目的 研究麝香乌龙丸联合甲氨蝶呤对寒湿痹阻型类风湿关节炎患者白介素-1（IL-1）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）的影响。方法 选择2015年2月-2018年1月铜川市人民医院收治的寒湿痹阻型类风湿关节炎患者103例，按入院顺序随机将其分为两组。对照组口服麝香乌龙丸，每次3 g，每日2次；观察组在对照组基础上联合甲氨蝶呤片，每次7.5 mg，每日1次。两组均治疗60 d。比较两组患者的疗效、中医证候积分、疼痛评分及治疗前后IL-1、IL-6、TNF-α含量的变化情况。结果 观察组的有效率96.08%明显高于对照组78.85%，差异有统计学意义（P<0.05）。治疗后，两组的中医证候积分、疼痛评分均比治疗前显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组明显低于对照组，差异有统计学意义（P<0.05）。与治疗前比较，两组患者治疗后IL-1、IL-6、TNF-α含量均显著下降（P<0.05）；治疗后两组患者相比，观察组IL-1、IL-6、TNF-α含量均显著低于对照组（P<0.05）。结论 麝香乌龙丸联合甲氨蝶呤治疗寒湿痹阻型类风湿关节炎患者的疗效显著，且该方法能够显著改善患者的IL-1、IL-6、TNF-α水平，临床应用效果显著。

Objective To investigate the effect of Shexiang Wulong Pill combined with Methotrexate Capsules on the levels of IL-1, IL-6 and TNF-α in rheumatoid arthritis patients with cold-stagnancy.Methods We selected 103 cases of rheumatoid arthritis patients with cold, dampness and rheumatoid arthritis who were admitted to our hospital between February 2015 and January 2018. According to the admission order, 103 patients were randomly divided into two groups. The control group was given oral musk shexiang wulong pill, 3 g each time, twice daily; the observation group was combined with methotrexate tablets, each 7.5 mg, once daily. Both groups were treated for 60 days. The curative effect, TCM syndrome scores, pain scores, and the changes of IL-1, IL-6 and TNF-α levels before and after treatment were compared between the two groups.Results The effective rate of the observation group was significantly higher than that of the control group (P<0.05). Before treatment, the TCM syndrome scores and pain scores of both groups were statistically different. After treatment, the above indicators of both groups were significantly lower than before treatment, and the observation group was more significant (P<0.05). The levels of IL-1, IL-6 and TNF-α in the two groups were decreased after treatment, and the IL-level of the observation group was compared with that before the treatment. The levels of IL-1, IL-6 and TNF-α were significantly decreased (P<0.05). After treatment, the levels of IL-1, IL-6 and TNF-α in the observation group were significantly lower than those in the control group (P<0.05).Conclusion Wuxiang Pills combined with methotrexate are effective in the treatment of rheumatoid arthritis in patients with cold-stagnant and rheumatoid arthritis, and this method can significantly improve the levels of IL-1, IL-6 and TNF-α in patients with significant clinical effects.

陕西省社会发展科技攻关项目（2015SF057）