After treatment, serum levels of IL-6, anti-CCP, CXCL13, and TNF-α in 2 groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of IL-6, anti-CCP, CXCL13, and TNF-α in treatment group were lower than those in control group (P < 0.05). Conclusion Compound Xiaohuoluo Pills combined with tofacitinib has good clinical effect in treatment of rheumatoid arthritis, and can shorten the time of symptom improvement, reduce VAS pain score and serum inflammatory factor level, which is worth learning for application.

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