| Objective:1.Literature research of the TCM treament laws for rheumatoid arthritis:Retrieval related literature of the Chinese medicine treatment for rheumatoid arthritis;Explore the treament laws.2.Clinical observation study on rheumatoid arthritis:under the guidance of the TCM treament laws for rheumatoid arthritis,choose to add Jiawei Sishenjian and the Guizhi Shaoyao zhimu soup,comparing the difference of the curative effect on the not type rheumatoid arthritis.Methods:1.Literature research of the TCM treament laws for rheumatoid arthritis:select the literatures of the past 30years which published on CNKI and are all related to“rheumatoid arthritis”、”arthralgia”、”bi disease”as the object of study,set up database,combine the Chinese medicine theory,through the analysis of frequency,probe into the treament laws for rheumatoid arthritis.2.Clinical observation study on rheumatoid arthritis:Collect the RA patients who in treatment in shanxi university of Chinese medicine affiliated hospital during september 2015 to september 2016,and are corresponding to diagnosis standards.divide them into Sishenjian group and Shaoyao Zhimu Soup group randomly.The treatment course for both of them are 12 weeks,we will observe the western medicine index CRP,ESR,RF,DAS28,the change of TCM symptoms integral,and the side effect before and after the treatment,evaluate its curative effects.Results:1.Literature research of the TCM treament laws for rheumatoid arthritis:(1)On the TCM syndrome type distribution,the top five syndromes cold heatjumble,rheumatic fever,liver and kidney deficiency,cold and dampness and damp heat blockage type,the most common of which cold heatjumble,accounting for19.31%.(2)On the prescription uses,we have 290 pieces of eligible prescriptions,the classical prescriptions are 9.85%,the current prescriptions are 12.55%,andthe self-prescriptions are 77.65%(3)On the medcine uses,they totaly use 264 wei Chinese medince;the usage frequency above 1%have 33 wei,for example:Danggui,Guizhi,Huangqin etc;Matched pair medicine have Duhuo with Qianghuo,Guizhi With Baishao etc;about medicine type,divided into 19 types,Buxu、curing rheumatism、resolving the exterior、promoting blood circulation to remove blood stasis and clearing heat aremostwildly used,thefrenquency is 81.63%;as about special used medicine,insect medicine 26 wei,had been used 335times;cany medicine 30 wei,had been used 289 times.2.Clinical observation study on rheumatoid arthritis:(1)On the treatment effecitive rate,the Jiawei Sishenjian group is 77.72%,the Guizhi Shaoyao Zhimu group is 71.43%,the comparison between these two have no statistical significance(P>0.05).(2)On the western medicine index,(1)in imoroving GRP,compared with the Jiawei Sishenjian group before treatment,the treatment in the 6th week and in the 12~thh week have statistical significance(P<0.05),reminding that Jiawei Sishenjian group have effect on reduce CRP,the comparision between before and after treatment of Guizhi Shaoyao Zhimu soup has no statistical significance,the comparision between groups also has no statistical significance.(2)In improving ESR,compared with the Guizhi Shaoyao Zhimu Soup group during the 12~thh week treatment,the comparison between the two groups have significant difference(P<0.05),reminding that Guizhi Shaoyao Zhimu Soup group is better than the Jiawei Sishen Group in the aspect of improving ESR;Compared with before treatment,the two groups before and after treatment have no statistical significance(P>0.05).(3)In improving RF,compared with the Guizhi Shaoyao Zhimu Soup group during the 6th week treatment,the comparison between the two groups have statistically significant(P<0.05),remindingthat Jiawei Sishenjian Group is better than Guizhi Shaoyao Zhimu Group;Compared with before treatment,the treatment in6th week and in 12th week between two groups have no statistical significance(P>0.05);compared with the Guizhi Shaoyao Zhimu Soup group before treatment,the treatment during the 12~thh week have statistically significant(P<0.05),reminding that have effect on reducing RF,the comparision between before and after treatment of Jiawei Sishenjian Group has no statistical significance,the comparision between groups also has no statistical significance.(P>0.05).(4)On the aspect of DAS28 activity,compared with the Jiawei Sishenjian group before treatment,the treatment after6 weeks and after 12 weeks are all have statistical significance(P<0.05);compared with the Guizhi Shaoyao Zhimu Soup group after treatment,the treatment after 6 weeks and after 12 weeks are all have statistical significance(P<0.05),reminding that they all improve the activity,but the comparision between groups has no statistical significance(P>0.05).(3)on the Chinese medcine symptom score(1)In improving joint flexion and extension adverse,compared with the Guizhi Shaoyao Zhimu Soup group before treatment,the treatment in the 6~thh week and the12~thh week are all have statistically significant(P<0.05),reminding that Guizhi Shaoyao Zhimu Soup have positive effect on joint flexion and extension adverse,Jiawei Sishenjian Group has no statistical significance(P>0.05)between before and after treatment,Compared with the Guizhi Shaoyao Zhimu Soup group during the 12~thh week treatment,the comparision between the two groups has statistically significant(P<0.05),reminding that Jiawei Sishenjian Group is better than Guizhi Shaoyao Zhimu Soup.(2)In improving joint pain,local fever,and joint tenderness,compared with before treatment,both of the two groups in the 6th week and the 12th week have statistically significant(P<0.05),reminding that they both can improve the effect,and the comparision between groups have no statistical significance(P>0.05).(3)In improving morning stiffness and joint swelling,compared with before treatment,the treatment in the 12th week both of the two groups have statistical significance(P<0.05),reminding that both of them have positive effect,the comparision between two groups have no statistical significance(P>0.05).Compared with the Jiawei Sishenjian group before treatment,the treatment during the 6th week has statistical significance(P<0.05)in improving joint swelling,Guizhi shaoyao zhimu soup group and the comparision between groups have no statistical significance(P>0.05)(4)In Safety observation,there are 6 cases met side effect,matched group 2cases,The two groups are all remission after take medicine.Conclusion:1.On account of the literature research of the TCM treament laws for RA,we reached the following conclusions:(1)On the type distribution,not type was the most common.(2)On the prescription uses,the self-prescriptions are the most.(3)On the medcine uses,the high frenquency single herbs are:Danggui,Guizhi,Huangqin etc;the high frenquency Matched pair medicine are Duhuo with Qianghuo,Guizhi With Baishao etc;As about the medicine type,Buxu、curing rheumatism、resolving the exterior、promoting blood circulation to remove blood stasis and clearing heat are most common,on the basic of syndrome differentiation,add some insect medicine and some cany medicine can help to improve effect.2.Jiawei Sishenjian and Guizhi Shaoyao Zhimu Soup are all have posive effect on curing not type RA.The western medicine index of the patients before and after treatment,for example CRP、ESR、RF,DAS28.Are all have some improvment,the symptoms in Chinese medcine symptom score are also relived.Guizhishaoyaozhimu Decoction group in the improvement of ESR is better than that of Jiawei sishenjian group;Jiawei sishenjian group in improving RF and joint flexion and extension aspects better than Guizhishaoyaozhimu Decoction group. |
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