目的:在使用甲氨喋呤治疗类风湿关节炎的同时,联合使用补肾祛寒治尪汤治疗肾虚寒盛证类风湿关节炎,评价其疗效与安全性。方法:选取我院符合肾虚寒盛证及类风湿关节炎诊断标准的患者100例,按照入院先后顺序将患者分组。其中西医组50例,每周两次空腹口服甲氨蝶呤;联合组50例,在服用甲氨蝶呤同时服用补肾祛寒治尪汤。两组患者均于2012年1月-2014年12月入诊,治疗20周观察疗效及其不良反应情况。结果:治疗前,两组患者关节屈伸受限个数及晨起恢复时间无明显差异(P>0.05),治疗后联合组关节屈伸受限个数及晨起恢复时间均优于西医组(P<0.05)。经过对比治疗,联合组总有效率为88.0%明显高于对比组的70.0%(P<0.05)。两组不良反应发生率相比,联合组(6%)低于西医组(26%)(P<0.05)。结论:补肾祛寒治尪汤联合甲氨喋呤治疗类风湿关节炎肾虚寒盛证疗效显著不良反应发生率低,值得临床推广。 Objective: In the use of methotrexate in the treatment of rheumatoid arthritis at the same time, the combined use of Kidney Qutan Zhiyin treatment of kidney deficiency syndrome, rheumatoid arthritis, evaluation of its efficacy and safety. Methods: Select our hospital in line with the diagnosis of kidney deficiency syndrome and rheumatoid arthritis in patients with 100 cases, according to the sequence of admission to patients. Western medicine group of which 50 cases twice weekly twice weekly oral methotrexate; combination group of 50 cases, taking methotrexate while taking Bushen Qu Han Zhi Tang. Both groups were admitted from January 2012 to December 2014, and the curative effect and adverse reactions were observed 20 weeks after treatment. Results: Before treatment, there was no significant difference between the two groups in the number of flexion and extension and the morning recovery time (P> 0.05). After treatment, the number of joint flexion and extension and the recovery time in early morning were better than those in Western medicine group (P <0.05). After comparative treatment, the total effective rate was 88.0% in the combined group, which was significantly higher than 70.0% in the control group (P <0.05). The incidence of adverse reactions was lower in the combination group (6%) than in the WM group (26%) (P <0.05). Conclusion: Bushen Quxiang Zhi Tang Decoction combined with methotrexate treatment of rheumatoid arthritis kidney deficiency syndrome has a significant effect of low incidence of adverse reactions, it is worth clinical promotion.