| Objectives:1.Clinical research:Through the analysis of the clinical features of RA patients with Cold-heat Complex of RA,to improve the understanding of the clinical features of RA patients with Cold-heat Complex of RA,provide evidence-based evidence for clinical diagnosis and treatment.2.Systematic review:systematic evaluation of Guizhi Shaoyao Zhimu Decoction in the treatment of rheumatoid arthritis efficacy and safety.Methods:1.Clinical Research Section:A retrospective survey of 217 patients with RA who were admitted to the Affiliated Hospital of Shandong University of Traditional Chinese Medicine between July 2014 and December 2017 and satisfied with the criteria of sub-standard.According to the diagnostic criteria of cold and heat complex syndromes are divided into 39 cases of cold and heat complex syndrome group and 178 cases of non-cold and heat complex syndrome group,including clinical data collected,including gender,age of onset,duration,morning stiffness,fatigue,joint swelling,joint tenderness DAS28 score,laboratory indexes(hemoglobin,platelet,ESR,CRP,CCP,RF)were analyzed.2.System evaluation part:Chinese as"Guizhi Shaoyaozhimu Tang","rheumatoid arthritis""Guizhi""peony""Anemarrhenali""rheumatoid""randomized group""clinical trial""Randomized controlled trials"in English as"Gui-zhi-shao-yao-zhi-muDecoction","GSZD,""Cassia Twig,""Guizhi,""Paeonia lactiflora,""Shaoyao,""Anemarrhena Rhizome,""Zhimu PubMed,EMBASE,Cochrane Library,Chinese Journal Full-text Database(CNKI),Chinese Science and Technology Periodicals Full-text Database(VIP),""rheumatoid arthritis,""randomized,""controlled trial,""clinical trial.VIP database,Wanfang database and other domestic and foreign full-text databases.The RCT of RA treated by Guizhi Shaoyao Zhimu Decoction was used as the research object,and the software Revman5.3 provided by the Cochrane Collaboration was used for statistical analysis.Results:1.Clinical research:(1)In 217 cases of RA patients,39 patients(17.9%)had an average age of 47.15 ± 15.51 years with an average duration of 12.09 ± 11.65 years.(2)There were 19 cases of fatigue in 39 patients with cold and heat syndrome(48.7%),24 cases without morning stiffness(61.5%)and 21cases(53.8%(P<0.05).There were no significant differences in the number of tender joints,swollen joints,joint function scores,and the incidence of joint deformities between the two groups(p>0.05).(3)The mean levels of HB,PLT,ESR,CRP,RF,CCP,DAS28 in 39 patients with cold-hot and complicated RA were 115.21 ± 18.325,272.49 ± 101.782,46.08 ±28.694,23.26±30.002,208.82±322.852,457.67±525.601,4.52±1.244,among which the results of PLT,CRP,RF and DAS28 were statistically significant(P<0.05)2.Meta analysis showed that the combined effect of Guizhishaoyaozhimu Decoction for the treatment of rheumatoid arthritis was based on the fixed effects model and the effect of combined values [RR=3.49,95%CI(2.15,5.67)],P<0.001<0.05,the results were statistically significant.The combined effect of different groups of Fang Guizhi Shaoyao Zhimu Decoction for the treatment of rheumatoid arthritis was based on a randomized effect model with a combined effect value[RR=3.49,95%CI(2.15,5.67)],P<0.001,with statistical significance significance.A total of 2 adverse reactions were reported in 6patients,accounting for 3%,which was significantly lower than that of the control group(p<0.05).Conclusion:1.Clinical study:The 217 patients were included in the study,the proportion of men with cold-heat Complex of RA RA is relatively high,the first symptom is more likelyto attack the large joints,clinical symptoms are more likely to appear fatigue,and the relative incidence of morning stiffness symptoms is relatively low.Cold and heat of the RA patients with CRP and platelet levels,rheumatoid factor,DAS28 levels are relatively low,suggesting that patients with cold and hot miscellaneous than ordinary RA patients with low inflammatory response and low disease activity characteristics.Cold and heat miscellaneous patients in the age of onset,duration,tenderness and swollen joints,joint deformity and ESR,CCP,hemoglobin levels and other indicators of RA patients with no significant difference.2.Meta analysis:Guizhi Shaoyaozhimu Tang alone or in combination with Western medicine,the effective rate of different prescriptions are superior to western medicine control group and has the advantage of safety comparison,and found that Guizhi Shaoyaozhimu Decoction for reducing The effect of inflammatory response is good,and some of the symptoms have some effect of remission,but due to the quality of the literature included in general,the number is small,the validity of the conclusions still need to be investigated,the need for further large sample,multi-center RCT study To be confirmed. |
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