目的 研究麝香烏龍丸聯(lián)合甲氨蝶呤對寒濕痹阻型類風(fēng)濕關(guān)節(jié)炎患者白介素-1（IL-1）、白介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）的影響。方法 選擇2015年2月-2018年1月銅川市人民醫(yī)院收治的寒濕痹阻型類風(fēng)濕關(guān)節(jié)炎患者103例，按入院順序隨機將其分為兩組。對照組口服麝香烏龍丸，每次3 g，每日2次；觀察組在對照組基礎(chǔ)上聯(lián)合甲氨蝶呤片，每次7.5 mg，每日1次。兩組均治療60 d。比較兩組患者的療效、中醫(yī)證候積分、疼痛評分及治療前后IL-1、IL-6、TNF-α含量的變化情況。結(jié)果 觀察組的有效率96.08%明顯高于對照組78.85%，差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組的中醫(yī)證候積分、疼痛評分均比治療前顯著降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且觀察組明顯低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。與治療前比較，兩組患者治療后IL-1、IL-6、TNF-α含量均顯著下降（P<0.05）；治療后兩組患者相比，觀察組IL-1、IL-6、TNF-α含量均顯著低于對照組（P<0.05）。結(jié)論 麝香烏龍丸聯(lián)合甲氨蝶呤治療寒濕痹阻型類風(fēng)濕關(guān)節(jié)炎患者的療效顯著，且該方法能夠顯著改善患者的IL-1、IL-6、TNF-α水平，臨床應(yīng)用效果顯著。

Objective To investigate the effect of Shexiang Wulong Pill combined with Methotrexate Capsules on the levels of IL-1, IL-6 and TNF-α in rheumatoid arthritis patients with cold-stagnancy.Methods We selected 103 cases of rheumatoid arthritis patients with cold, dampness and rheumatoid arthritis who were admitted to our hospital between February 2015 and January 2018. According to the admission order, 103 patients were randomly divided into two groups. The control group was given oral musk shexiang wulong pill, 3 g each time, twice daily; the observation group was combined with methotrexate tablets, each 7.5 mg, once daily. Both groups were treated for 60 days. The curative effect, TCM syndrome scores, pain scores, and the changes of IL-1, IL-6 and TNF-α levels before and after treatment were compared between the two groups.Results The effective rate of the observation group was significantly higher than that of the control group (P<0.05). Before treatment, the TCM syndrome scores and pain scores of both groups were statistically different. After treatment, the above indicators of both groups were significantly lower than before treatment, and the observation group was more significant (P<0.05). The levels of IL-1, IL-6 and TNF-α in the two groups were decreased after treatment, and the IL-level of the observation group was compared with that before the treatment. The levels of IL-1, IL-6 and TNF-α were significantly decreased (P<0.05). After treatment, the levels of IL-1, IL-6 and TNF-α in the observation group were significantly lower than those in the control group (P<0.05).Conclusion Wuxiang Pills combined with methotrexate are effective in the treatment of rheumatoid arthritis in patients with cold-stagnant and rheumatoid arthritis, and this method can significantly improve the levels of IL-1, IL-6 and TNF-α in patients with significant clinical effects.

陜西省社會發(fā)展科技攻關(guān)項目（2015SF057）