目的 研究金骨蓮膠囊聯(lián)合美洛昔康治療類風(fēng)濕性關(guān)節(jié)炎患者的臨床療效。方法 選擇駐馬店市中心醫(yī)院2020年1月—2021年12月收治的70例類風(fēng)濕性關(guān)節(jié)炎患者，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各35例。對(duì)照組口服美洛昔康片，7.5 mg/次，2次/d。治療組在對(duì)照組基礎(chǔ)上口服金骨蓮膠囊，2粒/次，3次/d。兩組患者均治療1個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善情況，以及C反應(yīng)蛋白（CRP）、類風(fēng)濕因子（RF）、紅細(xì)胞沉降率（ESR）、白細(xì)胞介素-17（IL-17）、IL-6和腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，治療組總有效率明顯高于對(duì)照組（91.43% vs 71.43%），兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組DAS28評(píng)分、疼痛評(píng)分、關(guān)節(jié)壓痛數(shù)和關(guān)節(jié)腫脹數(shù)比治療前均明顯下降（P＜0.05），且治療組DAS28與疼痛評(píng)分明顯低于對(duì)照組，關(guān)節(jié)壓痛數(shù)和腫脹數(shù)均少于對(duì)照組（P＜0.05）。治療后，兩組患者ESR、CRP、RF、IL-17、IL-6和TNF-α水平明顯低于治療前（P＜0.05），且治療后治療組ESR、CRP、RF、IL-17、IL-6和TNF-α水平明顯低于對(duì)照組（P＜0.05）。結(jié)論 金骨蓮膠囊聯(lián)合美洛昔康治療類風(fēng)濕關(guān)節(jié)炎的臨床效果更好，可改善患者的臨床癥狀，不增加不良反應(yīng)發(fā)生率。

Objective To study the clinical efficacy of Jingulian Capsules combined with and meloxicam in treatment of rheumatoid arthritis. Methods Patients (70 cases) with rheumatoid arthritis in Zhumadian Central Hospital from January 2020 to December 2021 were divided into control and treatment group by the random number table method, and each had 35 cases. Patients in the control group was po administered with Meloxicam Tablets, 7.5 mg/time, twice daily. Patients in the treatment group were po administered with Jingulian Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 1 months. After treatment, the clinical evaluation was evaluated, and the improvement of clinical symptom, and the levels of ESR, CRP, RF, IL-17, IL-6, and TNF-α in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was significantly higher than that of the control group (91.43% vs 71.43%), and there was significant difference between the two groups (P < 0.05). After treatment, the DAS28 score, pain score, joint tenderness, and joint swelling in two groups were significantly lower than those before treatment (P < 0.05), and the DAS28 and pain score in the treatment group were significantly lower than those in the control group, and the number of joint tenderness and swelling in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the expression level of ESR, CRP, RF, IL-17, IL-6, and TNF-α were significantly lower than those before treatment (P < 0.05). After treatment, the levels of ESR, CRP, RF, IL-17, IL-6, and TNF-α in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The clinical effect of Jingulian Capsules combined with and meloxicam in treatment of rheumatoid arthritis is better, which can can improve the clinical symptoms of patients without increasing the incidence of adverse reactions.

R977

中國(guó)藥學(xué)會(huì)全國(guó)醫(yī)藥信息網(wǎng)項(xiàng)目（CMEI2021KPYJ00145）