| Objective After the earlier preliminary study, external application of Compound Tripterygium wilfordii(CTW), which can clear heat and invigorate the circulation of blood, have clearly effection of treating Rheumatoid Arthritis(RA). On the basis of this, using Traditional Chinese Medicine external application, Voltaren external application, Traditonal Chinese Medicine iontophoresis method to treat RA in active stage, then discussing the efficacy of 3 methods at the corner of the different disease activity index.Method 90 RA patients in active stage were randomly divided into 3 groups:TCM external application group(30 cases), Voltaren group(30 cases) and TCM iontophoresis group(30 cases), TCM external application group and Voltaren group used CTW and Voltaren external application for each other. Placed the medicine on the top of the skin of the chosen joints, appropriated doses for appropriate parts. TCM iontophoresis group applied Qingre and Huoxue formula, put non-woven fabrics into the decoction and place it onto the skin of the chosen joints, with the electrode on, then with iontophoresis therapy. Each group treated 2 weeks. Recorded patients’sex, age and course of RA before the treatment. Recorded time of morning stiffness, counting the number of tenderness and swelling of joints, noted the VAS records of the whole disease from patients and physician at the point of 0,1 and 2 week. Recorded hemoglobin(Hb), erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) at the point of 0 and 2 week.Calculated Clinical Disease Activity Index(CDAI) at the point of 0,1 and 2 week. Calculated Disease Activity Score in 28 Joints(DAS28) and Simplified Disease Acitvity Index(SDAI) at the point of 0 and 2 week. Utilized the software SPSS 17.0 statistic the results. Compared each indexs in the 3 groups and in each group before and after the treatment. Compared the level of DAS28 reaction in each group. Analysed relativity of DAS28 with CDAI and SDAI in each group before and after the therapy.Result Before the therapy, the time of morning stiffness, the number of tenderness and swelling,the VAS scores of the whole disease from the patients and physician, Hb, ESR, CRP, DAS28, CDAI, SDAI in the three groups has no significance(P>0.05). At the end of one week, there is no significance of the indexs and scores in the three groups(P>0.05). At the end of 2 week, there is no significance of the indexs and scores in the three groups(P>0.05), but every indexs have became better than treatment before in each group(P<0.05). CTW and Voltaren external application, TCM iontophoresis can reduce the activity of RA in different degrees. After the treatment, the reaction of DAS28 in TCM external application group is higer than TCM iontophoresis group, then higer than Voltaren group. So in the aspect of improve the reaction of DAS28,CTW external application is better than Voltaren external application and TCM iontophoresis. After the treatment, DAS28 has a positive correlation with CDAI and SDAI(P<0.01) in each group, and the relevation between DAS28 and CDAI is higher than the relevation between DAS28 and SDAI. Before and after the therapy, DAS28 has better relevation with CDAI and SDAI in TCM external application group and Voltaren group, the same in TCM iontophoresis group after the treatment. DAS28 has the best relevation with CDAI,then better relevation with SDAI.Conclusion We can choose CTW and Voltaren external application, TCM iontophoresis to reduce the acitivity of RA. But from the activity index especially the reaction of DAS28, it’s more effective to use CTW external application in TCM external application relieving the patients’active situation. Reaction of DAS28 has more advantage in relieve the activity of RA. It can not only judge RA activity, but also estimate the reaction to treatment and medicine, can be widely used. As a new active index, CDAI can be more convenient appling in the clinical judgement. SDAI can be used when DAS28 can’t be calculated esily to judge the activity of RA cursorily.
|
PDF Full Text Request