| Objects:According to summarizing and exploring Professor Feng’s cognitive to etiology and pathogenesis of RA (rheumatoid arthritis), characteristics of syndrome differentiation and herbal prescriptions to inherit the academic thinking and experience of RA treatment, Which have implications for clinical performance. And corroborate the clinical affection to RA treatment simultaneity.Methods:1. Through epidemiology methods, design of clinical questionnaire, paternity consultation with teachers, access to relevant data. Use the frequency analysis and Association rules.2. According to compare the DAS28and HAQ of288patients of RA, who has been treated for three months, before and after the treatment to evaluate the efficacy.Results:1. This study included288cases of RA patients; the ratio of male to female is1:8.93. The average age between the two sexes no difference to statistics.2. Predisposing factors to statistics, the top five are fatigue, withdrawal, cold, infect ion and bad feel ings; the susceptible joints are hands, wrist and knee; Local symptoms are properly pain, flexion and extension negative, swelling, morning stiffness; and the systemic symptoms of the top five are afraid of wind and cold, weak waist, thirsty, fatigue and cold extremities.3. Check Syndrome factor statistically, the common ones are blood stasis, damp and heat, phlegm stasis, qi deficiency, kidney deficiency, blood deficiency, dampness, qi stagnation; and the six common syndromes are stasis of phlegm and blood, blockage of the damp and heat, blockage of damp, deficiency of liver and kidney, deficiency of qi and blood, stagnat ion of liver qi. Further analysi s of the6clinical syndromes shows that pain and swelling of the joints are the basic performance. stasis of phlegm and blood is differenced by severe pain at night, joint sting, dark purple tongue, ecchymosis on the tongue, white coating and wiry or slippery pulse; blockage of the damp and heat is heat pain of joint, red tongue, yellow thick coating, and rapid slippery pulse; blockage of damp is increasing pain to cold and decreasing pain to heat, pale tongue, white coating, wiry or tight pulse; deficiency of liver and kidney is eak waist, virtual hot, red tongue, less coating, rapid and fine pulse; deficiency of qi and blood is minimalist looking, dizziness, fatigue, pale tongue, thin coating, deep and weak pulse; stagnation of liver qi is channeling pain, irritability, red tongue, yellow coating, fine and wiry pulse. Besides, correlation analysis showed that the DAS28is a positive correlation with blockage of the damp and heat.4. The main prescription commonly used are sishenjiin, ju a nb ltang, simiaowan, shentongzhuyutang, bazhentang, duhuoj ish engtang, danzhixiaoya osan. And the traditional Chinese medicine are Coix Seed, Angelica sinensis, Glycyrrhizae, Paeonia veitchii, Savia miltiorrhiza, Ligusticum chuanxiong, Forsythia suspense, Incised Notopterygium, Rhizoma Curcumae, and Radix Astragail. The classes of drugs commonly used are a tonic drugs, antipyretic drugs, blood circulation drugs, diuresis drugs, and anti-rheumatism medicine.5. According to the correlation analysis among symptoms, syndrome factors, syndromes, prescript ions and drugs, it founded out that the main symptoms related to lower limbs are cured by sishenjian, and related to upper limbs are cured by juanbitang, shentongzhuyutang, and bazhentang. Blood stasis is related to Angelica sinensis, Paeonia veitchii, Savia miltiorrhiza, Ligusticum chuanxiong, Rhizoma Curcumae, and Flos Carthami; damp and heat is Coix Seed, Achyranthes bidentata, Forsythia suspense, Atractylodes lancea, Lonicera Japonica, Cortex Phellodendri, and Alisma plantago-aquatica. phlegm stasis is ChineseHoney locustSpine, Prunella vulgaris, Pinellia Tuber, and Semen Brassicae; qi deficiency is Glycyrrhizae, Atractylodes macrocepha la, Radix Astragail, Root of Pilose Asiabell/Pseudostel laria heterophylla, Wolfiporia cocos and Angelica sinensis; kidney deficiency is Achyranthes bidentata, Himalayan Teasel Root, Eucommia ulmoides, Epimedium davidii, and Rhizoma Drynariae; blood deficiency is Angelica sinensis, Radix Astragail, Radix Polygalae, White Paeony Root, and Glycyrrhizae; dampness is Incised Notopterygium, Saposhnikovia divaricate, Zoacys dhumnades, Adix Aconiti Lateralis Preparata, Radix Polygalae, rhizomeof Whiteback Greenbrier, and Clematis chinensis; qi stagnation is Citrus reticulate, Rhizoma Cyperi, Root of Chnese Thorowax, Fructus Amomi, Platycodon grandiforus and Corydalis turtschaninovii; stasis of phlegm and blood is shentongzhuyutang and si shenjian; blockage of the damp and heat is simiaowan, baihutang, sishenjian, and dangguinia ntongt ang; blockage of damp is u a nbitang; deficiency of liver and kidney is duhuojishengtang and dihuangwan; deficiency of qiand blood is bazhentang; stagnation of liver qiis danzhixiaoya osan. The drugs are used to treat the syndrome of stasis of phlegm and blood is promoting blood circulation drugs and supplemented by expectorant drugs, nourishing qi drugs, and relieving drugs; blockage of the damp and heat is clearing away heat and damp drugs and supplemented by promoting blood circulation drugs, Clearing and detoxifying drugs, and relieving drugs; blockage of damp is relieving and cold-dispelling drugs and supplemented by clearing wind drugs, promoting blood circulation drugs, and nourishing qi drugs; deficiency of liver and kidney is nourishing liver and kidney drugs, and supplemented by promoting blood circulation drugs and strengthening spleen to clear damp drugs; deficiency of qi and blood is nourishing qi and blood drugs, and supplemented by dredging qi drugs; stagnation of liver qi is dredging liver qi drugs, and supplemented by promoting blood circulation drugs and relieving drugs.6. Comparing DAS28and HAQ revealed that the scores before treatment were5.58±1.39and26.84±9.81, but after the treatment they are3.96±1.06and21.24±9.66, both p<0.001. There are significant statistical differences obviously.Conclusions:In this study, based by the statistical analysis of288cases of RA patient’s data, we get a preliminary draw of the general law of professor feng about diagnosis and treatment of RA, find out the experience about pathogenesis, syndrome differentiation and herbal prescription. This study clarify objectively the view of professor fang:(1) the causes of RA are not only evil of cold, damp and heat;(2) blockage of evils is the bas ic cause of RA;(3) stas is must bealways with RA, and stasis throughout the whole courses of disease;(4) RA has six syndrome types:stasis of phlegm and blood, blockage of the damp and heat, blockage of damp, deficiency of liver and kidney, deficiency of qi and blood, stagnation of liver qi. Confirm that driving out the evils is the basic rule for the treatments of RA.According to comparing the DAS28and HAQ of288patients of RA before and after the treatment, attest to a good efficacy. |
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