目的 探讨风湿二十五味丸联合塞来昔布胶囊治疗类风湿关节炎的临床疗效。方法 回顾性研究对象选取2022年5月—2024年6月首都医科大学附属北京康复医院泌尿与肾内代谢中心收治的98例类风湿性关节炎患者，按照随机数字表法分为对照组和治疗组，每组49例。对照组口服塞来昔布胶囊，0.2 g/次，每日2次。治疗组在对照组的基础上口服风湿二十五味丸，15粒/次，每日2次。两组连续用药8周。观察两组临床疗效，比较两组中医证候积分、红细胞沉降率（ESR）、血清类风湿因子（RF）、类风湿关节炎病情评价量表（DAS28）、生存质量评定量表（WHOQOL-100）评分、白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）、血清降钙素原（PCT）、血清淀粉样蛋白A（SAA）水平。结果 用药治疗后，治疗组总有效率是95.92%，显著高于对照组的81.63%（P＜0.05）。治疗后，关节晨僵积分、关节屈伸受限积分、关节肿而痛积分、关节轻度畸形积分均显著降低（P＜0.05）；与对照组对比，治疗后治疗组关节晨僵积分、关节屈伸受限积分、关节肿而痛积分、关节轻度畸形积分均更低（P＜0.05）。治疗后，两组患者ESR、RF水平较同组治疗前均显著降低（P＜0.05）；与对照组对比，治疗后治疗组的ESR、RF、指标均更低（P＜0.05）。治疗后，两组DAS28评分较同组治疗前降低，而WHOQOL-100评分升高（P＜0.05)；且治疗后治疗组DAS28评分低于对照组，WHOQOL-100评分高于对照组（P＜0.05）。治疗后，两组IL-6、PCT、hs-CRP、SAA水平均较同组治疗前显著降低（P＜0.05）；与对照组对比，治疗后治疗组IL-6、PCT、hs-CRP、SAA水平均更低（P＜0.05）。结论 风湿二十五味丸联合塞来昔布胶囊协同治疗类风湿性关节炎效果显著，能使关节炎性反应降低，改善关节功能状态，且药物安全，值得借鉴与应用。

Objective To explore the clinical efficacy of Fengshi Ershiwuwei Pills combined with celecoxib in treatment of rheumatoid arthritis. Methods The subjects of the retrospective study were 98 patients with rheumatoid arthritis who were admitted to the Urology and Renal Internal Metabolism Center of Beijing Rehabilitation Hospital Affiliated to Capital Medical University from May 2022 to June 2024. They were randomly divided into control group and treatment group according to random number table method, with 49 cases in each group. Patients in control group were given oral Celecoxib Capsules, 0.2 g/time, twice a day. Patients in treatment group were given the same medication as the control group, along with the addition of Fengshi Ershiwuwei Pills, 15 pills/time, twice a day. Both groups took the medication for 8 consecutive weeks. The clinical efficacy of two groups was observed, and the scores of traditional Chinese medicine syndromes, ESR, RF, DAS28 score, WHOQOL-100 score, IL-6, hs-CRP, PCT, and serum SAA levels were compared between two groups. Results After medication treatment, the total effective rate of treatment group was 95.92%, significantly higher than that of control group (81.63%) (P < 0.05). After treatment, the scores of morning stiffness of joints, limitation of joint flexion and extension, swelling and pain of joints, and mild deformity of joints all significantly decreased (P < 0.05). Compared with control group, the scores of morning stiffness of joints, limitation of joint flexion and extension, swelling and pain of joints, and mild deformity of joints in treatment group were all lower (P < 0.05). After treatment, the levels of ESR and RF in both groups were significantly lower than those before treatment in the same group (P < 0.05). Compared with control group, the levels of ESR and RF in treatment group were all lower (P < 0.05). After treatment, the DAS28 scores of both groups were lower than those before treatment in the same group, while the WHOQOL-100 score increased (P < 0.05). After treatment, the DAS28 score of treatment group was lower than that of control group, and WHOQOL-100 score was higher than that of control group (P < 0.05). After treatment, the levels of IL-6, PCT, hs-CRP, and SAA in both groups were significantly lower than those before treatment in same group (P < 0.05). Compared with control group, the levels of IL-6, PCT, hs-CRP, and SAA in treatment group were all lower (P < 0.05). Conclusion Fengshi Ershiwuwei Pills combined with celecoxib for rheumatoid arthritis has a remarkable effect, and can reduce the inflammatory response of arthritis and improve the functional state of the joints. Moreover, the drugs are safe and worthy of reference and application.

R977