目的 探討大活絡(luò)聯(lián)合艾拉莫德治療類風(fēng)濕性關(guān)節(jié)炎的臨床療效。方法 選取2017年8月-2019年8月在河南中醫(yī)藥大學(xué)第三附屬醫(yī)院治療的類風(fēng)濕性關(guān)節(jié)炎患者96例，隨機(jī)分為對(duì)照組和治療組，每組各48例。對(duì)照組患者口服艾拉莫德片，25 mg/次，2次/d。治療組在對(duì)照組基礎(chǔ)上口服大活絡(luò)丸，1丸/次，2次/d。兩組連續(xù)治療14 d。觀察兩組臨床療效，同時(shí)比較治療前后兩組炎性因子白細(xì)胞介素6（IL-6）、IL-8、腫瘤壞死因子-α（TNF-α）和C反應(yīng)蛋白（CRP）水平，及類風(fēng)濕因子、紅細(xì)胞沉降率、類風(fēng)濕DAS28評(píng)分和不良反應(yīng)。結(jié)果 治療后，對(duì)照組總有效率為81.25%，明顯低于治療組的95.83%（P<0.05）。治療后，兩組IL-6、IL-8、TNF-α、CRP均顯著降低（P<0.05），治療組IL-6、IL-8、TNF-α、CRP均低于對(duì)照組患者（P<0.05）。治療后，兩組類風(fēng)濕因子、紅細(xì)胞沉降率、類風(fēng)濕DAS28評(píng)分、壓痛關(guān)節(jié)數(shù)、腫脹關(guān)節(jié)數(shù)均顯著降低（P<0.05）。治療后，治療組類風(fēng)濕因子、紅細(xì)胞沉降率指標(biāo)均低于對(duì)照組（P<0.05），治療組患者類風(fēng)濕DAS28評(píng)分、壓痛關(guān)節(jié)數(shù)、腫脹關(guān)節(jié)數(shù)均低于對(duì)照組（P<0.05）。對(duì)照組不良反應(yīng)發(fā)生率12.00%，明顯高于治療組的8.33%（P<0.05）。結(jié)論 大活絡(luò)丸聯(lián)合艾拉莫德治療類風(fēng)濕關(guān)節(jié)炎臨床效果明顯優(yōu)于艾拉莫德治療，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the curative effect of Dahuoluo Pills combined with iguratimod in treatment of rheumatoid arthritis. Methods Patients (96 cases) with rheumatoid arthritis in Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from August 2017 to August 2019 were randomly divided into control and treatment groups, and each group had 48 cases. Patients in the control group were po administered with Iguratimod Tablets, 25 mg/time, twice daily. Patients in the treatment group were po administered with Dahuoluo Pills on the basis of the control group, 1 pill/time, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the serum levels of IL-6, IL-8, TNF-α and CRP, the rheumatoid factor, erythrocyte sedimentation rate, rheumatoid DAS28 score and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.25%, which was significantly lower than 95.83% in the treatment group (P<0.05). After treatment, IL-6, IL-8, TNF-α and CRP in two groups were significantly decreased (P<0.05). The serum levels of IL-6, IL-8, TNF-α and CRP in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the rheumatoid factor, erythrocyte sedification rate, rheumatoid DAS28 score, the number of painful joints and the number of swollen joints were significantly decreased in both groups (P<0.05). After treatment, the rheumatoid factor, erythrocyte sedimentation rate in the treatment group were significantly lower than those in the control group (P<0.05), the rheumatoid DAS28 score, tenderness joint number, swelling joint number in the treatment group were significantly lower than those in the control group (P<0.05). During the treatment, the adverse reactions rate in the control group was 12.00%, which was significantly higher than 8.33% in treatment the group (P<0.05). Conclusion The therapeutic effect of Dahuoluo Pills combined with iguratimod in treatment of rheumatoid arthritis is significantly better than that of single treatment of iguratimod, which has a certain clinical application value.

R977