来源：风湿病与关节炎,2017,6（11）:28-31,41.

通络开痹片联合甲氨蝶呤治疗类风湿关节炎临床观察（临床研究）

尚如国¹，接红宇²，钟世耀³，林昌松⁴，于清宏⁵，黄清春⁶，接力刚⁷，吴启富²

　　【摘　要】目的：观察通络开痹片联合甲氨蝶呤治疗类风湿关节炎的临床疗效，探讨中西医结合治疗类风湿关节炎的有效方案。方法：将136例寒热错杂兼瘀血阻络证类风湿关节炎患者随机分为通络开痹片治疗组（A组）、甲氨蝶呤治疗组（B组）和通络开痹片加甲氨蝶呤片治疗组（C组），3组均治疗3个月，观察各组治疗前后关节压痛数、关节肿胀数、关节疼痛度、晨僵时间、关节功能等临床指标和红细胞沉降率、C-反应蛋白、类风湿因子、抗环瓜氨酸肽抗体等实验室指标。结果：治疗后，3组患者关节压痛数、关节肿胀数、关节疼痛度、晨僵时间、关节功能、红细胞沉降率、C-反应蛋白、类风湿因子、抗环瓜氨酸肽抗体较治疗前均有显著改善（P < 0.01），且C组效果优于A、B组（P < 0.01）。结论：通络开痹片联合甲氨蝶呤治疗类风湿关节炎的疗效优于单用甲氨蝶呤或通络开痹片，是治疗类风湿关节炎的有效方案。

　　【关键词】　关节炎，类风湿；通络开痹片；甲氨蝶呤

Clinical Observation on the Treatment of Rheumatoid Arthritis with Tongluo Kaibi Pian（通络开痹片）Combining Methotrexate

SHANG Ru-guo,JIE Hong-yu,ZHONG Shi-yao,LIN Chang-song,YU Qing-hong,HUANG Qing-chun,JIE Li-gang,WU Qi-fu

　　【ABSTRACT】Objective:To explore the effective way of combining Chinese medicine and Western medicine in the treatment of rheumatoid arthritis by observing the clinical curative effect of Tongluo Kaibi Pian（通络开痹片）combining methotrexate.Methods:One hundred and thirty six cases of rheumatoid arthritis with cold and heat and blood stasis syndrome were randomly divided into Group A（treated with Tongluo Kaibi Pian）,Group B（treated with methotrexate）and Group C（treated with methotrexate combined with Tongluo Kaibi Pian）.The three groups were treated for three months.Before and after treatment,their joint tenderness,joint swelling,joint pain,morning stiffness,joint function and other clinical parameters and erythrocyte sedimentation rate,C-reactive protein,rheumatoid factor and anti cyclic citrullinated peptide antibody were observed.Results:After treatment,joint tenderness,joint swelling,joint pain,morning stiffness,joint function,erythrocyte sedimentation rate,C-reactive protein,rheumatoid factor and anti cyclic citrullinated peptide antibody in the three groups were significantly improved than those before treatment（P < 0.01）,and the effect in Group C was better than that in Group A and Group B（P < 0.01）.Conclusion:The therapeutic effect of Tongluo Kaibi Pian combined with methotrexate is better than that of each singly used in the treatment of rheumatoid arthritis.

　　【Keywords】 arthritis,rheumatoid;Tongluo Kaibi Pian（通络开痹片）;methotrexate