【目的】观察自拟类风湿二方 （由黄芪桂枝五物汤加鸡血藤、宽筋藤、广东海风藤、木瓜等中药组成） 联合巴瑞替尼和 甲氨蝶呤治疗寒湿痹阻型类风湿性关节炎 （RA） 的临床疗效。 【方法】将60例寒湿痹阻型RA患者随机分为观察组和对照组， 每组各30例。对照组给予巴瑞替尼+甲氨蝶呤治疗，观察组在对照组的基础上联合自拟类风湿二方治疗，疗程为8周。观察 2组患者治疗前后中医证候积分、疼痛程度视觉模拟量表 （VAS） 评分以及红细胞沉降率 （ESR） 和血清C反应蛋白 （CRP） 、类风 湿因子 （RF） 、抗环瓜氨酸肽抗体 （anti-CCP） 等相关实验室指标的变化情况，并评价2组患者的临床疗效。 【结果】（1） 疗效方 面：治疗8周后，观察组的总有效率为93.33% （28/30） ，对照组为70.00% （21/30） ，组间比较 （χ²检验） ，观察组的疗效明显优 于对照组 （P＜0.05） 。 （2） 中医证候积分方面：治疗后，2组患者的中医证候积分均较治疗前明显降低 （P＜0.05或P＜0.01） ，且 观察组的降低幅度明显优于对照组 （P＜0.01） 。 （3） 疼痛程度方面：治疗后，2组患者的疼痛程度VAS评分均较治疗前明显降 低 （P＜0.01） ，且观察组的降低幅度明显优于对照组 （P＜0.01） 。 （4） 相关实验室指标方面：治疗后，2组患者的ESR和血清 CRP、RF、anti-CCP水平均较治疗前明显降低 （P＜0.05） ，且观察组的降低幅度均明显优于对照组 （P＜0.05） 。 【结论】自拟类 风湿二方内服联合巴瑞替尼和甲氨蝶呤治疗寒湿痹阻型RA疗效确切，可有效缓解患者的临床症状和体征，改善患者的相关 实验室指标，其疗效优于单纯西药巴瑞替尼和甲氨蝶呤治疗。

Objective To observe the clinical efficacy of self-made Rheumatoid No. 2 Formula （derived from Huangqi Guizhi Wuwu Decoction with Spatholobi Caulis， Tinosporae sinensis Caulis， Guangdong Piperis Kadsurae Caulis，Chaenomelis Fructus，etc. added） combined with Barrettinib and Methotrexate for the treatment of rheumatoid arthritis（RA） of cold-damp obstruction type. Methods Sixty patients with RA of cold-damp obstruction type were randomly divided into an observation group and a control group，with 30 cases in each group. The control group was treated with Baritinib and Methotrexate orally，and the observation group was treated with self-made Rheumatoid No. 2 Formula orally on the basis of treatment for the control group. The course of treatment covered 8 weeks. The changes of traditional Chinese medicine （TCM） syndrome score，pain visual analogue scale （VAS） score，erythrocyte sedimentation rate （ESR） ，serum C-reactive protein （CRP） ，rheumatoid factor （RF） ， anti-cyclic citrullinated peptide antibody（anti-CCP） and other related laboratory indicators in the two groups before and after treatment were observed. After treatment，the clinical efficacy of the two groups was evaluated. Results （1） After 8 weeks of treatment，the total effective rate of the observation group was 93.33% （28/30） ，and that of the control group was 70.00%（21/30） . The intergroup comparison（tested by chi-square test） showed that the efficacy of the observation group was significantly superior to that of the control group（P＜0.05） . （2） After treatment，the scores of TCM syndromes in the two groups were significantly lower than those before treatment （P＜ 0.05 or P＜0.01） ，and the decrease in the observation group was significantly superior to that in the control group （P＜0.01） . （3） After treatment，the VAS scores of pain in the two groups were significantly lower than those before treatment（P＜0.01），and the decrease in the observation group was significantly superior to that in the control group（P＜0.01） . （4）After treatment，the levels of related laboratory indicators of ESR and serum CRP， RF and anti-CCP in the two groups were significantly lower than those before treatment （P＜0.05），and the decrease in the observation group was significantly superior to that in the control group （P＜0.05） . Conclusion The self-made Rheumatoid No. 2 Formula combined with Baritinib and Methotrexate exerts certain effect for the treatment of RA of cold-damp obstruction type，which can effectively alleviate the clinical symptoms and signs of patients and improve the relevant laboratory indexes of patients. Its curative effect is superior to that of western medicine of Baritinib and Methotrexate.

R259.932

广东省中医药局科研项目 （编号：20220292）；佛山市“十四五”中医药重点专科项目 （编号：ZDZKJS35）