| Objective: To observe the effect of Qubi Tongluo Prescription on platelet parameters and D-2 polymer level of RA with cold and dampness obstruction and to explore its mechanism.Methods: Screening standard and dampness type bizu RA patients with60 cases,using random distribution,divided into the treatment group 30 cases and control group,30 cases in treatment group to remove bi only strengthen the joint celecoxib capsules,methotrexate and folic acid pills treatment,control group with celecoxib capsules,methotrexate,and folic acid pills treatment,two groups of a course of 8 weeks.The indexes of patients in the two groups before treatment,at the 4th week of treatment and at the 8th week of treatment were observed.The main clinical symptoms and signs,VAS pain score(visual analogue score,VAS),DAS28score(diseases activity score in 28 joints,DAS28),TCM symptoms of quantitative score,rheumatoid factor(rheumatoid factor,RF),c-reactive protein(C-reactive protein,CRP),blood sedimentation(erythrocyte sedimentation rate,ESR),platelet parameters and D-2 polymer,etc,at each observation node,the changes and correlations of various indexes of the two groups were compared,the influence of Qubi Tongluo Prescription on platelet parameters and d-2 polymer level was studied,and the action mechanism of Qubi Tongluo Prescription in the treatment of RA was discussed,and finally the conclusion was drawn.Results:1.TCM symptom score: Compared with before treatment,TCM symptom score at the 4th week and the 8th week of treatment were significantly decreased in both groups(P < 0.01),with statistical significance.Compared with the control group,both the 4th week and the 8th week of treatment showed a more significant decrease in TCM symptom scores in the treatment group(P < 0.05),indicating that the treatment group was better than the control group.2.VAS pain score and DAS28 score: Compared with before treatment,VAS pain score and DAS28 score in 2 groups at the 4th and 8th week of treatment were significantly decreased(P < 0.01),and the differences were statistically significant.Compared with the control group,both the VAS pain score and DAS28 score of the treatment group decreased more significantly at the 4th week and the 8th week of treatment(P < 0.05),the difference was statistically significant,indicating that the treatment group was better than the control group.3.CRP and ESR: Compared with before treatment,the CRP and ESR of patients in 2 groups were significantly decreased at the 4th week and the8 th week of treatment(P < 0.01),with statistical significance.Compared with the control group,CRP and ESR of the treatment group decreased more significantly in the 4th week and the 8th week of treatment(P < 0.05),indicating that the treatment group was better than the control group.4.RF: Compared with before treatment,the RF of patients in 2 groups at the 4th week and the 8th week of treatment decreased significantly(P< 0.01),and the difference was statistically significant.Compared with the control group,both the 4th week and the 8th week of treatment showed a more significant decrease in RF in the treatment group(P < 0.05),indicating that the treatment group was better than the control group.5.D-2 polymers: Compared with before treatment,D-2 polymer levels in 2 groups were significantly decreased at the 4th week and the 8th week of treatment(P < 0.01),and the difference was statistically significant.Compared with the control group,both the 4th week and the 8th week of treatment showed a more significant decrease in the D-2 polymer level in the treatment group(P < 0.05),indicating that the treatment group was better than the control group.6.Platelet parameters: Compared with before treatment,PLT,MPV and PDW of 2 groups at the 4th and 8th week of treatment were significantly decreased(P < 0.01),and the difference was statistically significant.Compared with the control group,PLT,MPV and PDW of the treatment group decreased more significantly at the 4th week and the 8th week of treatment(P < 0.05),indicating that the treatment group was better than the control group.However,when the PCT and P-LCR of patients in the two groups were observed at each observation node,it was found that the P values were greater than 0.05,indicating no significant difference,and it could not be concluded that the two groups’ regimen had an effect on PCT and P-LCR.7.TCM syndrome efficacy score: After treatment,the rank sum test of the two groups showed that P = 0.031 < 0.05,which was statistically significant,and the total effective rate of the treatment group was >and the total effective rate of the control group,indicating that the treatment group was better than the control group.8.Safety: During the study period,the incidence of adverse reactions was 10.00% in the control group and 3.33% in the treatment group.Adverse reactions between the two groups were examined as P > 0.05,indicating no significant difference.Conclusion:1.Qubi Tongluo Prescription can effectively improve the TCM symptoms and disease activity of cold-dampness Bi type RA,indicating that the treatment is effective;2.Qubi Tongluo Prescription can reduce CRP,ESR and other indexes,indicating that this prescription has anti-inflammatory and analgesic effects;3.Platelet parameters and D-2 polymer indexes are related to the occurrence and development of RA disease,which provides a new direction for the diagnosis and treatment of RA.4.Qubi Tongluo Prescription can decrease the indexes of PLT,MPV,PDW and D-2 polymer,indicating that this prescription can improve blood coagulation function,which may be one of the mechanisms of its treatment of RA.5.Qubi Tongluo Prescription can reduce the value of RF,indicating that this prescription can alleviate the condition of RA patients,and there is no significant adverse reaction. |
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