Meta Analysis Of The Curative Effect Of Duhuojisi Decoction Combined With Conventional Western Medicine In The Treatment Of Rheumatoid Arthritis

Purpose:To conduct a meta-analysis of a number of independent studies on the clinical efficacy of Duhuo Jisheng Decoction plus conventional western medicine in the treatment of rheumatoid arthritis,and to explore its clinical efficacy,adverse reactions,and CRP,ESR,joint swelling,and joint tenderness.Impact,providing evidence-based evidence for clinical treatment and research of rheumatoid arthritis.Materials and Methods:A systematic and randomized controlled trial of the use of Duhuo Jisheng Decoction combined with western medicine for rheumatoid arthritis and conventional western medicine as a control group was collected and evaluated.The domestic search database used has Wanfang data resource statistics(WF,1992-2018),China Knowledge Network database(CNKI,1992-2018),VIP database(VIP,1992-2018),and China Biomedical Literature Database(CBM,1992).-2018),etc.;foreign medical databases include Pubmed(1992-2018),EMBASE database(1992-2018),and Cochrane(1992-2018)library.Through the retrieval system,a comprehensive randomized controlled study of the treatment of rheumatoid arthritis with Duhuosheng Decoction combined with conventional western medicine was conducted,and the quality of the literature was evaluated through strict inclusion criteria and exclusion criteria.Meta-analysis was performed using statistical software Revman Manager5.3.Results:A total of 18 articles mentioned efficiency,and the meta-analysis showed:Chi2=7.34,df=17(P=0.98);I~2=0%,OR=4.32,95%CI[3.16,5.91],Z=9.19(P<0.00001)Explain that the effectiveness of Duhuo Jisheng Decoction combined with conventional western medicine in the treatment of rheumatoid arthritis is better than the simple application of conventional western medicine.A total of 12 articles mentioned CRP as an observation index.The meta-analysis showed that Chi2=19.08,df=11(P=0.06),I~2=43%,SMD=0.57,95%CI[0.41,0.74],Z=6.68(P<0.00001).It is indicated that Duhuo Jisheng Decoction combined with conventional western medicine for rheumatoid arthritis is superior to traditional western medicine in reducing CRP laboratory index.A total of 13 articles mentioned ESR as an observation index.The meta-analysis showed that Chi2=44.07,df=12(P<0.0001),I~2=73%,SMD=8.21,95%CI[6.53,9.89],Z=9.57(P<0.00001).It is indicated that Duhuo Jisheng Decoction combined with conventional western medicine for rheumatoid arthritis is superior to the simple application of conventional western medicine in reducing ESR laboratory indicators.A total of 10 articles mentioned the number of joint tenderness as an indicator,and the meta-analysis showed.Chi2=21.71,df=9(P=0.01),I~2=59%,SMD=0.52,95%CI[0.30,0.75],Z=4.60(P<0.00001).It is indicated that Duhuo Jisheng Decoction combined with conventional western medicine for rheumatoid arthritis is superior to traditional western medicine in improving the number of joint tenderness.A total of 10 articles mentioned the number of joint swelling as an indicator,and the meta-analysis showed.Chi2=28.12,df=9(P=0.0009)I2=68%SMD=0.49,95%CI[0.23,0.74],Z=3.78(P=0.0002).It is indicated that Duhuojisheng Decoction combined with conventional western medicine for rheumatoid arthritis is better than traditional western medicine in improving the number of joint swelling.A total of 2 articles mentioned the DAS28 score,and the meta-analysis showed:Chi2=2.96,df=1(P=0.09)I2=66%,SMD=0.52,95%CI[0.06,0.99],Z=2.20(P=0.03).It is indicated that Duhuo Jisheng Decoction combined with conventional western medicine for rheumatoid arthritis is better than traditional western medicine in improving DAS28 score.A total of 9 reports of adverse reactions occurred.The meta-analysis showed:Chi2=7.55,df=6,(P=0.27),I2=21%,RR=0.47,95%CI[0.33,0.66],Z=4.22(P<0.0001).There is a statistical difference,and the incidence of adverse reactions of Duhuo Jisheng Decoction combined with conventional western medicine in the treatment of rheumatoid arthritis is less than that of western medicine alone.Conclusion:1.The effective rate of the treatment of rheumatoid arthritis with the addition and subtraction of Duhuojisheng Decoction combined with conventional western medicine,CRP and ESR laboratory indicators are better than the conventional Western medicine alone.2.The combination of Duhuojisheng Decoction combined with conventional western medicine in the treatment of rheumatoid arthritis DAS28 score,improvement of joint swelling number and joint tenderness clinical symptoms are superior to conventional western medicine alone.3.Compared with conventional western medicine and conventional western medicine for the treatment of rheumatoid arthritis,Duhuo Jisheng Decoction has higher safety tolerance and lower adverse reaction rate,which is worthy of promotion.