目的 探討大活絡(luò)膠囊聯(lián)合美洛昔康片治療類風(fēng)濕性關(guān)節(jié)炎的臨床療效。方法 選取2018年3月-2019年10月在天津市泰達(dá)醫(yī)院就診的88例類風(fēng)濕性關(guān)節(jié)炎患者作為研究對(duì)象，按照隨機(jī)數(shù)字表法將全部患者分為對(duì)照組和治療組，每組各44例。對(duì)照組患者口服美洛昔康片，7.5 mg/次，2次/d。治療組患者在對(duì)照組治療的基礎(chǔ)上口服大活絡(luò)膠囊，1.0 g/次，3次/d。兩組患者連續(xù)治療8周。觀察兩組患者臨床療效，并比較治療前后兩組患者癥狀體征改善情況、血液流變學(xué)指標(biāo)、血清因子水平、類風(fēng)濕關(guān)節(jié)炎患者病情評(píng)分（DAS28）。結(jié)果 治療后，治療組患者的總有效率（93.18%）高于對(duì)照組（77.27%），兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的腫脹關(guān)節(jié)數(shù)、壓痛關(guān)節(jié)數(shù)、晨僵時(shí)間、VAS評(píng)分均明顯降低（P<0.05），且治療組的癥狀體征改善情況明顯低于對(duì)照組（P<0.05）。治療后，兩組的高切血液黏度、血漿黏度、血沉（ESR）、纖維蛋白原（FIB）均低于治療前（P<0.05）；治療后治療組的高切血液黏度、血漿黏度、ESR、FIB比對(duì)照組低（P<0.05）。治療后，兩組的類風(fēng)濕因子（RF）、抗鏈球菌溶血素O（ASO）、C反應(yīng)蛋白（CRP）、抗環(huán)瓜氨酸肽抗體（ACCP）水平均明顯低于治療前（P<0.05）；且治療組血清因子水平均低于對(duì)照組（P<0.05）。治療后，兩組的DAS28評(píng)分明顯降低（P<0.05），且治療組DAS28評(píng)分降低的更明顯（P<0.05）。結(jié)論 大活絡(luò)膠囊聯(lián)合美洛昔康片可提高類風(fēng)濕性關(guān)節(jié)炎的療效，減輕患者的臨床癥狀體征，降低疼痛程度，改善血流流變學(xué)水平，具有重要臨床研究?jī)r(jià)值。

Objective To explore the clinical effect of Dahuoluo capsule combined with Meloxicam Tablets in treatment of rheumatoid arthritis. Methods Patients (88 cases) with rheumatoid arthritis in Tianjin TEDA Hospital from March 2018 to October 2019 were divided into control (44 cases) and treatment (44 cases) groups according to random number table. Patients in the control group were po administered with Meloxicam Tablets, 7.5 mg/time, twice daily. Patients in the treatment group were po administered with Dahuoluo Capsules on the basis of the control group, 1.0 g/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and symptom and sign, hemorheology, serum factors, and DAS28 score in two groups were compared. Results The total effective rate of the treatment group was 93.18%, which was significantly higher than that of the control group (77.27%), and there were differences between two groups (P<0.05). After treatment, the number of swelling joints, tenderness joints, morning stiffness time, and VAS score in the two groups were significantly decreased (P<0.05). And the symptom and signs in the treatment group were significantly lower than those in the control group (P<0.05). The blood viscosity, plasma viscosity, ESR, and FIB in the two groups were significantly decreased (P<0.05). And the hemorheology indexes in the treatment group were significantly lower than those in the control group (P<0.05). RF, ASO, CRP, and ACCP in the two groups were significantly decreased (P<0.05). And the serum factors in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the DAS28 scores in two groups were significantly decreased (P<0.05). And the DAS28 scores in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Dahuoluo capsule combined with Meloxicam Tablets can improve the curative effect of rheumatoid arthritis, reduce the clinical symptoms and signs and pains, and improve the level of hemorheology, which has important clinical research value.

R977

天津市濱海新區(qū)衛(wèi)生局科技項(xiàng)目（2014BWKY013）