目的 探討尪痹膠囊聯(lián)合艾拉莫德治療類風濕關節(jié)炎的臨床療效。方法 選取2020年1月—2021年1月鄭州市中醫(yī)院收治的130例類風濕關節(jié)炎患者，隨機分為對照組（65例）和治療組（65例）。對照組患者口服艾拉莫德片，25 mg/次，2次/d。治療組患者在對照組基礎上口服尪痹膠囊，5粒/次，3次/d。兩組患者均治療12周。觀察兩組患者臨床療效，比較治療前后兩組患者主要癥狀和體征，紅細胞沉降率（ESR）、C反應蛋白（CRP）、類風濕因子（RF）和抗環(huán)瓜氨酸肽抗體（Anti-CCP）水平，腫瘤壞死因子-α（TNF-α）、白細胞介素-6（IL-6）和IL-17水平，及Th17比例、Th17/Treg值和Treg細胞比例。結(jié)果 治療后，治療組總有效率為96.92%，明顯高于對照組的87.69%（P<0.05）。治療后，兩組關節(jié)疼痛數(shù)、關節(jié)腫脹數(shù)、晨僵時間、VAS評分均較治療前降低，雙手握力上升（P<0.05），且治療組主要癥狀和體征明顯好于對照組（P<0.05）。治療后，兩組ESR、CRP、RF、Anti-CCP水平均較治療前降低（P<0.05），且治療組比對照組降低更顯著（P<0.05）。治療后，兩組TNF-α、IL-6、IL-17水平均較治療前降低（P<0.05），且治療組較對照組降低更顯著（P<0.05）。治療后，兩組Th17比例、Th17/Treg值均降低，而Treg細胞比例均上升（P<0.05），且治療組免疫功能明顯好于對照組（P<0.05）。結(jié)論 尪痹膠囊聯(lián)合艾拉莫德可以提高類風濕關節(jié)炎患者療效，改善患者臨床癥狀和體征，抑制炎癥反應，改善免疫功能，安全性高。

Objective To investigate the clinical effect of Wangbi Capsules combined with iguratimod in treatment of rheumatoid arthritis. Methods Patients (130 cases) with rheumatoid arthritis in Zhengzhou TCM Hospital from January 2020 to January 2021 were randomly divided into control (65 cases) and treatment (65 cases) groups. Patients in the control group were po administered with Iguratimod Tablets, 25 mg/time, twice daily. Patients in the treatment group were po administered with Wangbi Capsules, 5 grains/time, twice daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the main symptoms and signs, the levels of ESR, CRP, RF, Anti-CCP, TNF-α, IL-6, IL-17, Th17 ratio, Th17/Treg ratio and Treg cell ratio in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 96.92%, which was significantly higher than 87.69% of the control group (P < 0.05). After treatment, the number of joint pain, joint swelling, morning stiffness time and VAS score of two groups were significantly lower than those before treatment, and the grip strength of both hands increased (P < 0.05), the main symptoms and signs of the treatment group were significantly better than those of the control group (P < 0.05). After treatment, the levels of ESR, CRP, RF, and anti CCP in two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the levels of TNF-α, IL-6, and IL-17 in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the ratio of Th17 and Th17/Treg were significantly decreased, while the ratio of Treg cells was significantly increased (P < 0.05), and the immune function of the treatment group was significantly better than that of the control group (P < 0.05). Conclusion Wangbi Capsules combined with iguratimod can improve the clinical efficacy of patients with rheumatoid arthritis, improve clinical symptoms and signs, inhibit inflammatory reaction, improve immune function, and have high safety.

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