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【摘 要】目的：观察桂母湿痹消颗粒联合甲氨蝶呤治疗类风湿关节炎的临床疗效。方法：将102例类风湿关节炎患者隨机分为治疗组和对照组，每组51例。对照组口服甲氨蝶呤片（每周7.5 mg）治疗，治疗组在对照组治疗基础上加服桂母湿痹消颗粒。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压痛关节数、肿胀关节数、晨僵时间、红细胞沉降率（ESR）、C-反应蛋白（CRP）、类风湿因子（RF）、病情活动度评分（DAS28评分）。结果：治疗组临床治愈40例，显效4例，有效2例，无效5例，总有效率为90.20%;对照组临床治愈30例，显效10例，有效1例，无效10例，总有效率为80.39%。2组临床疗效比较，差异有统计学意义（P < 0.05）。治疗后，2组患者压痛关节数、肿胀关节数、晨僵时间、ESR、CRP、RF、DAS28评分较治疗前均降低（P < 0.05），且治疗组压痛关节数、肿胀关节数、ESR、CRP、RF显著优于对照组（P < 0.05）。治疗组不良反应发生率为7.84%，对照组为17.65%，2组比较，差异有统计学意义（P < 0.05）。结论：桂母湿痹消颗粒联合甲氨蝶呤治疗类风湿关节炎患者疗效确切，安全可靠，有利于改善关节症状，缓解病情，增效解毒。
【关键词】 关节炎，类风湿;桂母湿痹消颗粒;甲氨蝶呤;临床疗效
【ABSTRACT】Objective：To observe the clinical effect of Guimu Shibixiao Keli（桂母湿痹消颗粒）combined with methotrexate in the treatment of rheumatoid arthritis.Methods：One hundred and two patients with rheumatoid arthritis were randomly divided into a treatment group and a control group，51 cases in each group.The control group was treated with methotrexate tablets（7.5 mg per week），and the treatment group was treated with Guimu Shibixiao Keli based on the treatment for the control group.Both groups were treated for 12 weeks as a course.The clinical effect，tenderness joints count，swelling joints count，morning stiffness time，ESR，CRP，RF and DAS28 were observed before and after treatment.Results：In the treatment group，40 cases were recovered，4 cases were markedly effective，2 cases were effective，5 cases were ineffective，and the total effective rate was 90.20%.In the control group，30 cases were recovered，10 cases were markedly effective，one case was effective，10 cases were ineffective，and the total effective rate was 80.39%.The difference between the two groups was statistically significant（P < 0.05）.After treatment，the scores of tenderness joint count，swelling joint count，morning stiffness time，ESR，CRP，RF and DAS28 in the two groups were lower than those before treatment（P < 0.05），and the tenderness joint count，swelling joint count，ESR，CRP，and RF in the treatment group were significantly better than those in the control group（P < 0.05）.The incidence of adverse reactions was 7.84% in the treatment group and 17.65% in the control group，The difference between the two groups was statistically significant（P < 0.05）.Conclusion：Guimu Shibixiao Keli combined with methotrexate is effective，safe and reliable in the treatment of rheumatoid arthritis，improving the symptoms of the joint，relieving the disease，enhancing the curative effect and detoxification.
【Keywords】 arthritis，rheumatoid;Guimu Shibixiao Keli（桂母湿痹消颗粒）;methotrexate;clinical efficacy
【关键词】 关节炎，类风湿;桂母湿痹消颗粒;甲氨蝶呤;临床疗效
【ABSTRACT】Objective：To observe the clinical effect of Guimu Shibixiao Keli（桂母湿痹消颗粒）combined with methotrexate in the treatment of rheumatoid arthritis.Methods：One hundred and two patients with rheumatoid arthritis were randomly divided into a treatment group and a control group，51 cases in each group.The control group was treated with methotrexate tablets（7.5 mg per week），and the treatment group was treated with Guimu Shibixiao Keli based on the treatment for the control group.Both groups were treated for 12 weeks as a course.The clinical effect，tenderness joints count，swelling joints count，morning stiffness time，ESR，CRP，RF and DAS28 were observed before and after treatment.Results：In the treatment group，40 cases were recovered，4 cases were markedly effective，2 cases were effective，5 cases were ineffective，and the total effective rate was 90.20%.In the control group，30 cases were recovered，10 cases were markedly effective，one case was effective，10 cases were ineffective，and the total effective rate was 80.39%.The difference between the two groups was statistically significant（P < 0.05）.After treatment，the scores of tenderness joint count，swelling joint count，morning stiffness time，ESR，CRP，RF and DAS28 in the two groups were lower than those before treatment（P < 0.05），and the tenderness joint count，swelling joint count，ESR，CRP，and RF in the treatment group were significantly better than those in the control group（P < 0.05）.The incidence of adverse reactions was 7.84% in the treatment group and 17.65% in the control group，The difference between the two groups was statistically significant（P < 0.05）.Conclusion：Guimu Shibixiao Keli combined with methotrexate is effective，safe and reliable in the treatment of rheumatoid arthritis，improving the symptoms of the joint，relieving the disease，enhancing the curative effect and detoxification.
【Keywords】 arthritis，rheumatoid;Guimu Shibixiao Keli（桂母湿痹消颗粒）;methotrexate;clinical efficacy