目的 探討托法替布聯(lián)合柳氮磺吡啶治療類風(fēng)濕關(guān)節(jié)炎的臨床療效。方法 選擇2020年6月—2022年6月中國人民解放軍空軍軍醫(yī)大學(xué)第一附屬醫(yī)院收治的118例類風(fēng)濕關(guān)節(jié)炎患者，采用隨機(jī)數(shù)字表法分為對(duì)照組（59例）和治療組（59例）。對(duì)照組患者口服柳氮磺吡啶腸溶片，4片/次，3次/d。在對(duì)照組的基礎(chǔ)上，治療組口服枸櫞酸托法替布片，5mg/次，2次/d。兩組患者連續(xù)服用藥物7周。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀緩解時(shí)間，關(guān)節(jié)疼痛評(píng)分（VAS），實(shí)驗(yàn)室指標(biāo)紅細(xì)胞沉降率（ESR）、腫瘤壞死因子-α（TNF-α）、血清類風(fēng)濕因子（RF）、C反應(yīng)蛋白（CRP）水平及不良反應(yīng)。結(jié)果 治療后，治療組患者總有效率（98.31%）明顯高于對(duì)照組（83.05%，P<0.05）。治療后，治療組出現(xiàn)的關(guān)節(jié)疼痛、關(guān)節(jié)腫脹、關(guān)節(jié)晨僵、食欲減退等癥狀緩解時(shí)間均明顯早于對(duì)照組（P<0.05）。治療后，兩組VAS評(píng)分均明顯下降（P<0.05），且治療組明顯低于對(duì)照組（P<0.05）。治療后，兩組患者實(shí)驗(yàn)室指標(biāo)ESR、RF、TNF-α、CRP水平均明顯低于治療前（P<0.05），且治療組患者明顯低于對(duì)照組（P<0.05）。治療期間，治療組患者不良反應(yīng)發(fā)生率為8.47%，明顯低于對(duì)照組（18.64%，P<0.05）。結(jié)論 托法替布聯(lián)合柳氮磺吡啶治療類風(fēng)濕關(guān)節(jié)炎療效確切，可有效緩解關(guān)節(jié)炎癥狀，關(guān)節(jié)止痛效果較佳，且安全有效。

Objective To study the clinical effect of tofacitinib combined with sulfasalazine in treatment of rheumatoid arthritis. Methods Patients (118 cases) with rheumatoid arthritis in the First Affiliated Hospital of Air Force Medical University from June 2020 to June 2022 were divided into control (59 cases) and treatment (59 cases) group by random number table method. Patients in the control group were po administered with Sulfasalazine Enteric-coated Tablets, 4 tablets/time, three times daily. Patients in the treatment group were po administered with Tofacitinib Citrate Tablets on the basis of the control group, 5 mg/time, twice daily. Patients in two groups were treated for 7 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, VAS score, the levels of Laboratory indicators ESR, TNF-α, RF, and CRP, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (98.31%) was significantly higher than that of the control group (83.05%, P < 0.05). After treatment, the relief time of joint pain, joint swelling, joint morning stiffness, loss of appetite and other symptoms in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the VAS score of both groups were significantly decreased (P < 0.05), and which in the treatment group was significantly lower than that of the control group (P< 0.05). After treatment, the levels of ESR, RF, TNF-α, and CRP in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group was 8.47%, which was significantly lower than that in the control group (18.64%, P < 0.05). Conclusion Tofacitinib combined with sulfasalazine have definite curative effect, can effectively relieve the symptoms of arthritis, the effect of joint pain relief is better, and it is safe and effective.

R982

陜西省自然科學(xué)基礎(chǔ)研究計(jì)劃項(xiàng)目（2019ZY-CXPT-03-01）