Clinical Observation Of Qufeng Shengshi Decoction In Treating Rheumatoid Arthritis(Rheumatic Obstruction Syndrome)

Objective: To observe the efficacy and safety of Qufeng Shengshi Decoction combined with traditional methotrexate tablets and celecoxib capsules in treating rheumatoid arthritis(rheumatism obstruction syndrome).So as to provide theoretical basis for Qufeng Shengshi Decoction in treating RA rheumatism obstruction syndrome.Methods: Sixty RA patients who met the inclusion criteria were enrolled in the Second Affiliated Hospital of Henan University of Chinese Medicine from December 2019 to November 2020.According to random number table method,they were divided into treatment group and control group,with 30 cases in each group.The control group was given methotrexate tablets(10mg each time,once a week)and celecoxib capsules(0.2g each time,twice a day).The treatment group was given Qufeng Shengshi Decoction(200ml each time,twice a day)on the basis of the control group.After 12 weeks,the changes of clinical symptoms,physical signs,laboratory indicators,disease activity,pain scores and TCM syndrome scores were observed.SPSS26.0 software was used for statistical analysis,and the differences between the two groups were compared.Results: A total of 60 patients were included in the study,including 1 shedding case in the treatment group and 2 shedding cases in the control group.A total of 57 patients were completed.The specific results of the study are as follows:(1)In terms of alleviating clinical symptoms,the two groups were significantly improved after treatment compared with before treatment(P < 0.05).There were no significant differences in the number of joint tenderness and VAS scores between the two groups after treatment(P > 0.05).Compared with the number of joint swelling,morning stiffness time and overall health assessment,the improvement was more obvious in the treatment group(P < 0.05).(2)In terms of remission laboratory indicators,both groups were significantly improved after treatment compared with before treatment(P < 0.05).There was no significant difference in RF and ESR between the two groups after treatment(P > 0.05).The improvement of CRP in the treatment group was more significant(P < 0.05).(3)In terms of comprehensive efficacy indexes,the two groups were significantly improved after treatment compared with before treatment(P < 0.05).There was no significant difference in DAS28(ESR)between the two groups after treatment(P >0.05).The improvement of disease activity and TCM syndromes was more obvious in the treatment group(P < 0.05).(4)In terms of curative effect indexes,the comparison of western medicine’s curative effect and the evaluation of DAS28(ESR)curative effect: In the treatment group,there were 11 cases of excellent reaction,16 cases of moderate reaction,2 cases of no reaction and 0 cases of deterioration.In the control group,there were 6 cases of excellent reaction,18 cases of moderate reaction,4 cases of no reaction and 0 cases of deterioration.The efficacy of the treatment group was better than that of the control group(P < 0.05).The total effective rate of the treatment group was 89.7%,including 2 cases of clinical cure,12 cases of obvious effect,11 cases of effective and 3 cases of ineffective.In the control group,the total effective rate was 71.4%,including 0 cured,4 significantly effective,16 effective and 8 ineffective.The efficacy of the treatment group was better than that of the control group(P < 0.05).Conclusion:(1)Qufeng Shengshi Decoction combined with methotrexate tablets+celecoxib capsule and simple application of methotrexate tablets+celecoxib capsule can effectively improve the disease activity and TCM syndrome of DAS28(ESR)in patients with RA(rheumatism impediment syndrome).(2)Qufeng Shengshi Decoction combined with Methotrexate tablet + Celecoxib capsule has more advantages in improving joint swelling,morning stiffness time,CRP and TCM syndrome than simple application of methotrexate tablets+celecoxib capsule indicating that Qufengshengshi decoction has synergism.