| Rheumatoid arthritis (RA), cause is not clear yet, is a chronic systemic autoimmune disease, the main clinical manifestations are both side Hand joints, wrist joints, knee joints and ankle joints pain and swelling, stiffness. The disease can be caused by the destruction of cartilage and bone erosion, joint deformity, disability, and eventually loss of function and adversely impact the patient’s physiologically and psychologically. it also afects social activities and daily activity life, sometimes seriously affecting the quality of life of patients. According traditional Chinese medicine, the clinical manifestations of RA belongs to,"Arthralgia" category. Generally we believe that cold, air, damp and heat etc. Exogenous pathogens invasion, or the endogenous production of cold, pleghm, hot and humid etc. invade inside the body can cause this disease. Congenital deficiency, acquired deficiency, excessive labor, oldage kidney deficiency, after give a birth and after disease etc. can cause lack of the body’s energy, which are an important reason for this disease. The basic pathogenesis of this disease is loss of body energey, lack of Qi and blood, liver and kidney deficiency, phlegm and stasis, wind cold dampness evil all Blockage the meridian and collected in joints. The injuries of internal organs is the important reason of Arthralgia, and also results Arthralgia prolonged and dificult to treat.Objective:using the symptom score methods, study the clinical efficacy and evaluation of addition and subtraction Guizhishaoyaozhimu decoction on hot and cold mixed type rheumatoid arthritis and study on impact of quality of life of rheumatoid arthritis patients.Methods:In this study, selected60patients who met the RA diagnostic criteria, as well as the with cold and heat mixed type TCM diagnostic criteria, both completion of the study.60RA patients were randomly divided into two groups, the treatment group and the control group, each group of30patients, the treatment group is given methotrexate10mg once in a week oral+addition and subtraction Guizhishaoyaozhimu decoction; control group is given Methotrexate10mg once weekly oral+Tripterygium glycosides tablets10mg,3times a day oral; duration of treatment for each group is two months.Results:The total effective rate of treatment group is93.3%, and the control group is86.7%, both statistically significant (P<0.05). In both treatment and control groups, TCM syndromes and clinical symptoms eg. joint tenderness count, joint swollen count, two-hand grip, DAS28, HAQ, VAS score and laboratory tests improved significantly (P<0.01). Treatment group in improving TCM syndrome score, joint hot, chills, fatigue, weakness, HAQ reduce discomfort index number higher than that of the control group (P<0.05or P<0.01), the reduction in the number of the PLT is lower than the control group (P<0.05). During the treatment, none of the groups of patients have serious adverse reactions, mild adverse reaction was seen, treatment group is of3.3%, which is significantly lower than that of control group10%.Conclusion:The addition and subtraction Guizhishaoyaozhimu decoction combination with Methotrexate treatment is better than methotrexate combination Tripterygium glycosides tablets in the effect in improving the symptoms of cold and heat mixed type the RA; also can reduce patient HAQ scores, patient quality of life etc. improved significantly. At the same time, this is a safe treatment method and there is no significant side effects. |
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