目的 探討祛風(fēng)止痛膠囊聯(lián)合重組人Ⅱ型腫瘤壞死因子受體-抗體融合蛋白治療類風(fēng)濕關(guān)節(jié)炎的臨床療效。方法 選取2020年1月—2020年12月天津中醫(yī)藥大學(xué)第一附屬醫(yī)院風(fēng)濕免疫科收治的109例類風(fēng)濕關(guān)節(jié)炎患者，按照隨機(jī)數(shù)字法分為對照組（n=54）和治療組（n=55）。對照組患者皮下注射注射用重組人Ⅱ型腫瘤壞死因子受體-抗體融合蛋白，25 mg/次，2次/周；治療組在對照組的基礎(chǔ)上口服祛風(fēng)止痛膠囊，6粒/次，2次/d。1個(gè)月為1個(gè)療程，兩組患者連續(xù)治療2個(gè)療程。觀察兩組臨床療效，比較兩組癥狀改善情況，血清炎癥因子、實(shí)驗(yàn)室指標(biāo)和不良反應(yīng)情況。結(jié)果 治療后，治療組總有效率94.55%顯著高于對照組的81.48%（P<0.05）。治療后，兩組患者關(guān)節(jié)腫脹數(shù)目、關(guān)節(jié)壓痛數(shù)目、DAS28評分和VAS評分均顯著降低（P<0.05）；治療后，治療組臨床癥狀改善情況優(yōu)于對照組（P<0.05）。治療后，兩組腫瘤壞死因子α（TNF-α）、環(huán)氧合酶-2（COX-2）、白細(xì)胞介素-β（IL-1β）、白細(xì)胞介素-6（IL-6）和C反應(yīng)蛋白（CRP）水平顯著降低（P<0.05）；治療后，治療組血清炎癥因子水平明顯低于對照組（P<0.05）。治療后，兩組患者紅細(xì)胞沉降率（ESR）、類風(fēng)濕因子（RF）、補(bǔ)體C3和C4水平均顯著降低（P<0.05）；治療后，治療組ESR、RF、C3、C4水平明顯低于對照組（P<0.05）。結(jié)論 祛風(fēng)止痛膠囊聯(lián)合重組人Ⅱ型腫瘤壞死因子受體-抗體融合蛋白治療類風(fēng)濕關(guān)節(jié)炎臨床療效顯著，可有效改善患者的反應(yīng)癥狀，降低相關(guān)炎性因子水平，并減少不良反應(yīng)的發(fā)生，值得臨床推廣。

Objective To investigate the efficacy of Qufeng Zhitong Capsules combined with recombinant human tumor necrosis factor receptor-antibody fusion protein type Ⅱ in treatment of rheumatoid arthritis. Methods A total of 109 patients with rheumatoid arthritis who were admitted to the department of rheumatology of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2020 to December 2020 were selected and divided into control group (n=54) and treatment group (n=55) according to random number method. Patients in the control group were sc administered with Recombinant Human Tumor Necrosis Factor Receptor-antibody Fusion Protein Type Ⅱ for injection, 25 mg/time, twice weekly. Patients in the treatment group were po administered with Qufeng Zhitong Capsules on the basis of the control group, 6 grains/time, twice daily. One month was one course of treatment, and the two groups were treated for two courses of treatment continuously. The clinical efficacy of the two groups was observed, and the improvement of symptoms, serum inflammatory factors, laboratory indicators and adverse reactions were compared between the two groups. Results After treatment, the total effective rate in the treatment group was 94.55% significantly higher than that in the control group (81.48%) (P < 0.05). After treatment, the number of joint swelling, number of joint tenderness, DAS28 score, and VAS score in two groups were significantly decreased (P < 0.05). After treatment, the improvement of clinical symptoms in the treatment group was better than that in the control group (P < 0.05). After treatment, the levels of tumor necrosis factor (TNF-α), cyclooxygenase-2 (COX-2), interleukin-β (1L-1β), interleukin-6 (1L-6), and C-reactive protein (CRP) in two groups were significantly decreased (P < 0.05). After treatment, the levels of serum inflammatory factors in treatment group were significantly lower than those in control group (P < 0.05). After treatment, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), complement C3 and C4 levels in two groups were significantly decreased (P < 0.05). After treatment, the levels of ESR, RF, C3, and C4 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Qufeng Zhitong Capsules combined with recombinant human tumor necrosis factor receptor-antibody fusion protein type Ⅱ has a significant clinical effect in treatment of rheumatoid arthritis, and can effectively improve the reaction symptoms of patients, reduce the level of related inflammatory factors and the occurrence of adverse reactions, which is worthy of clinical promotion.

R977

天津市科技計(jì)劃項(xiàng)目（15ZXLCSY00020）