目的 探讨疏风活络丸联合柳氮磺吡啶治疗类风湿性关节炎的临床疗效。方法 选取2023年8月—2024年8月复旦大学附属中山医院青浦分院收治的类风湿性关节炎患者100例，随机分为对照组和治疗组，每组各50例。对照组口服柳氮磺吡啶肠溶片，2片/次，4次/d。在对照组的基础上，治疗组口服疏风活络丸，半丸/次，2次/d。两组用药28 d。观察两组疗效情况，比较两组的症状缓解时间、视觉模拟疼痛评分（VAS）、类风湿关节炎病情评价量表（DAS28）评分和日常生活活动能力评分量表（ADL）评分，及血清细胞间黏附分子-1（ICMAM-1）、炎性趋化因子配体20（CCL20）、肿瘤坏死因子-α（TNF-α）和淀粉样蛋白A（SAA）水平。结果 治疗后，治疗组总有效率高于对照组（94.00% vs 80.00%，P＜0.05）。治疗后，与对照组对比，治疗组关节晨僵、关节肿痛、肌肉酸痛、食欲减退等缓解时间均明显缩短（P＜0.05）。治疗后，两组患者VAS评分和DAS28评分与治疗前比较明显下降，而ADL评分明显升高（P＜0.05），且与对照组对比，治疗后治疗组评分明显好于对照组（P＜0.05）。治疗后，两组患者ICMAM-1、CCL20、TNF-α、SAA水平均低于治疗前（P＜0.05），且治疗后治疗组ICMAM-1、CCL20、TNF-α、SAA水平均低对照组（P＜0.05）。结果 治疗后，治疗组临床总有效率为94.00%，明显高于对照组80.00%（P＜0.05）。治疗后，与对照组对比，治疗组关节晨僵、关节肿痛、肌肉酸痛、食欲减退等缓解时间均明显缩短（P＜0.05）。结论 柳氮磺吡啶与疏风活络丸协同治疗类风湿性关节炎效果较好，可降低关节炎症反应，使关节疼痛减轻，并能够促进关节功能提升。

Objective To explore the clinical efficacy of Shufeng Huoluo Pills combined with sulfasalazine in treatment of rheumatoid arthritis. Methods Patients (100 cases) with rheumatoid arthritis in Qingpu Branch, Zhongshan Hospital Affiliated to Fudan University from August 2023 to August 2024 were randomly divided into control and treatment group, and each group had 50 cases. Patients in the control group were po administered with Sulfasalazine Enteric-Coated Tablets, 2 tablets/time, four times daily. Patients in the treatment group were po administered with Shufeng Huoluo Pills on the basis of the control group, 0.5 pill/time, twice daily. Patients in two groups were treated for 28 d. After treatment, the clinical evaluations were evaluated, and the symptom relief time, the scores of VAS, DAS28 and ADL, and the levels of ICMAM-1, CCL20, TNF-α and SAA in two groups before and after treatment were compared. Results After treatment, the effective rate in treatment was higher (94.00% vs. 80.00%, P < 0.05). After treatment, compared with the control group, the relief time for morning stiffness, joint swelling and pain, muscle soreness, and loss of appetite in the treatment group was significantly shortened (P < 0.05). After treatment, the VAS score and DAS28 score in two groups were significantly decreased compared with before treatment, while the ADL score was significantly increased (P < 0.05). Compared with the control group, the score of the treatment group was significantly better than that of the control group after treatment (P < 0.05). After treatment, the levels of ICMAM-1, CCL20, TNF-α, and SAA in two groups were lower than those before treatment (P < 0.05), and which in the treatment group were lower than those in the control group (P < 0.05). Conclusion The synergistic treatment of sulfasalazine and Shufeng Huoluo Pills has a good effect on rheumatoid arthritis, which can reduce joint inflammation response, alleviate joint pain, and promote joint function improvement.

R982

长三角数字干线青浦区科技发展基金项目（QKY2023-09）