目的 探讨复方雪莲胶囊联合枸橼酸托法替布片治疗类风湿关节炎的临床疗效。方法 选取黄山首康医院在2022年7月—2024年6月收治的类风湿关节炎患者共68例，按随机数字表法分为对照组和治疗组，每组34例。对照组口服枸橼酸托法替布片，1片/次，2次/d。治疗组在对照组基础上口服复方雪莲胶囊，2粒/次，2次/d。两组患者总共治疗12周。比较两组的治疗效果、关节体征、疼痛程度、疾病活动度、血清指标。结果 与对照组的总有效率67.65%对比，治疗组的总有效率88.24%更高，组间差异显著（P＜0.05）。治疗后，两组的关节压痛数、肿胀数、VAS评分显著降低（P＜0.05）；治疗组的关节压痛数、肿胀数、VAS评分明显低于对照组（P＜0.05）。治疗后，两组的DAS28-ESR评分均明显减小（P＜0.05），治疗组的DAS28-ESR评分与对照组比较更小（P＜0.05）。治疗后，两组的类风湿因子（RF）、抗环瓜氨酸肽（CCP）抗体、白细胞介素（IL）-8、IL-2R、IL-1β均明显降低（P＜0.05）；治疗组的RF、抗CCP抗体、IL-8、IL-2R、IL-1β均低于对照组（P＜0.05）。结论 复方雪莲胶囊联合枸橼酸托法替布片可提高类风湿关节炎的治疗效果，减轻关节疼痛程度和体征，降低疾病活动度，降低炎症反应。

Objective To explore the clinical efficacy of Compound Xuelian Capsules combined with Tofacitinib Citrate Tablets in treatment of rheumatoid arthritis. Methods A total of 68 patients with rheumatoid arthritis admitted by Huangshan Shoukang Hospital from July 2022 to June 2024 were selected and divided into control group and treatment group according to the random number table, with 34 cases in each group. The control group patients took Tofacitinib citrate tablets, twice daily, 1 tablets per time. On the basis of the control group, patients in the treatment group took Compound Xuelian Capsules, twice daily, 2 capsules/time. The treatment efficacy, joint signs, pain level, disease activity, and serum indicators between the two groups were compared. ResultsCompared with the control group, the total effective rate of the treatment group was higher, and the difference between the groups was significant (P < 0.05). The number of joint tenderness, swelling, and VAS score in both groups were significantly decreased (P < 0.05), and the number of joint tenderness, swelling, and VAS score in the treatment group were significantly lower than those in the control group (P < 0.05). The DAS28-ESR in both groups were significantly reduced (P < 0.05). Compared with the control group, the DAS28-ESR score in the treatment group were smaller (P < 0.05). The levels of RF, anti CCP antibodies, IL-8, IL-2R, and IL-1β in both groups after treatment were significantly reduced (P < 0.05). The levels of RF, anti CCP antibodies, IL-8, IL-2R, and IL-1β in the treatment group were lower than those in the control group (P < 0.05). Conclusion The combination of Compound Xuelian Capsules and Tofacitinib Citrate Tablets can improve the therapeutic effect of rheumatoid arthritis, further reduce joint pain and signs, lower disease activity, and alleviate inflammatory reactions.

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