标题：艾拉莫德联合金乌骨通胶囊治疗对类风湿关节炎患者临床症状及血清学指标的影响

      作者：杨波 1，董良杰 2    1.鹤壁市人民医院骨科，河南 鹤壁 458030；2.河南省中医院&河南中医药大学第二附属医院骨科，河南 郑州 450000

      卷次： 2024年35卷1期

      【摘要】 目的 观察艾拉莫德联合金乌骨通胶囊治疗类风湿关节炎患者的临床效果。方法 回顾性分析2019年2月至 2022年2月在鹤壁市人民医院就诊治疗的 70例类风湿关节炎患者的临床资料，按治疗方法不同分组，其中35例采用艾拉莫德治疗者纳入对照组，35例采用艾拉莫德联合金乌骨通胶囊治疗者纳入观察组，两组患者均治疗12周。比较两组患者的临床治疗效果，以及治疗前、治疗12周后的关节肿胀数目、关节压痛数目、症状积分、疼痛评分和血清红细胞沉降率(ESR)、白细胞介素-8 (IL-8)、骨特异性碱性磷酸(B-ALP)、类风湿因子(RF)，同时比较两组患者治疗期间的不良反应发生情况。结果 观察组患者的治疗总有效率为 94.29%，明显高于对照组的82.86%，差异有统计学意义(P<0.05)；观察组患者治疗后的关节肿胀数目、关节压痛数目分别为(3.97±1.13)个、(4.56±1.13)个，明显少于对照组的(7.42±1.97)个、(8.53±1.79)个，差异均有统计学意义(P<0.05)；观察组患者治疗后的症状积分、疼痛评分分别为(12.03±1.50)分、(12.55±3.96)分，明显低于对照组的(18.22±2.07)分、(21.56±8.31)分，差异均有统计学意义(P<0.05)；观察组患者治疗后的 ESR、IL-8、B-ALP、RF水平分别为(36.57±4.59) mm/h、(8.47±1.42) ng/L、(29.08±6.92) U/L、(43.15±13.26) U/mL，明显优于对照组的(63.22±7.25) mm/h、(11.12±1.60) ng/L、(21.57±5.96) U/L、(57.12±17.28) U/mL，差异均有统计学意义(P<0.05)；治疗期间，观察组患者的不良反应总发生率为8.57%，略高于对照组的5.71%，但差异无统计学意义(P>0.05)。结论 金乌骨通胶囊联合艾拉莫德治疗类风湿关节炎疗效较好，其不仅能改善患者的临床症状，减轻疼痛感，还能明显改善血清学指标，值得临床上借鉴应用。
      【关键词】 类风湿关节炎；艾拉莫德；金乌骨通胶囊；疼痛；临床症状
      【中图分类号】 R593.22 【文献标识码】 A 【文章编号】 1003—6350（2024）01—0048—04

Effect of iguratimod combined with Jinwu Gutong Capsule on clinical symptoms and serological indexes inpatients with rheumatoid arthritis.
YANG Bo 1, DONG Liang-jie 2. 1.Department of Orthopedics, Hebi People's Hospital,Hebi 458030, Henan, CHINA; 2.Department of Orthopedics, Henan Provincial Hospital of Traditional Chinese Medicine &the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, CHINA
【Abstract】 Objective To observe the clinical effect of iguratimod combined with Jinwu Gutong Capsule in thetreatment of patients with rheumatoid arthritis. Methods The clinical data of 70 patients with rheumatoid arthritis treat-ed in Hebi People 's Hospital from February 2019 to February 2022 were retrospectively analyzed. According to differ-ent treatment methods, 35 patients treated with iguratimod were included in the control group, 35 patients treated with ig-uratimod combined with Jinwu Gutong Capsule were included in the observation group, for 12 weeks. The clinical effica-cy, as well as number of joint swelling, number of joint tenderness, symptom score, pain score, serum erythrocyte sedimen-tation rate (ESR), interleukin-8 (IL-8), bone-specific alkaline phosphate (B-ALP), and rheumatoid factor (RF) before treat-ment and 12 weeks after treatment were compared between the two groups. The incidence of adverse reactions during treat-ment was compared between the two groups. Results The total effective rate of treatment in the observation group was94.29%, which was significantly higher than 82.86% in the control group (P<0.05). The number of joint swelling and jointtenderness in the observation group after treatment were (3.97±1.13) units and (4.56±1.13) units, respectively, which weresignificantly lower than (7.42±1.97) units and (8.53±1.79) units in the control group (P<0.05). The symptom score andpain score in the observation group after treatment were (12.03 ± 1.50) points and (12.55 ± 3.96) points, respectively,which were significantly lower than (18.22±2.07) points and (21.56±8.31) points in the control group (P<0.05). The lev-els of ESR, IL-8, B-ALP, and RF in the observation group after treatment were (36.57±4.59) mm/h, (8.47±1.42) ng/L,(29.08 ± 6.92) U/L, and (43.15 ± 13.26) U/mL, respectively, which were significantly higher than (63.22 ± 7.25) mm/h,(11.12±1.60) ng/L, (21.57±5.96) U/L, and (57.12±17.28) U/mL in the control group (P<0.05). During the treatment, thetotal incidence of adverse reactions in the observation group was 8.57%, which was slightly higher than 5.71% in thecontrol group, with no statistically significant difference (P>0.05). Conclusion Jinwu Gutong Capsule combined withiguratimod has good clinical effect in the treatment of rheumatoid arthritis. It can not only improve the clinical symp-toms of patients, reduce pain, but also significantly improve serological indicators, which is worthy of clinical referenceand application.
      【Key words】 Rheumatoid arthritis; Iguratimod; Jinwu Gutong Capsule; Pain; Clinlcal symptom