| Rheumatoid Arthritis (RA) is one of autoimmunity disease manifested as chronic arthritis inflammation which caused highly disabled ratio. In order to control aggravation of the disease and avert the damage of bone joints, Western medicine emphasizes the use of anti—rheumatism drugs and the combined use with other drugs, such as NSAIDs. The treatment of Traditional Chinese Medicine (TCM) in treating RA has been always focused on bian zheng shi zhi, which is the treatment on the basis of syndrome differentiation. It has already got good effect to control aggravation of the disease, to delay the development of RA and to promote life quality. Our department has been doing the research about bi for lasting twenty years and accumulated plenty of clinic experiences. Therefore, we concluded the main point of RA pathogenesy is blood obstruction caused by accumulated of damp-heat and blood stasis and it's main treatment should be set up as clearing heat, dispelling dampness and activating blood and resolving stasis. In order to explore all the possibility of treating RA which is at active stage in TCM, this study evaluate those effect which includes clinical effect, safety, patients' life quality and the final effect about TCM clinical syndrome of Qinre Huoxue therapy.In order to evaluate the clinical effect of Fengshiqing-Heji in treating RA at active stage, the studies observed 70 activity cases that had good compliance with the research project under the method of Prospective cohort study. The period of treatment was 12 weeks. Validity observation included the main index of the curative effect:ACR-20, the therapeutic effect on symptom of TCM: the secondary index: symptom/body signs, subjective index, laboratory index, survival quality HAQ measure scale and so on. Security observations mostly included bad events and analysis of the laboratory abnormal indexes. The standard of evaluating used the internationally recognized recommendation of RA disease curative effect standards-American College of Rheumatology 20% improvement criteria (ACR20),the Health Assessment Questionnaire and the joint partial symptoms and TCM syndrome assessment criterion (Chinese material new drug clinical research guidance).Conclusion:1. The comprehend index of ACR-20 showed: after 12 weeks the improvement of ACR-20 in the experience group which has 30 cases was higher than the control group which has 8 cases and the results showed that the difference was statistics significance (P<0.05). The result explained that the effect of experience group was better than the control group. The comprehend index of ACR-50 showed: after 12 weeks the improvement of ACR-50 in the experience group which has 17 cases was higher than the control group which has 4 cases and the results showed that the difference was statistics significance (P<0.05). The result explained that the effect of experience group was better than the control gourp. In the respect of disease effect this result explained that the effect of experience group was better than the control group.2. The inefficacy, availability, apparent effect ratio of experience group is 96%, 22 % and74 % ; the control group is 79%,16 %,68 %. This conclusion can explain that there was a statistics significance in the availability rate between the two groups after 12weeks (P<0.05) at the comparison of the curative effect of TCM symptoms.3. The difference was statistics significance (P<0.05) when the experience group compared to the control group on those indexes such as tenderness count, tenderness index, swollen count, swollen index, morning numb, joint functional grading, HAQ scale, evaluation on pre and past treatment from patients and doctors and so on. The difference was also statistics significance (P<0.05) when experience group compared to itself. It could be concluded that TCM treatment plans, which were used to treat RA has the better effect than the control group.4. In the respect of proving life quality the experience group could improve more effectively than the control group. That can explain that the TCM treatment not only can control the aggravation and delay the development of the disease, but also adjust patient's basis body quantity at the same time.5. On the ratio of active RA patient transferred to non-active RA patient, the experience group and the control group has 38 cases (76%)and 12 cases (63%) after 12 weeks. The difference is not of statistic significance (P>0.05) between two groups. That explained the effect of which in experience group was equivalent to the control group.6. The difference was statistics significance (P<0.05) when experience group compared to itself under those indexes such as tenderness count, tenderness index, swollen count, swollen index, morning numb, joint functional grading, HAQ scale, evaluation on pre and past treatment from patients and doctors and so on. The value of ESR of experience group was decreased obviously after 12 weeks and it's result is better than the control group. There are 26 cases (52%) transferred their ESR from abnormal to negative.7. In the respect of security the TCM treatment has some advantage over the western medical group.TCM integration plan such as Fengshiqing-Heji could effectively inhibit the inflammation, and the effect was similar to that of generally accepted western medicine therapy, the effects of which were manifested as improving joint functions, reducing the pain and swelling, promoting life quality. And what's more, TCM treatment had some potential value in the respect of delaying the development of RA. |
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