A Clinical Observation On Active Rheumatoid Arthritis By The Moxibustion Combined Drugs Treatment

Objective:Aimed to compare the efficacy of two treatments of Active Rheumatoid Arthritis(RA) treatment with pure drug alone and moxibustion combined drugs treatment. Discussed the moxibustion combined drugs treatmetnt on the profit to improve the patients' symptoms and quality of the life, Observed the influences on the levels of Interleukin-1(IL-1),Interleukin-2(IL-2),Interleukin-4(IL-4) and Tumor Necrosis Factor-alpha(TNF-α) in serum. Investigated the mechanism and clinical effects of moxibustion combined drugs therapy in treating RA, In order to broaden the scope of moxibustion combined drugs therapy treating diseases.Method:Sixty-four patients with active RA, which all came from Rheumatology and Immunology Dept during the period of January 2010 to December 2010, paried comparison based on age, gender, disease duraion, disease condition, all cases were randomly divided into two groups,pure drug group (control group) with 31 cases and moxibusiton combined drug group(treatment group) with 33 cases. Control group was treated mainly with convertional medicine, methotrexate (MTX) tablets, once a week,10mg each time; used meloxicam(Mobic) as NSAIDs, once a day,7.5mg each time,while patients suffered severe pain,Mobic added to twice a day,7.5mg each time; and chinese herbal medicine. While treatment group was treated with moxibustion on the basis of control group,the main points are bilateral shenshu (BL-23),bilateral zusanli(ST-36) and two Ashi pionts, each point roasted 20 mins per day. Both groups were kept on treating 20 days. The main clinicl symptoms and objecitve signs(VAS scale, the joint ache degree, the number of joint tenderness, the number of joint swelling, duration of morning stiffness time,20 meters walking time,equally hold dint, TCM syndromes scores, HAQ index)were observed, the laboratory index such as C-reactive protein (CRP), immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA), erythrocyte sedimentation rate (ESR), rheumatoid factor(RF) were compared and observed ate the same time. Clinal effect was assessed with American College of Rheumatology(ACR) criterial, Disease activity score (DAS)28 score and efficacy of traditional Chinese medicine. The levels of IL-1,IL-2,IL-4 and TNF-a in serum were determined by Enzyme-linked Immunosorbent Assay (ELISA).Results:1.In terms of clinical symptoms and signs:after 20 days treatment,the indicators of both groups have certain improvement,which TCM syndrome score,the number of joint tenderness, the number of joint swelling,duration of morning stiffness,20 meters walking time,equally hold dint and VAS scale,treatment group improved better than conrol group,were significantly different (P<0.05). On the aspect of patients self-assessment and researchers assessment, treatment group improved markedly, with significant difference(P< 0.01).The two group in HAQ index was no significant difference (P>0.05).2.The disease curative effect, treatment group total effectiveness was 93.94%, control group,the total effecitive rate was 80.65%,the comparison was no significant difference between the two group (P>0.05). DAS 28 score:the treatment group improved significantly better than the control group (P<0.05). Control group had 14 cases reached ACR20,8 cases of ACR50,1 case of ACR70, treatment group had 14cases reached ACR20,12cases of ACR50 and 3 cases of ACR70, by no significant difference between the two group ((P>0.05).3. Indicators in laboratory, both groups before and after treatment compared to patients with IgM, RF and ESR were singnificantly improved, by the statistical test, there are differences(P< 0.05),the adjustment of treatment group is better than control group,there is difference ((P< 0.05).In indicators on IgG, IgA and CRP of the two groups have no significant differences (P> 0.05).4.The levels of IL-1,IL-2,IL-4 and TNF-α:After treatment,the level of TNF-αin treatment group reduce more than the control group,had a significant difference (P<0.05).There were no obviously differences in the level of IL-1,IL-2,IL-4 of the two groups after treatment (P> 0.05).5. Safety assessment:Control group of mouth ulcers and gastrointestinal symptoms in patients less thancontrol group,was statistically significant(P<0.05).6.NSAIDs taken:After treatment,17 cases of treatment group were treated with NSAIDs,14 patients stopped taking it.25cases of control group were served by NSAIDs, only 5 patients stopped taking it, by comparison,the number of non-taken NSAIDs in treatment group is more than the control group,the difference was statistically significant(P<0.05).Conclusion:1. The treatment with moxbustion combine drugs and pure drug treantment are all effecitve for active RA patients.2.The treatment with moxbustion combine drugs and pure drug treantment for active RA patients,could alleviate disease condition. The treatment with moxibustion combined drugs could alleviate more disease symptoms and signs,regulate more laboratory indicators than pure drug treatment.3.Moxibustion combined drugs treatment has a low incidence of side effects,safe and effictive.4.Moxibustion combined drugs treatment could reduce the level of TNF-αin serum.