Clinical Study On Jiawei Juanbi Decoction In Treating Rheumatoid Arthritis Of Cold-dampness Obstruction Type

Objective:The purpose of this study is to observe the clinical efficacy and safety of Jiawei Juanbi Decoction in treating rheumatoid arthritis(RA)of cold-dampness arthralgia obstruction type,and to evaluate objectively the curative effect of Jiawei Juanbi Decoction.And further explore its therapeutic mechanism,to provide theoretical basis and effective methods for the combined treatment of rheumatoid arthritis with Chinese and Western medicine.Methods:All cases were selected from outpatients and inpatients who met the diagnostic and inclusion criteria of rheumatoid arthritis(cold-dampness obstruction type)in rheumatology department of Shanxi Integrated Hospital of Traditional Chinese and Western Medicine.The collection time of cases was January 2018-October 2018.A total of58 RA patients who met the diagnostic and inclusion criteria were collected.After screening strictly according to the inclusion criteria and exclusion criteria,they were divided into treatment groups by randomized control method.The control group was treated for 12 weeks with 29 cases in the treatment group and 29 cases in the control group.During the treatment period,the control group was given leflunomide tablets(enovar),10mg/time,once a day,and diclofenac sodium sustained-release tablets,75 mg/time,once a day.The treatment group was given Jiawei Juanbi Decoction on the basis of the treatment of the control group,one dose per day,300 ml per dose,each time 150 ml was taken orally twice in the morning and evening.Observe and record the TCM syndrome score,DAS28,VAS score,ESR,CRP and other therapeutic indicators before and after treatment,and make statistical analysis to evaluate the efficacy and safety of Jiawei Juanbi Decoction combined with western medicine in the treatment of rheumatoid arthritis.In the course of clinical observation,there were 4 cases falling off,3 cases due to personal affairs and 1case with poor compliance in the two groups.Finally,54 patients completed the experiment,27 in each group.(Note: Exfoliated cases are excluded from the statistics of general data and the data before treatment of various therapeutic indicators.)Results:1.The effect on the symptoms and scores of typical clinical symptoms such as joint tenderness and swelling: Both groups could significantly improve the clinical symptoms and TCM syndrome scores,DAS28 and VAS scores,and the improvement of clinical symptoms and scores in the treatment group was better than that in the control group(P <0.05).2.Influences on laboratory indicators: In the experiment,the two groups can significantly reduce laboratory indicators(ESR,CRP,RF),and there is a significant difference between the indicators before and after treatment(P < 0.05).At the same time,after treatment,ESR and CRP in the treatment group are significantly lower than those in the control group(P < 0.05).3.The influence of TCM syndrome integral(single symptom)and TCM syndrome total integral: There was no significant difference in TCM syndrome integral between the two groups before treatment(P > 0.05),showing no statistical significance.The scores of TCM syndromes in both groups decreased significantly after treatment,and there was a significant difference compared with the scores of TCM syndromes before treatment(P <0.05);there was a significant difference in the scores of TCM syndromes between the treatment group and the control group after treatment(P < 0.05).4.The influence on the total curative effect of TCM: the total effective rate of the treatment group was 92.59% in the experiment,and the total effective rate of the control group was 81.48%.There was significant difference between the two groups(P < 0.05),and the total curative effect of TCM in the treatment group was significantly higher than that in the control group.5.Safety and adverse reactions: Blood cell analysis,liver and kidney function were closely monitored in both groups,and no obvious abnormalities were found.The incidence of adverse reactions in both groups was low and mild.Conclusion: 1.Jiawei Juanbi Decoction combined with western medicine in the treatment of RA patients with cold-dampness obstruction can effectively improve the clinical efficacy,clinical symptoms and signs,and can significantly improve the TCM syndrome of RA patients with cold-dampness obstruction,the effect is better than that of Western medicine alone.2.Jiawei Juanbi Decoction combined with western medicine can significantly reduce the laboratory acute inflammation index(ESR,CRP)of RA patients with cold-dampness obstruction type,and the improvement degree is better than that of Western medicine group.3.Jiawei Juanbi Decoction combined with western medicine in the treatment of RA patients with cold-dampness obstruction has no obvious adverse reactions and good safety.