Clinical Study On Modified Wutou Decoction Combined With Time-Selective Moxibustion In The Treatment Of Rheumatoid Arthritis Of Cold-Dampness Bizhong Type

Objective: To observe the improvement of clinical symptoms and signs,VAS score,DAS28 score and related laboratory examination index of rheumatoid arthritis of cold dampness Bi obstruction type by modified Wutou decoction combined with Moxibustion in time selection,and to explore its clinical effect,so as to provide reference for clinical treatment of rheumatoid arthritis of cold dampness Bi obstruction type.Methods: from March 2018 to June 2019,60 patients with rheumatoid arthritis of cold dampness Bi obstruction type were selected from the outpatient department and inpatient department of Rheumatology and immunology of Ruikang Hospital Affiliated to Guangxi University of traditional Chinese medicine.After numbering,they were randomly divided into control group and treatment group with 30 cases in each group.The control group was treated with methotrexate 10 mg / time,1 time / week,leflunomide 20 mg / time,1 time / day,and diclofenac sodium double release enteric coated capsule 75 mg / time,1 time / day.The treatment group was treated with Aconitum Decoction on the basis of Western medicine and moxibustion at 7:00-9:00 and 17:00-19:00 every day for 8 weeks.Before and after treatment,the improvement of joint symptoms and signs,28 joint disease activity scores,10 cm visual pain simulation scores,ESR,C-reactive protein,rheumatoid factor,anti cyclic citrullinated peptide antibody,interleukin-6,TCM syndrome curative effect,clinical disease curative effect and adverse reaction rate of the two groups were collected,and the indexes before and after treatment were compared To evaluate the therapeutic effect.Results:(1)there were 30 cases in the treatment group,28 cases completed and 2 cases dropped.In the control group,30 cases were completed.(2)The total effective rate of the treatment group was 92.86%,which was significantly higher than that of the control group(73.33%)(P < 0.05).(3)The total effective rate of TCM syndromes in the treatment group was89.29%,and that in the control group was 70%,which was significantly higher than that in the control group(P < 0.05).(4)In terms of joint symptoms and signs,the two groups can effectively improve the patients’ joint tenderness index,joint tenderness number,joint swelling number,morning stiffness time,average grip strength of hands and 15 m walking time(P < 0.05),but the improvement of symptoms and signs in the treatment group is significantly better than that in the control group(P < 0.05).(5)After treatment,DAS28 score and VAS score of the two groups were significantly improved(P < 0.05),and the improvement of the treatment group was better than that of the control group(P < 0.05).(6)The indexes of ESR,C-reactive protein,rheumatoid factor,anti cyclic citrullinated peptide antibody and interleukin-6 in the two groups were all decreased(P < 0.05).The decrease of the treatment group was significantly better than that of the control group(P <0.05).(7)The incidence of adverse reactions was 13.33% in the control group and 7.14% in the treatment group.The incidence of adverse reactions in the treatment group was significantly lower than that in the control group(P <0.05).Conclusion: 1.Wutou decoction combined with selective moxibustion is superior to methotrexate alone and leflunomide alone in the treatment ofrheumatoid arthritis of cold dampness Bi obstruction type.2.In the treatment of rheumatoid arthritis of cold dampness Bi obstruction type,Wutou decoction combined with moxibustion at the right time is better than methotrexate and leflunomide in the control of inflammation index.Aconitum decoction combined with moxibustion is effective and has less adverse reactions.