| Purpose:Rheumatoid arthritis (RA) is a kind of chronic, progressive, aggressive arthritis as the main manifestation of systemic autoimmune diseases, to continuity, symmetry, progressive and destructive joint disease as the main feature, showing peripheral persistent joint synovitis, synovial hyperplasia, inflammatory cell infiltration, pannus formation, and then lead to progressive cartilage and bone destruction, resulting in joint deformity and loss of function, leading to different degrees of disability. As occuring in any age, extremely broad distribution, and prolonged course and recurrent, the disease has serious threat to people's health. Its etiology and pathogenesis are unclear, so for there is a lack of effective treatment. Western medicine has obvious long-term side effects, and patients have difficult to uphold. A long history of Chinese medicine treatment of RA, clinical studies have shown that the process of traditional Chinese medicine in the treatment of RA with anti-inflammatory pain, improve circulation, immune suppression, immune regulation, and has side effects, so patients are easy to adhere to. In recent years it is widely used in clinical medicine, and has made some achievements.Through this research, we observed before and after treatment in patients with rheumatoid arthritis index changes of blood circulation, did the analysis and comparison between Chinese and Western medicine therapy, to optimize treatment of this disease and provide evidence. Then further explore the process of Chinese medicine in the treatment of RA in the mechanism, and provide a new way for clinical treatment.Method:The diagnosis of 81 patients were randomly divided into 2 groups:Control group:As western medicine for the control group. Patients with oral leflunomide tablets(trade name:Arava, 10mg / film, Suzhou Long March-Xin Kai Pharmaceuticals, Inc, Zhunzi: H20000550) 10mg / time,2 times / day; Loxoprofen sodium tablets (trade name:Le Song,60mg / film, Shanghai Sankyo Pharmaceutical Co, Zhunzi:H20030769),60mg / time,2 times / day.Treatment group:Western medicine combined with traditional Chinese medicine group. In the control group on the basis of medication, plus taking prescription chinese medicine from the proposed treatment of promoting blood circulation, dispelling wind and removing obstruction (Chinese Herbal Medicine use the "small package" from Chinese Medicine Hospital of Wuhan City, which produced by Traditional Chinese Medicine Hospital of Wuhan production base), decoction,200ml / time,2 times / day.1 months as a course of treatment, and observation of a course.Application of enhanced power Doppler imaging were observed in both groups before and after treatment in patients with rheumatoid arthritis finger pulp artery peak systolic velocity (PSV), diastolic peak velocity (EDV) and vascular resistance (RI) parameters, hemorheology related indicators and changes in clinical symptoms. Then did therapeutic evaluation after the observation.Results:1. Comparison of total effective rate:The total effective rate in treatment group is 90.24%, significantly higher than the 75.00% of control group (P<0.05).2. Comparison of clinical symptoms and signs:the treatment group significantly improved clinical symptoms and signs, joint pain index, swelling index, dysfunction index decreased, duration of morning stiffness was significantly reduced, and compared with the control group improved more significantly.3. Detection of indicators improved:the treatment group pulp microcirculation index PSV, EDV, RI, hemorheology ESR, whole blood viscosity, plasma viscosity, hematocrit, platelet adhesion rate and erythrocyte electrophoresis, compared with the control group showed significant improvement.4. Security:There were no significant reduced bloodcells, liver and kidney dysfunction, gastrointestinal discomfort and other adverse reactions after the treatment.Conclusion:The methods of promoting blood circulation, dispelling wind and removing obstruction united leflunomide tablets, loxoprofen sodium tablets in patients with Rheumatoid arthritis can improve joint pain, joint swelling, joint dysfunction and other clinical symptoms and signs, can significantly reduce the ESR, whole blood viscosity, plasma viscosity, hematocrit, platelet adhesion rate and erythrocyte electrophoresis and other indicators, can significantly improve the pulp artery peak systolic velocity and diastolic peak velocity, reduced vascular resistance parameters. These studies have shown that the promoting blood circulation, dispelling wind and removing obstruction method combined with leflunomide tablets, loxoprofen sodium tablets in the treatment of rheumatoid arthritis microcirculation is effective and safe to use, and is more competitive than Western medicine alone, so it is worth for reference and application to the majority of clinicians. |
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