目的 探討風(fēng)濕馬錢(qián)片聯(lián)合甲氨蝶呤治療類(lèi)風(fēng)濕關(guān)節(jié)炎的臨床療效。方法 選取2016年1月-2016年8月在南陽(yáng)醫(yī)學(xué)高等專(zhuān)科學(xué)校第一附屬醫(yī)院診治的類(lèi)風(fēng)濕關(guān)節(jié)炎患者84例，根據(jù)治療方案的不同分為對(duì)照組（42例）和治療組（42例）。對(duì)照組患者口服甲氨蝶呤片，10 mg/次，1次/周。治療組在對(duì)照組的基礎(chǔ)上口服風(fēng)濕馬錢(qián)片，4片/次，1次/d，1周為1個(gè)療程，兩個(gè)療程間隔3 d。兩組患者均治療12周。評(píng)價(jià)兩組患者臨床療效，同時(shí)比較治療前后兩組患者臨床癥狀評(píng)分和血清學(xué)指標(biāo)改善情況。結(jié)果 治療后，對(duì)照組和治療組總有效率分別為71.43%和90.48%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者關(guān)節(jié)疼痛、關(guān)節(jié)腫脹和晨僵等評(píng)分均顯著下降，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者下降比對(duì)照組更明顯，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者血清C反應(yīng)蛋白（CRP）、白細(xì)胞介素-17（IL-17）、腫瘤壞死因子-α（TNF-α）、環(huán)氧化酶-2（COX-2）、腫瘤壞死因子樣配體1A（TL1A）和血沉（ESR）水平均明顯降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者上述血清學(xué)指標(biāo)顯著低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 風(fēng)濕馬錢(qián)片聯(lián)合甲氨蝶呤治療類(lèi)風(fēng)濕關(guān)節(jié)炎可有效改善患者臨床癥狀及血清細(xì)胞因子水平，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Fengshi Maqian Tablets combined with methotrexate in treatment of rheumatoid arthritis. Methods Patients (84 cases) with rheumatoid arthritis in the First Affiliated Hospital of Nanyang Medical College from January 2016 to August 2016 were divided into control (42 cases) and treatment (42 cases) groups based on different treatment. Patients in the control group were po administered with Methotrexate Tablets, 10 mg/time, once a week. Patients in the treatment group were po administered with Fengshi Maqian Tablets on the basis of the control group, 4 tablets/time, once daily, 1 week for a course of treatment, and two course of treatment was 3 d apart. Patients in two groups were treated for 12 weeks. After treatment, clinical efficacy was evaluated, and the clinical symptoms scores and serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 71.43% and 90.48%, respectively, and there were differences between two groups (P<0.05). After treatment, the clinical symptoms scores of joint pain, joint swelling and stiffness in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the decreased degree in the treatment group was more significant than that in the control group, with significant difference between two groups (P<0.05). After treatment, the CRP, IL-17, TNF-α, COX-2, TL1A and ESR levels in two groups was significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the levels of these serological indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Fengshi Maqian Tablets combined with methotrexate can significantly improve the clinical symptoms and the serum cytokine level in treatment of rheumatoid arthritis, which has a certain clinical application value.