Objective To observe the clinical effect of leflunomide combined with total glucosides of paeony (TGP) on rheumatoid arthritis (RA).Methods From September 2014 to June 2016,83 RA patients in Jiuquan People's Hospital were selected in the research,and according to time sequence seeing doctors,the patients were divided into control group (41 patients) and treatment group (42 patients).The patients of the two groups were orally given leflunomide (20 mg,1 time/d),while the treatment group was added with TGP (0.6 g,3 times/d).The patients of the two groups were treated for one month.The changes of clinical indicators such as RF,ESR,CRP,2-dimer of the two groups before and after treatment were observed.Results Before treatment,the RF,ESR,CRP,2-dimer between the two groups had no statistically significant differences (all P ＞ 0.05).After treatment,the RF,ESR,CRP,2-dimer of treatment group were (76.9 ±25.6)U/L,(18.5 ±6.3)mm/h,(15.4 ±6.3) rmg/L,(5.22 ±4.65) mg/L,respectively,which of the control group were (99.6 ±32.7)U/L,(27.8±8.6) mm/h,(21.7 ±7.8) mg/L,(14.08 ±5.76)mg/L,respectively,the differences between the two groups were statistically significant (t =3.480,5.230,4.680,4.513,all P ＜ 0.05).The total effective rate of the treatment group was 83.33 ％,which was higher than 58.54％ of the control group,the difference was statistically significant (x2 =5.330,P ＜ 0.05).Conclusion The clinical effect of leflunomide combined with TGP in the treatment of RA is better than leflunomide.

Objective To investigate the chemical constituents of Wedelia trilobata.Methods The chemical constituents were separated by chromatography and their structures were determined by physico-chemical constants and spectral analyses.Results Eleven compounds were isolated and identified as grandiflorenic acid(1),1?-acetoxy-6?,9?-dihydroxy-4,10?-dimethyl-5?H,7?H,8?H-endesm-3-en-8,12-olide(2),1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide(3),16?-hydroxy-ent-kauran-19-oic acid(4),(3R,4R,6R)-3,4-dihydroxy-1-menthene(5),trilobolide-6-O-isobutyrate(6),1?-acetoxy-4?,9?-dihydroxy-6?-isobutyroxyprostatolide(7),16?,17-dihydroxy-ent-kauran-19-oic acid(8),daucosterol(9),protocatechualdehyde(10),and caffeic acid(11).Conclusion All the compounds are isolated from W.trilobata for the first time except compounds 6 and 7.Compounds 2 and 3 are new sesquiterpene lactones,named as trilobolide A and 1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide,respectively.