目的 研究白芍總苷膠囊聯(lián)合醋酸潑尼松片治療類(lèi)風(fēng)濕關(guān)節(jié)炎的臨床療效。方法 選取2019年1月-2019年10月在天津市人民醫(yī)院治療的70例類(lèi)風(fēng)濕關(guān)節(jié)炎患者，將所有患者隨機(jī)分為對(duì)照組和治療組，每組各35例。對(duì)照組患者口服醋酸潑尼松片，10 mg/次，2次/d。治療組在對(duì)照組基礎(chǔ)上口服白芍總苷膠囊，2粒/次，3次/d。兩組患者持續(xù)治療3個(gè)月。觀(guān)察兩組的臨床療效，比較兩組的關(guān)節(jié)腫脹分級(jí)、20 m步行時(shí)間、視覺(jué)模擬評(píng)分（VAS）評(píng)分、病情活動(dòng)度評(píng)價(jià)表（DAS28）評(píng)分、血清炎性因子水平。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為77.14%、94.29%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者關(guān)節(jié)腫脹分級(jí)情況顯著好轉(zhuǎn)，20 m步行時(shí)間顯著縮短（P<0.05），且治療組改善程度較大（P<0.05）。治療后兩組患者VAS評(píng)分和DAS28評(píng)分均顯著降低（P<0.05）；且治療組VAS評(píng)分和DAS28評(píng)分降低更顯著（P<0.05）。治療后，兩組類(lèi)風(fēng)濕因子（RF）、紅細(xì)胞沉降率（ESR）和C反應(yīng)蛋白（CRP）水平均顯著降低（P<0.05）；并且治療組血清炎性因子降低較多（P<0.05）。結(jié)論 白芍總苷膠囊聯(lián)合醋酸潑尼松片治療類(lèi)風(fēng)濕關(guān)節(jié)炎具有較好的療效，能夠改善患者臨床癥狀，緩解關(guān)節(jié)腫脹度和疼痛度，降低血清炎性因子水平，安全性較高，值得在臨床上推廣應(yīng)用。

Objective To study the efficacy of Total Glucosides of White Paeony Capsules combined with Prednisone Acetate Tablets in treatment of rheumatoid arthritis. Methods Patients (70 cases) with rheumatoid arthritis in Tianjin Union Medical Center from January 2019 to October 2019 were randomly divided into control and treatment groups, and each group had 35 cases. Patients in the control group were po administered with Prednisone Acetate Tablets, 10 mg/time, twice daily. Patients in the treatment group were po administered with Total Glucosides of White Paeony Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and joint swelling classification, 20 m walking time, VAS score, DAS28 score, and serum level of inflammatory factor in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.14% and 94.29%, respectively, and there was difference between two groups (P<0.05). After treatment, the grade of joint swelling in two groups were significantly improved, but 20 m walking time in two groups were significantly shortened, with significant difference between two groups (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, VAS score and DAS28 score in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the VAS score and DAS28 score in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, RF, ESR, and CRP in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum levels of inflammatory factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Total Glucosides of White Paeony Capsules combined with Prednisone Acetate Tablets has clinical curative effect in treatment of rheumatoid arthritis, can improve the clinical symptoms of patients, relieve the degree of joint swelling and pain, and reduce the serum level of inflammatory factors, with good safety, which is worthy of clinical application.

R976