目的 探討骨瓜提取物注射液聯(lián)合洛索洛芬鈉片治療類風(fēng)濕性關(guān)節(jié)炎的臨床療效。方法 選取2020年7月—2022年10月北京中醫(yī)醫(yī)院懷柔醫(yī)院收治的85例類風(fēng)濕性關(guān)節(jié)炎患者，按計(jì)算機(jī)隨機(jī)排列將所有患者分為對(duì)照組（42例）和治療組（43例）。對(duì)照組患者口服洛索洛芬鈉片，60 mg/次，3次/d。治療組在對(duì)照組治療的基礎(chǔ)上靜脈滴注骨瓜提取物注射液，50 mg加入250 mL 5%葡萄糖注射液中充分稀釋，1次/d。兩組患者連續(xù)治療30 d。觀察兩組的臨床療效，比較兩組的晨僵時(shí)間、關(guān)節(jié)壓痛數(shù)、關(guān)節(jié)腫脹數(shù)、視覺模擬評(píng)分法（VAS）評(píng)分以及血清類風(fēng)濕因子（RF）、抗環(huán)瓜氨酸肽抗體（抗CCP抗體）、抗突變型瓜氨酸波形蛋白抗體（抗MCV抗體）、中高遷移率族蛋白B1（HMGB1）、基質(zhì)金屬蛋白酶-2（MMP-2）、白細(xì)胞介素-33（IL-33）水平。結(jié)果 治療后，治療組患者的總有效率88.37%明顯高于對(duì)照組的總有效率69.05%（P<0.05）。治療后，兩組的晨僵時(shí)間、關(guān)節(jié)壓痛數(shù)、關(guān)節(jié)腫脹數(shù)、VAS評(píng)分明顯低于治療前（P<0.05），且治療組晨僵時(shí)間、關(guān)節(jié)壓痛數(shù)、關(guān)節(jié)腫脹數(shù)、VAS評(píng)分較對(duì)照組更低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的RF、抗CCP抗體、抗MCV抗體水平均顯著降低（P<0.05），治療組RF、抗CCP抗體、抗MCV抗體水平均較對(duì)照組降低更明顯，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的血清HMGB1、MMP-2、IL-33水平低于治療前（P<0.05），且治療組的血清HMGB1、MMP-2、IL-33水平低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 骨瓜提取物注射液聯(lián)合洛索洛芬鈉片治療類風(fēng)濕性關(guān)節(jié)炎療效好，能顯著減輕患者癥狀體征，控制病情發(fā)展，減輕炎癥反應(yīng)，治療安全性良好。

Objective To investigate the clinical effect of Gugua Extractives Injection combined with Loxoprofen Sodium Tablets in treatment of rheumatoid arthritis. Methods Patients (85 cases) with rheumatoid arthritis in Beijing Huairou Hospital of Traditional Chinese Medicine from July 2020 to October 2022 were divided into the control group (42 cases) and the treatment group (43 cases) according to the computer random arrangement method. Patients in the control group were po administered with Loxoprofen Sodium Tablets, 60 mg/time, three times daily. Patients in the treatment group were iv administered with Gugua Extractives Injection on the basis of the control group, 50 mg added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacies were evaluated, and the morning stiffness time, joint tenderness number, joint swelling number, VAS score, the levels of RF, anti-CCP antibody, anti-MCV antibody, HMGB1, MMP-2, and IL-33 in two groups were compared. Results After treatment, the total effective rate of 88.37% in the treatment group was significantly higher than that of 69.05% in the control group (P < 0.05). After treatment, the morning stiffness time, joint tenderness number, joint swelling number, and VAS score of two groups were significantly lower than those before treatment (P < 0.05), and the morning stiffness time, joint tenderness number, joint swelling number, and VAS score in the treatment group were lower than those in the control group (P< 0.05). After treatment, the levels of RF, anti-CCP antibody, and anti-MCV antibody in two groups were significantly decreased (P < 0.05), and levels of RF, anti-CCP antibody, and anti-MCV antibody in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of HMGB1, MMP-2, and IL-33 in two groups were lower than those before treatment (P < 0.05). The serum levels of HMGB1, MMP-2, and IL-33 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Gugua Extractives Injection combined with Loxoprofen Sodium Tablets is effective in treatment of rheumatoid arthritis, can significantly reduce the symptoms and signs of patients, control the disease, reduce the inflammatory reaction, with good safety.

R982