目的 探讨复方夏天无片联合艾拉莫德治疗类风湿关节炎患者的临床疗效。方法 选取2022年2月—2024年2月武汉市中医医院收治的106例类风湿关节炎患者，随机分为对照组（53例）和治疗组（53例）。对照组患者口服艾拉莫德片，25 mg/次，2次/d。治疗组在对照组的基础上口服复方夏天无片，4片/次，3次/d。两组患者用药10周。观察两组患者临床疗效，比较治疗前后两组患者炎性因子Ⅱ型胶原C端肽（CTX-Ⅱ）、白三烯B4（LTB4）、P物质（SP）和白细胞介素-1β（IL-1β）水平，关节疾病活动度（DAS-28）评分和视觉模拟疼痛评分（VAS），及类风湿因子血沉（ESR）、类风湿因子（RF）、抗环瓜氨酸肽抗体（CCP）和C反应蛋白（CRP）水平。结果 治疗后，治疗组临床总有效率（96.23%）明显高于对照组（83.02%）。治疗后，两组DAS-28评分、VAS评分均明显低于治疗前（P＜0.05），且治疗组DAS-28评分、VAS评分明显低于对照组（P＜0.05）。治疗后，两组患者CTX-Ⅱ、LTB4、SP、IL-1β、ESR、RF、CCP、CRP水平明显降低（P＜0.05），且治疗组这些指标水平均明显低于对照组（P＜0.05）。结论 复方夏天无片联合艾拉莫德治疗类风湿关节炎疗效确切，可对关节肿胀、疼痛等症状较好的改善，并能增加关节血流，促使关节恢复到稳定状态。

Objective To explore the clinical efficacy of Compound Xiatianwu Tablets combined with iguratimod in treatment of rheumatoid arthritis. Methods Patients (106 cases) with rheumatoid arthritis in Wuhan Hospital of Traditional Chinese Medicine from February 2022 to February 2024 were randomly divided into control (53 cases) and treatment (53 cases) group. Patients in the control group were po administered with Iguratimod Tablets, 25 mg/time, twice daily. Patients in the treatment group were po administered with Compound Xiatianwu Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 10 weeks. After treatment, the clinical evaluations were evaluated, the scores of DAS-28 and VAS, the levels of CTX-Ⅱ, LTB4, SP, IL-1β, ESR, RF, CCP and CRP in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 96.23% significantly higher than 83.02% in the control group (P < 0.05). After treatment, the DAS-28 scores and VAS scores in two groups were significantly lower than before treatment (P < 0.05), and the scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of CTX-Ⅱ, LTB4, SP, IL-1β, ESR, RF, CCP, and CRP in two groups were significantly reduced (P < 0.05), and the levels of these indicators in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The combination of iguratimod and Compound Xiatianwu Tablets in treatment of patients with rheumatoid arthritis has a definite effect. It can improve joint swelling, pain and other symptoms, increase joint blood flow, and promote the joint to return to a stable state.

R982

湖北省科学技术厅资助项目(2018CFB707)