目的 探討通滯蘇潤江膠囊聯(lián)合塞來昔布治療類風(fēng)濕性關(guān)節(jié)炎的臨床療效。方法 選取2018年2月-2020年2月在河南省洛陽正骨醫(yī)院（河南省骨科醫(yī)院）就診的86例類風(fēng)濕性關(guān)節(jié)炎患者，隨機(jī)分為對(duì)照組和治療組，每組各43例。對(duì)照組口服塞來昔布膠囊，0.2 g/次，2次/d；治療組在對(duì)照組治療基礎(chǔ)上口服通滯蘇潤江膠囊，7粒/次，2次/d。兩組均經(jīng)8周治療。觀察兩組的臨床療效，比較兩組臨床癥狀緩解時(shí)間、相關(guān)評(píng)分和血清學(xué)因子的情況。結(jié)果 經(jīng)治療，治療組的總有效率是97.67%明顯高于對(duì)照組81.40%（P<0.05）。經(jīng)治療，治療組晨僵、關(guān)節(jié)壓痛、屈伸不利、關(guān)節(jié)腫脹、關(guān)節(jié)發(fā)熱癥狀緩解時(shí)間均顯著短于對(duì)照組（P<0.05）。經(jīng)治療，兩組HAQ指數(shù)、DAS28評(píng)分、VAS評(píng)分均較治療前顯著降低（P<0.05）；治療后，治療組HAQ指數(shù)、DAS28評(píng)分、VAS評(píng)分顯著低于對(duì)照組（P<0.05）。經(jīng)治療，兩組血清類風(fēng)濕因子（RF）、抗環(huán)瓜氨酸抗體（ACCP）、白細(xì)胞介素-1β（IL-1β）、白細(xì)胞介素-17（IL-17）、白細(xì)胞介素-37（IL-37）水平均顯著降低，但骨保護(hù)素（OPG）顯著升高（P<0.05）；治療后，治療組RF、ACCP、IL-1β、IL-17、IL-37水平顯著低于對(duì)照組，而OPG高于對(duì)照組（P<0.05）。結(jié)論 通滯蘇潤江膠囊聯(lián)合塞來昔布治療類風(fēng)濕性關(guān)節(jié)炎具有較好的臨床療效，可顯著改善患者相關(guān)癥狀和細(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 efficacy of Tongzhi Surunjiang Capsules combined with celecoxib in treatment of rheumatoid arthritis. Methods A total of 86 patients with rheumatoid arthritis treated in Luoyang Orthopedic Traumatological of Henan Province (Henan Orthopaedic Hospital) from February 2018 to February 2020 were selected and randomly divided into control group and treatment group, with 43 patients in each group. Patients in the control group were po administered with Celecoxib Capsules, 0.2 g/time, twice daily. Patients in the treatment group were po administered with Tongzhi Surunjiang Capsules on the basis of the control group, 7 granules/time, twice daily. Both groups were treated for 8 weeks. The clinical efficacy of the two groups was observed, and the clinical symptom relief time, relevant scores and serological factors were compared between two groups. Results After treatment, the total effective rate of the treatment group was 97.67%, which was significantly higher than that of the control group (81.40%, P<0.05). After treatment, the remission time of morning stiffness, joint tenderness, adverse flexion and extension, joint swelling and joint fever in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, HAQ index, DAS28 score and VAS score in both groups were significantly decreased compared with that before treatment (P<0.05). After treatment, HAQ index, DAS28 score and VAS score in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, serum levels of rheumatoid factor (RF), anti-cyclic citrulline antibody (ACCP), interleukin-1β (IL-1β), interleukin-17 (IL-17), and interleukin-37 (IL-37) were significantly decreased in both groups, but OPG was significantly increased (P<0.05). After treatment, RF, ACCP, IL-1β, IL-17, IL-37 levels in the treatment group were significantly lower than those in the control group, while OPG levels were higher than those in the control group (P<0.05). Conclusion Tongzhi Surunjiang Capsules combined with celecoxib has good clinical effect in treatment of rheumatoid arthritis, and can significantly improve symptoms and cytokine levels in patients, which has certain clinical application value.

R977

河南省中醫(yī)藥科學(xué)研究專項(xiàng)課題（20-21zy1059）