来源：风湿病与关节炎,2019,8（8）:14-17,35.

脊蛇祛湿胶囊联合小剂量甲氨蝶呤治疗类风湿关节炎42例临床观察（临床研究）

田　镭¹，钟　琴²，马武开²，唐明炜²，曹跃鹏²，孙贵炎¹，吕宁霁¹，彭　倩¹，

冯在亮¹

   　 【摘　要】目的：观察脊蛇祛湿胶囊联合小剂量甲氨蝶呤治疗类风湿关节炎的临床疗效。方法：将84例类风湿关节炎患者随机分为治疗组和对照组，每组42例。2组初期均给予美洛昔康片1周，对照组加服常规剂量甲氨蝶呤，治疗组加服脊蛇祛湿胶囊联合小剂量甲氨蝶呤。2组均以12周为1个疗程。观察2组临床疗效，以及治疗前后临床症状评分、实验室指标，并观察不良反应情况。结果：治疗组显效23例，有效17例，无效2例，总有效率为95.24%；对照组显效14例，有效16例，无效12例，总有效率为71.43%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组关节肿胀数、关节压痛数、医生对疾病活动性的总体评价、患者对疾病活动性的总体评价、患者对关节疼痛的评估、患者对生活能力的评估、红细胞沉降率、C-反应蛋白、类风湿因子较治疗前均有改善（P < 0.05），且治疗组优于对照组（P < 0.05）。治疗组不良反应发生率为7.14%，远低于对照组的35.71%（P < 0.05）。结论：脊蛇祛湿胶囊联合小剂量甲氨蝶呤治疗类风湿关节炎优于单纯甲氨蝶呤治疗，且能减少不良反应。

　　【关键词】　关节炎，类风湿；脊蛇祛湿胶囊；甲氨蝶呤；美洛昔康片；临床疗效

Clinical Observation on 42 Cases of Rheumatoid Arthritis Treated with Jishe Qushi Jiaonang（脊蛇祛湿胶囊）and Low-dose Methotrexate

TIAN Lei,ZHONG Qin,MA Wu-kai,TANG Ming-wei,CAO Yue-peng,SUN Gui-yan,LYU Ning-ji,PENG Qian,FENG Zai-liang

　　【ABSTRACT】Objective:To observe the clinical effect of Jishe Qushi Jiaonang（脊蛇祛湿胶囊）combined with low-dose methotrexate in the treatment of rheumatoid arthritis.Methods:Eighty-four patients with rheumatoid arthritis were randomly divided into a treatment group and a control group,42 cases in each group.Meloxicam tablets were given to both groups for 1 week at the initial stage.The control group was given routine dose of methotrexate,while the treatment group was given Jishe Qushi Jiaonang combined with low-dose of methotrexate.The course of treatment was 12 weeks for both groups.The clinical curative effect,the clinical symptom score and laboratory index before and after treatment and the adverse reaction were observed.Results:In the treatment group,23 cases were markedly effective,17 cases were effective,2 cases were ineffective,and the total effective rate was 95.24%;while in the control group,14 cases were markedly effective,16 cases were effective,12 cases were ineffective,and the total effective rate was 71.43%.There was a significant difference between the two groups（P < 0.05）.After treatment,joint swelling number,joint tender count,doctors' general evaluation of disease activity,patients' assessment of disease activity,patients' assessment of joint pain,patients' assessment of life ability,erythrocyte sedimentation rate,C-reactive protein and rheumatoid factor in the two groups were all improved compared with those before treatment（P < 0.05）.The treatment group was better than the control group（P < 0.05）.The incidence of adverse reactions was 7.14% in the treatment group,which was much lower than 35.71% in the control group（P < 0.05）.Conclusion:Jishe Qushi Jiaonang combined with low-dose methotrexate is superior to methotrexate alone in the treatment of rheumatoid arthritis,and can reduce adverse reactions.

　　【Keywords】 arthritis,rheumatoid;Jishe Qushi Jiaonang（脊蛇祛湿胶囊）;methotrexate;clinical efficacy