目的 观察痹祺胶囊联合甲氨蝶呤治疗类风湿关节炎的临床疗效。方法 选取2018年5月—2020年12月邯郸市中心医院收治的200例类风湿关节炎患者，根据信封抽签法将患者分为对照组和观察组，每组各100例。对照组温水送服甲氨蝶呤片，7.5 mg/次，1次/周。观察组在对照组的基础上温水送服痹祺胶囊，4粒/次，3次/d。两组连续治疗12周。观察两组患者的临床疗效，同时比较两组C反应蛋白（CRP）、类风湿因子滴度（RF）、抗链球菌溶血素"O"（ASO）、红细胞沉降率（ESR）、免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）及补体C3、C4水平。结果 治疗后，观察组的临床总有效率为83.00%，显著高于对照组的69.00%（P<0.05）。治疗后，两组CRP、ASO、ESR和RF水平均显著下降（P<0.05）；治疗后，观察组的风湿四项指标水平显著低于对照组（P<0.05）。治疗后，两组IgG、IgA、IgM均较治疗前下降（P<0.05）；治疗后，观察组的IgA、IgM、IgG均低于对照组（P<0.05）。两组治疗前后补体C3、C4组间对比均未见统计学差异。结论 痹祺胶囊联合甲氨蝶呤治疗类风湿关节炎患者，可有效控制疾病进展，调节血清免疫球蛋白水平，提高治疗效果。

Objective To observe the clinical efficacy of Biqi Capsules combined with methotrexate in treatment of rheumatoid arthritis.Methods A total of 200 patients with rheumatoid arthritis admitted to Handan Central Hospital from May 2018 to December 2020 were selected, and the patients were divided into control group and observation group according to the envelope lottery method, with 100 cases in each group. Patients in the control group were po administered with Methotrexate Tablets with warm water, 7.5 mg/time, once weekly. Patients in the observation group were po administered with Biqi Capsules on the basis of the control group, 4 capsules/time, 3 times daily. Both groups were treated for 12 weeks. The clinical efficacy of two groups was observed, and the levels of CRP, RF, ASO, ESR, IgA, IgG, IgM, complement C3 and C4 were compared between two groups. Results After treatment, the total clinical effective rate of observation group was 83.00%, which was significantly higher than 69.00% of control group (P < 0.05). After treatment, the levels of CRP, ASO, ESR and RF in two groups were significantly decreased (P < 0.05). After treatment, the four indexes of rheumatism in observation group were significantly lower than those in control group (P < 0.05). After treatment, IgG, IgA, and IgM in two groups were decreased compared with before treatment (P < 0.05). After treatment, IgA, IgM, and IgG in observation group were lower than those in control group (P < 0.05). There was no statistical difference in complement C3 and C4 between two groups before and after treatment.Conclusion Biqi Capsules combined with methotrexate in treatment of patients with rheumatoid arthritis can effectively control the disease progression, regulate the level of serum immunoglobulin, and improve the therapeutic effect.

R979.5

河北省医学科学研究课题（20200477）