Clinical Study On Treatment Of Rheumatoid Arthritis(Damp-Heat Obstruction Type)with Rebi Prescription

Objective: To observe the difference of clinical efficacy between Rebi prescription and Shirebi granule in the treatment of rheumatoid arthritis dampness-heat obstruction type,and to evaluate the clinical efficacy and safety of Hot Paralysis Formula in the treatment of damp-heat paralysis obstruction type of RA,with the expectation that this study will provide a clinical basis for the treatment of this disease in Chinese medicine and provide a new treatment strategy for RA.Methods: A single-center,randomized controlled clinical trial method was used to study 70 RA subjects who attended the orthopedic clinic of the Second People’s Hospital of Gansu Province from January 2020 to December 2020,and 70 patients who met the trial criteria were randomly and equally assigned into two groups,namely,the treatment group and the control group.The treatment group was given Hot Paralysis Formula and methotrexate tablets,while the control group was given Wet Paralysis Granules and methotrexate tablets,and was followed up after 8 weeks of treatment.The main symptoms and signs,laboratory indexes(ESR,CRP,RF,CCP),TCM evidence score,VAS score,DAS28 score,HAQ score and safety indexes of the two groups were compared before and after 8 weeks,respectively,and statistical analysis was performed using the statistical software SPSS22.0 to evaluate their clinical efficacy and safety.Results: A total of 70 patients with RA were included in this study,35 cases in the treatment group,3 cases were dropped,1 of them withdrew from the study due to personal factors,2cases were lost to follow-up,and 32 cases were finally enrolled;35 cases in the control group,2 cases were dropped,1 of them terminated the study due to the unauthorized addition of biological agents,1 case was dropped due to work travel,and 33 cases were finally enrolled.1.Comparison of baseline data: Before treatment,there was no statistical difference between the two groups in terms of gender,age,disease duration,main symptoms and signs,laboratory index,TCM symptoms score,VAS score,DAS28 score and HAQ score(P> 0.05),which were comparable.2.Comparison of the efficacy of TCM symptoms: the effective rate of the treatment group was 93.8%,and the effective rate of the control group was 81.8%,and the difference between the two groups was statistically significant(P < 0.05),and the effective rate of TCM symptoms in the treatment group was better than that in the control group.3.Comparison of main symptoms and signs and related scores: After 8 weeks of treatment,the main symptoms and signs,VAS scores,DAS28 scores and HAQ scores of patients in both groups were significantly improved compared with those before treatment,with statistical differences(P < 0.05).and the improvement of symptoms and signs and related scores in the treatment group was better than that in the control group when compared between groups(P <0.05).4.Comparison of laboratory indices: After 8 weeks of treatment,the laboratory indices of patients in both groups improved significantly compared with those before treatment,with statistical differences(P < 0.05).In comparison between groups,the treatment group was better than the control group in improving CRP and RF indexes(P < 0.05),but there was no statistically significant difference between the two groups in ESR and CCP indexes(P >0.05).5.Safety evaluation: In this study,there were 2 cases of mild gastrointestinal discomfort in the treatment group and 1 case of mildly elevated transaminases in the control group.Conclusion: Heat paralysis formula combined with methotrexate is more effective than wet heat paralysis granules combined with methotrexate in the treatment of damp-heat paralysis blocked RA,which can significantly improve the patients’ symptoms and signs,alleviate the severity of the disease and improve the quality of life.