The Research Of Professor Chen Jifan Academic Experience In Treatment Of Rheumatoid Arthritis

Objective:Rheumatoid arthritis (RA) is a major chronic joint inflammation and the tissue around the joints becomes mainly venereal chronic systemic diseases, due to its pathogenesis is not fully understood, the purpose of the treatment or control of pain and reduce inflammation only, relieve symptoms and maintain the function of the affected joints to prevent joint deformities, improve the quality of life of patients. Because of the high morbidity of RA, thus preventing bone erosion in RA treatment is very important. Chinese medicine to the muscles, bones, joints pain, numbness flexion and extension negative, or joint swelling burning as the main clinical manifestations of the disease referred to as paralysis disease, such syndromes of unknown etiology, pathogenesis complex syndromes varied, therefore, it is hard to obtain the treatment available.Chen Jifan professors in the field of prevention and treatment of rheumatism of traditional Chinese medicine is good at using the neijing, treatise on febrile disease and synopsis "and other classic works of French drug on evidence-based medicine. Professor Chen explicitly points out that the pathogenesis of rheumatoid arthritis is " injury of bones and muscles ", its etiology is kidney deficiency of qi and blood, bones and muscles alongwith, wind, cold, dampness, heat, such as the invasion block meridian, and wind, cold, dampness, phlegm and blood stasis is the mark, liver and kidney deficiency and qi and blood is its weakness, fever, imbalance of Yin and Yang, mixed the actual phase and is the main pathological features; In addition, pay attention to integral, professor Chen syndrome differentiation treatment promoting from the differentiation, and Yin and Yang, ping ping xie, professor Chen in combination with the climate and soil characteristics of guangdong, in the treatment of pathological feature is proposed according to the different periods of different therapeutic principles and methods:in the early, middle, appropriate on treatment of breeze exorcism is given priority to, such as clear heat, qushi huoxue reduce "muscle injury and prevent bone loss; Patients with advanced liver and kidney qi deficiency, joint deformity, the pathological characteristic of muscle injury, bone damage, when benefit hepatorenal, harmonic camp guard, to prevent the further development of the injury of bones.To better summarize professor Chen Jifan academic thoughts and clinical experience, in order to explore the clinical and academic characteristics, explore its scientific connotation, and sublimation and innovation, this topic research is under the guidance of TCM theory, combined with years of experience in clinical, professor Chen objective evaluation the cane of joint TongBiLing combined Erteng tong bi mixture resist tendon injury and bone damage in the near future for the treatment of RA clinical curative effect and security, in order to better inherit the famous veteran teran doctors of TCM academic experience, to carry forward and prosperity of traditional Chinese medicine.Methods:This topic selection of parallel randomized controlled trials, small sample for sexual prospective study at the same time, the study choose between December2013and March2013, the first affiliated hospital of guangzhou university of TCM doctor inpatient and outpatient conforms to the inclusion criteria,120cases of patients with RA, the random number table method is adopted in accordance with the proportion of1will be into the group, all cases being randomly divided into treatment group and control group A and control group B and control group C, A total of four groups, guide each group patients rehabilitation exercise general treatment measures, such as massage therapy and rehabilitation treatment group given in Erteng tong bi mixture with TongBiLing therapy, the control group A with celecoxib capsules combined methotrexate treatment, control group B alone TongBiLing treatment, control group C alone Erteng tong bi mixture treatment. After12weeks of treatment, during treatment stopped all other internal and external use drugs and treatment of the disease.During treatment the DAS-28standard for clinical curative effect of observation, record each into the group of patients before and after12weeks of treatment,28in joint disease activity score (DAS-28) changes, and observe the record number of tenderness joints (TJC) in patients with degree of pain, swelling of the joints (SJC), the overall evaluation (GH) in patients with symptoms and signs of change, and in all the groups were compared before and after treatment of blood sedimentation (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and related index