目的 探讨风湿骨痛胶囊联合柳氮磺吡啶治疗类风湿关节炎的临床疗效。方法 纳入2022年1月—2024年1月保定市第一中心医院收治的类风湿关节炎患者82例，按随机数字表法分为对照组和治疗组，每组各41例。对照组口服柳氮磺吡啶肠溶片，0.75 g/次，3次/d。在对照基础上，治疗组饭后30 min口服风湿骨痛胶囊，3粒/次，2次/d。两组患者疗程为12周。观察两组患者临床疗效，比较治疗前后两组患者症状/体征积分，肌骨超声半定量评分和28个关节疾病活动度（DAS28）评分，超声造影参数达峰时间（TTP）、上升支斜率（a3）、峰值强度（PI）和平均灌注时间（MTT），及血清C反应蛋白（CRP）、血管生成素样蛋白4（ANGPTL4）、钙卫蛋白（CALP）和C-C趋化因子配体5（CCL5）水平。结果 治疗后，治疗组总有效率为95.12%，明显高于对照组的80.49%（P＜0.05）。治疗后，两组各项症状/体征积分、肌骨超声半定量评分和DAS28评分均明显减少（P＜0.05），且治疗组明显低于对照组（P＜0.05）。治疗后，两组超声造影参数TTP延长，而MTT、PI和a3都降低（P＜0.05），且治疗组超声造影参数明显好于对照组（P＜0.05）。治疗后，两组血清CRP、ANGPTL4、CALP和CCL5水平比治疗组均明显下降（P＜0.05），且治疗组明显低于对照组（P＜0.05）。结论 风湿骨痛胶囊联合柳氮磺吡啶治疗类风湿关节炎安全性较好，患者症状能得到有效控制，且可进一步抑制滑膜血管新生及机体炎症反应，改善滑膜微循环，增强疾病活动度控制效果。

Objective To investigate the clinical efficacy of Fengshi Gutong Capsules combined with sulfasalazine in treatment of rheumatoid arthritis. Methods Patients (82 cases) with rheumatoid arthritis in Baoding No.1 Central Hospital from January 2022 to January 2024 were divided into control and treatment group by random number table method, and each group had 41 cases. Patient in the control group were po administered with Sulfasalazine Enteric-coated Tablets, 0.75 g/time, three times daily. Patient in the treatment group were po administered with Fengshi Gutong Capsules on the basis of the control group 30 min after meals, 3 grains/time, twice daily. Patient in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, and the symptom/sign scores, musculoskeletal ultrasound semi-quantitative score and DAS28 score, ultrasound contrast parameters TTP, MTT, PI and a3, and the levels of CRP, ANGPTL4, CALP and CCL5 in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 95.12%, which was significantly higher than 80.49% in the control group (P < 0.05). After treatment, the scores of symptoms/signs, semi-quantitative musculoskeletal ultrasound scores, and DAS28 scores in two groups were significantly reduced (P< 0.05), and the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the contrast ultrasound parameters TTP was prolonged in two groups, while MTT, PI, and a3 were decreased (P < 0.05). The contrast ultrasound parameters in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum CRP, ANGPTL4, CALP and CCL5 levels in two groups were significantly lower than those in the treatment group (P < 0.05), and the treatment group was significantly lower than that in the control group (P < 0.05). Conclusion The combination treatment of rheumatoid arthritis with Fengshi Gutong Capsules and sulfasalazine has good medication safety, effective control of patient symptoms, and can further inhibit synovial angiogenesis and inflammatory response, improve synovial microcirculation, and enhance disease activity control.

R982

保定市科技计划项目（2441ZF208）