目的 探討復(fù)方小活絡(luò)丸聯(lián)合托法替布治療類風(fēng)濕關(guān)節(jié)炎的臨床療效。方法 選取2021年7月—2023年7月天津市北辰醫(yī)院骨科收治的128例類風(fēng)濕關(guān)節(jié)炎患者，按照隨機(jī)數(shù)字法分為對(duì)照組和治療組，每組各64例。對(duì)照組口服枸櫞酸托法替布片，1片/次，2次/d。治療組在對(duì)照組治療基礎(chǔ)口服復(fù)方小活絡(luò)丸，溫開(kāi)水送服1丸/次，2次/d。兩組均連續(xù)治療7周。觀察兩組的臨床療效和癥狀改善時(shí)間，比較兩組治療前后視覺(jué)模擬評(píng)分法（VAS）評(píng)分、白細(xì)胞介素-6（IL-6）、抗環(huán)瓜氨酸肽抗體（anti-CCP）、B細(xì)胞趨化因子CXC配體13（CXCL13）、腫瘤壞死因子-α（TNF-α）的變化情況。結(jié)果 治療后，治療組總有效率是98.44%，顯著高于對(duì)照組的84.38%（P＜0.05）。治療后，治療組關(guān)節(jié)疼痛、關(guān)節(jié)腫脹、關(guān)節(jié)晨僵、關(guān)節(jié)屈伸不利改善時(shí)間均顯著短于對(duì)照組（P＜0.05）。治療后，兩組VAS疼痛評(píng)分均較同組治療前顯著降低（P＜0.05）；治療后，治療組VAS疼痛評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組血清IL-6、anti-CCP、CXCL13、TNF-α水平均較同組治療前顯著降低（P＜0.05）；治療后，治療組IL-6、anti-CCP、CXCL13、TNF-α水平均低于對(duì)照組（P＜0.05）。結(jié)論 復(fù)方小活絡(luò)丸聯(lián)合托法替布治療類風(fēng)濕關(guān)節(jié)炎具有較好的臨床療效，能縮短癥狀改善時(shí)間，降低VAS疼痛評(píng)分和血清炎性因子水平，值得借鑒應(yīng)用。

Objective To investigate the therapeutic effect of Compound Xiaohuoluo Pills combined with tofacitinib in treatment of rheumatoid arthritis. MethodsA total of 128 patients with rheumatoid arthritis admitted to the Department of Orthopedics of Tianjin Beicchen Hospital from July 2021 to July 2023 were selected and divided into control group and treatment group according to random number method, with 64 cases in each group. Patients in the control group were po administered with Tofacitinib Citrate Tablets, 1tablet/time, twice daily. Patients in the treatment group were po administered with Compound Xiaohuoluo Pills on the basis of the control group, 1 pill/time with warm water, twice daily. Both groups were treated continuously for 7 weeks. The clinical efficacy and symptom improvement time of two groups were observed, and the changes of visual analogue scale (VAS) score, interleukin-6 (IL-6), anti-cyclic citcitine peptide antibody (anti-CCP), B-cell chemokine CXC ligand 13 (CXCL13), and tumor necrosis factor-α (TNF-α) before and after treatment were compared. ResultsAfter treatment, the total effective rate of the treatment group was 98.44%, which was significantly higher than that of the control group (84.38%, P < 0.05). After treatment, the improvement time of joint pain, joint swelling, joint stiffness, and joint flexion and extension in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, VAS pain scores in both groups were significantly lower than those before treatment (P < 0.05). After treatment, the VAS pain score of treatment group was lower than that of the control group (P < 0.05). After treatment, serum levels of IL-6, anti-CCP, CXCL13, and TNF-α in 2 groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of IL-6, anti-CCP, CXCL13, and TNF-α in treatment group were lower than those in control group (P < 0.05). Conclusion Compound Xiaohuoluo Pills combined with tofacitinib has good clinical effect in treatment of rheumatoid arthritis, and can shorten the time of symptom improvement, reduce VAS pain score and serum inflammatory factor level, which is worth learning for application.

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