目的 探討舒筋活絡(luò)丸聯(lián)合硫酸羥氯喹片治療類風(fēng)濕性關(guān)節(jié)炎的臨床療效。方法 選取2020年3月—2022年3月在聊城市第二人民醫(yī)院診治的90例類風(fēng)濕性關(guān)節(jié)炎患者，依據(jù)用藥區(qū)別分為對(duì)照組和治療組，每組各45例。對(duì)照組口服硫酸羥氯喹片，0.1 g/次，4次/d；治療組在對(duì)照組的基礎(chǔ)上口服舒筋活絡(luò)丸，2丸/次，2次/d。兩組患者治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀改善時(shí)間，DAS-28評(píng)分、HAQ指數(shù)、VAS評(píng)分和HSS評(píng)分，及血清肽聚糖識(shí)別蛋白-1（PGLYRP-1）、抗環(huán)瓜氨酸多肽抗體（ACCP）、胰島素樣生長(zhǎng)因子結(jié)合蛋白-6（IGFBP-6）、中粒細(xì)胞集落刺激因子（GM-CSF）、白細(xì)胞介素-17（IL-17）和金屬蛋白酶-3（MMP-3）水平。結(jié)果 經(jīng)治療，治療組有效率為97.78%，明顯高于對(duì)照組（82.22%，P＜0.05）。經(jīng)治療，治療組癥狀改善時(shí)間均早于對(duì)照組（P＜0.05）。經(jīng)治療，兩組患者DAS-28評(píng)分、HAQ指數(shù)、VAS評(píng)分均明顯降低，而HSS評(píng)分明顯升高（P＜0.05），且治療組評(píng)分較對(duì)照組改善更明顯（P＜0.05）。經(jīng)治療，兩組患者血清PGLYRP-1、ACCP、IGFBP-6、GM-CSF、IL-17、MMP-3水平均明顯下降（P＜0.05），且治療組患者比對(duì)照組降低更明顯（P＜0.05）。結(jié)論 舒筋活絡(luò)丸聯(lián)合硫酸羥氯喹片治療類風(fēng)濕性關(guān)節(jié)炎可有效改善患者癥狀，減輕患者疼痛，促進(jìn)細(xì)胞因子水平改善。

Objective To explore the clinical effect of Shujin Huoluo Pills combined with hydroxychloroquine sulfate in treatment of rheumatoid arthritis. Methods Patients (90 cases) with rheumatoid arthritis in Liaocheng Second People's Hospital from March 2020 to March 2022 were divided into control and treatment group based on different treatments, and each group had 45 cases. Patients in the control group were po administered with Hydroxychloroquine Sulfate Tablets, 0.1 g/time, four times daily. Patients in the treatment group were po administered with Shujin Huoluo Pills on the basis of the control group, 2 pills/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, and the improvement time of symptom, DAS-28 scores, HAQ indexes, VAS, and HSS scores, the levels of serum PGLYRP-1, ACCP, IGFBP-6, GM-CSF, IL-17 and MMP-3 in two groups before and after treatment were compared. Results After treatment, the effective rate of the treatment group was 97.78%, which was significantly higher than that of the control group (82.22%, P < 0.05). After treatment, the time of symptom improvement in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the DAS-28 score, HAQ index and VAS score of the two groups were significantly decreased, while the HSS score was significantly increased (P< 0.05), and the score of the treatment group improved most significantly (P< 0.05). After treatment, the levels of serum PGLYRP-1, ACCP, IGFBP-6, GM-CSF, IL-17 and MMP-3 were significantly decreased in two groups (P< 0.05), and the decrease in the treatment group was more obvious than that in the control group (P < 0.05). Conclusion Shujin Huoluo Pills combined with hydroxychloroquine sulfate tablets can effectively improve the symptoms of RA, alleviate the pain of patients, and promote the improvement of cytokine levels.

R977

山東省中醫(yī)藥科技項(xiàng)目（2021M030）