来源：风湿病与关节炎,2021,10（2）:23-27.

腰腿痛宁胶囊联合八段锦治疗早期类风湿关节炎42例临床观察（临床研究）

安　璐¹，刘　浪¹，赵文海²，赵长伟²，潘贵超³

　　【摘　要】目的：观察腰腿痛宁胶囊联合八段锦治疗早期寒湿痹阻型类风湿关节炎的临床疗效及对血清炎性因子的影响，为临床治疗类风湿关节炎提供新思路。方法：将84例类风湿关节炎患者分为治疗组和对照组，每组42例。治疗组给予腰腿痛宁胶囊联合八段锦治疗，对照组给予甲氨蝶呤片治疗，根据病情临时使用对乙酰氨基酚。2组均以8周为1个疗程。观察2组临床疗效，以及治疗前后红细胞沉降率（ESR）、类风湿因子（RF）、C反应蛋白（CRP）、抗环瓜氨酸肽抗体（抗CCP抗体）、肿瘤坏死因子-α（TNF-α）表达水平和中医症状指标。结果：治疗组治愈4例，显效27例，有效9例，无效2例，总有效率为95.24%；对照组治愈1例，显效22例，有效14例，无效5例，总有效率为88.10%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组ESR、CRP、抗CCP抗体、RF、TNF-α、关节肿胀度、压痛程度、疼痛数目、晨僵时间较治疗前均明显改善（P < 0.05）；除TNF-α外，治疗组以上指标均优于对照组（P < 0.05）。结论：腰腿痛宁胶囊联合八段锦可降低类风湿关节炎患者血清炎性因子的表达，从而减轻关节肿痛等临床症状，比单独使用甲氨蝶呤片更具优势，值得临床推广应用。

　　【关键词】　关节炎，类风湿；寒湿痹阻型；腰腿痛宁胶囊；八段锦；甲氨蝶呤；炎性因子；临床疗效

Clinical Observation on 42 Cases of Early Rheumatoid Arthritis Treated by Yaotuitongning Jiaonang（腰腿痛宁胶囊）Combined with Baduanjin

AN Lu,LIU Lang,ZHAO Wen-hai,ZHAO Chang-wei,PAN Gui-chao

　　【ABSTRACT】Objective:To observe the clinical efficacy of Yaotuitongning Jiaonang（腰腿痛宁胶囊）combined with Baduanjin（a set of qigong exercises originated in China）in the treatment of early rheumatoid arthritis of cold-dampness-obstruction type and their influence on serum inflammatory factors,so as to provide a new idea for the clinical treatment of rheumatoid arthritis.Methods:Eighty-four patients with rheumatoid arthritis were divided into a treatment group and a control group,42 cases in each group.The treatment group was treated with Yaotuitongning Jiaonang combined with Baduanjin,and the control group was treated with methotrexate tablets,and paracetamol was used temporarily according to the condition.Both groups were treated for 8 weeks as a course.The clinical efficacy,erythrocyte sedimentation rate（ESR）,rheumatoid factor（RF）,C-reactive protein（CRP）,anti cyclic citrullinated peptide antibody（anti-CCP antibody）,tumor necrosis factor-α（TNF-α）expression levels and TCM symptom indexes before and after treatment were observed.Results:In the treatment group,4 cases were recovered,27 cases were markedly effective,9 cases were effective and 2 cases were ineffective,and the total effective rate was 95.24%;while in the control group,1 case was recovered,22 cases were markedly effective,14 cases were effective and 5 cases were ineffective,and the total effective rate was 88.10%.The difference between the two groups was statistically significant（P < 0.05）.After treatment,ESR,CRP,anti-CCP antibody,RF,TNF-α,joint swelling degree,tenderness degree,number of joint pain,morning stiffness duration of the two groups were significantly improved（P < 0.05）,except for TNF-α,the above indexes of the treatment group was better than those of the control group（P < 0.05）.Conclusion:Yaotuitongning Jiaonang combined with Baduanjin can reduce the expression of serum inflammatory factors in patients with rheumatoid arthritis,so as to reduce the clinical symptoms of joint swelling and pain,which has more advantages than methotrexate alone,worthy of clinical application.

　　【Keywords】 arthritis,rheumatoid;cold-dampness-obstruction type;Yaotuitongning Jiaonang（腰腿痛宁胶囊）;Baduanjin;methotrexate;inflammatory factors;clinical efficacy