changes, the comprehensive curative effect evaluation, close observation during the experiment, and the objective record and treatment-related adverse events, To objective and accurate evaluate the curative effect of Erteng tong bi mixture combined TongBiLing treatment of rheumatoid arthritis (ra) resistance to muscle injury and bone damage in the near future.Results:Participate in the study of120patients were randomized, according to statistical results after four groups of patients than in factors such as gender, age, course of formation of difference has no statistical significance (P>0.05), patients with groups, in terms of gender, age and course of a fundamental equilibrium, into the group of patients before treatment contrast DAS-28score, count (SJC), tenderness joint swelling of the joints (TJC), and blood biochemical examination RF, CRP, ESR was statistically significant difference was not found, basic equilibrium tip into the group of patients, comparable; After12weeks of treatment, four groups of patnients in patients with tender joint count, swollen joint, the overall evaluatio of disease (GH), and related laboratory index (ESR, CRP, RF), etc, and compared before treatment were obviously improved (P<0.05), DAS-28standard evaluating the effect of the end, four groups of treatment effect of the treatment group respectively86.7%, control group A was76.7%, control group B were63.3%and70.0%of the control group C, the effect of treatment group is obvious superior to the other control group (P<0.05); And treatment group in improving patient DAS-28points and reduce SJC, TJC and lower ESR, CRP, RF compared with other aspects such as the control group were different significantly (P<0.05), suggesting the cane tong bi mixture combined TongBiLing RA curative effect than control group A celecoxib capsules combined methotrexate, control group B use TongBiLing pills, and the control group C alone Erteng tong bi mixture in the treatment of RA scheme is better; In terms of adverse reactions, the treatment group and control group A and control group B compared with control group C no statistically significant difference (P>0.05), prompted two Erteng tong bi mixture joint TongBiLing RA treatment security good; Control group A celecoxib capsules combined therapy with methotrexate tablets compared with control group B and control group C, control group A decrease in SJC, TJC, and reduce the effect of CRP, ESR, RF, etc were superior to control group and contrast group C, B is compared between group difference was statistically significant (P<0.05) and control group B and control group C incidence of adverse reaction is less than the control group A, but not statistical comparison, there is statistical significance (P>0.05), prompted celecoxib combined methotrexate treatment RA is more adverse effects, but in alleviating symptoms and control the condition is better than Tong BiLing alone, Erteng tongbi mixture; Control group B patients in improving patients DAS-28points and reduce SJC, TJC and lower ESR, RF, CRP and so on the above indicators, to improve compared before treatment (P<0.05), but compared with the control group C is relatively insufficient (P<0.05), in terms of adverse reactions, control group B did not see obvious difference compared with control group C (P>0.05), prompted to use the cane tong bi mixture is TongBiLing alone can better improve the symptoms of RA, control their condition, and the adverse effects. Between groups during the treatment of patients with adverse symptoms are mild, can disappear by symptomatic treatment, did not affect the duration of each group does not appear significant liver kidney function in patients with injury and adverse effects on blood cells.Conelusion:Used Erteng tong bi mixture and the TongBiLing can improve clinical symptoms of RA and control the condition, prevent muscle injury and bone damage, the adverse reaction basic quite, and Erteng tong bi mixture is better than use TongBiLing group; Tong bi mixture respectively, with two cane, TongBiLing therapeutic effect compared with celecoxib combined methotrexate is still inadequate, but the latter adverse effects are more than the use of traditional Chinese medicine treatment group; Resistant steel the injured bone as the guiding principle of the treatment group Erteng tong bi mixture combined TongBiLing contrast treatment, respectively, with Erteng tong bi mixture, TongBiLing vines, and the western medicine celecoxib combined methotrexate in the treatment of RA recent clinical curative effect more precise, can significantly improve the clinical symptoms and control the condition, can be used as the model of combination therapy of traditional Chinese medicine in clinical, and point out the direction for treat RA by TCM.