目的 探寻神农镇痛膏联合羟氯喹治疗类风湿关节炎的临床疗效。方法 选取2025年1月—2025年10月武汉市中医医院80例类风湿关节炎患者，随机数字表法将其分为对照组和治疗组，每组各40例。对照组口服硫酸羟氯喹片，0.1 g/次，4次/d，连续治疗14 d。治疗组在对照组的基础上用清水洗净患处擦干后，将神农镇痛膏敷于关节肌肉疼痛处，每天更换1次，连续敷14 d。治疗结束时，对比两组临床疗效、疼痛缓解情况（VAS评分与止痛起效时间）、症状（关节肿胀、关节晨僵、关节疼痛及关节活动受限）缓解时间、疾病活动度（DAS28评分）及血清因子[类风湿因子（RF）、抗环瓜氨酸肽抗体（ACCP）、白细胞介素-6（IL-6）、C反应蛋白（CRP）和红细胞沉降率（ESR）]水平。结果 治疗后，治疗组总有效率（97.50%）高于对照组（75.00%，P＜0.05）。治疗后，两组患者的VAS评分均低于治疗前（P＜0.05），且治疗组VAS低于对照组，止痛起效时间短于对照组（P＜0.05）。治疗后，与对照组比较，治疗组关节肿胀、关节晨僵、关节疼痛及关节活动受限缓解时间均较早（P＜0.05）。治疗后，两组DAS28评分均较治疗前下降（P＜0.05），且治疗组DAS28评分低于对照组（P＜0.05）。治疗后，两组患者ESR、ACCP、RF、IL-6、CRP水平均低于治疗前（P＜0.05），且治疗组ESR、ACCP、RF、IL-6、CRP水平降低更优于对照组（P＜0.05）。结论 神农镇痛膏联合硫酸羟氯喹治疗类风湿关节炎，可显著提升整体疗效，表现为临床症状的快速缓解、止痛起效时间提前，同时有助于调节异常的血清学指标。

Objective To explore the clinical efficacy of Shennong Zhentong Plaster combined with hydroxychloroquine in treatment of rheumatoid arthritis. Methods A total of 80 patients with rheumatoid arthritis treated at Wuhan Traditional Chinese Medicine Hospital from January 2025 to October 2025 were enrolled and divided into control group and treatment group by the random number table method, with 40 patients in each group. Patients in the control group were po administered with Hydroxychloroquine Sulfate Tablets at a dose of 0.1 g four times daily for a consecutive 14-day treatment course. On the basis of the control group, patients in the treatment group were applied Shennong Zhentong Plaster to painful joints and muscles after cleaning and drying the affected areas with clean water; the plaster was replaced once daily for 14 consecutive days. At the end of treatment, the two groups were compared in terms of clinical efficacy, pain relief status (VAS score and time to analgesic onset), relief time of clinical symptoms (joint swelling, morning stiffness, joint pain and limited joint movement), disease activity score (DAS28), and serum levels of rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (ACCP), interleukin-6 (IL-6), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Results After treatment, the total effective rate of the treatment group (97.50%) was significantly higher than that of the control group (75.00%, P < 0.05). The VAS scores of both groups decreased significantly after treatment compared with baseline (P < 0.05), the treatment group obtained lower VAS scores and a shorter time to analgesic onset than the control group (P < 0.05). The relief time of joint swelling, morning stiffness, joint pain and limited joint movement was markedly shorter in the treatment group relative to the control group (P < 0.05). DAS28 scores were reduced in both groups after treatment (P < 0.05), with lower scores observed in the treatment group (P < 0.05). Serum levels of ESR, ACCP, RF, IL-6 and CRP declined significantly in both groups post-treatment (P < 0.05), and the reduction was more pronounced in the treatment group (P < 0.05). Conclusion Shennong Zhentong Plaster combined with hydroxychloroquine can markedly improve the overall therapeutic effect for patients with rheumatoid arthritis, which is manifested as rapid alleviation of clinical symptoms and accelerated onset of pain relief. Meanwhile, this combined therapy helps regulate abnormal serological indicators.

R982

湖北省中医药管理局科研项目（ZY2025M061）