Clinical Curative Effect Observation Of Angelica Niantong Decoction Combined With Western Medicine On Damp-heat Type Of Active Rheumatoid Arthritis In Patients

Objective:The purpose of this study is to evaluate the clinical efficacy and safety of Angelica Niantong Decoction combined with western medicine on Damp-heat type of active rheumatoid arthritis by observing the changes of clinical indicators and related safety indicators before and after treatment,and to provide evidence for clinical application of combined treatment of traditional Chinese and Western medicine in rheumatoid arthritis.Methods:A total of 88 patients were enrolled in this study,all of whom were from Department of Rheumatology.Patients will be recruited from First Hospital Affiliated with Gansu University of Traditional Chinese Medicine,and all of them met the inclusion criteria.The 88 patients were classified into two groups consisting of 44 and 44 for the treatment and control group,respectively.The patients in control group received Methotrexate and Iguratimod administration,while the the patients in treatment group received Angelica Niantong Decoction treatment and Methotrexate and Iguratimod administration.There were12 weeks for a course of treatment.To evaluate the clinical efficacy of treatment plan by recording and comparing the changes of clinical symptoms and physical signs,TCM syndromes and laboratory indexes of the two groups of patients before and after treatment.The security of treatment plan was evaluated by monitoring blood routine,urine routine,liver function and kidney function and possible adverse reactions during medication.Data were analyzed with the aid of the statistical software SPSS,version24.0.Results:A total of 4 patients in the two groups fell off during the treatment,84 patients were finally included and completed the experimental study with 42 patients in each group.(1)Clinical efficacy and influence of TCM syndromes:The overall response rate rates of the observation group and the control group in clinical efficacy were 92.86%(39/42)and85.71%(36/42),respectively,and the difference was statistically significant(P<0.05)Comparison of TCM symptom integral of patients between the two groups.After 12 weeks,the TCM syndrome integral in the two groups were decreased when compared with the levels before treatment,and the decreasing rates of the TCM syndrome integral in the observation group were significantly lower than those in the control group(P<0.05).(2)Influence of main clinical symptoms,physical signs and scores:After treatment,the levels of joint tenderness number,joint swelling number,morning stiffness time,DAS28 score and HAQ score in the two groups were lower than those before treatment,and the decrease in the observation group was more significant than that in the control group(P<0.05).Followingtreatment,the levels of hand-grip strength in the observation group were higher than those in the control group(P<0.05).(3)laboratory index influence: ESR,CRP laboratory index levels were decreased in both groups,and there was a statistical difference before and after treatment(P<0.05),while the laboratory index level of treatment group was lower than that of control group(P<0.05).(4)Influence of adverse reactions and security: During the test,there were slight adverse reactions in the two groups.No obvious adverse reactions were found in either group during the entire study duration.No safety differences between observation and control groups were evident.(P> 0.05)Conclusion:(1)Angelica Niantong Decoction combined with western medicine treatment scheme and simple western medicine treatment scheme have better clinical effects on Damp-heat type of active rheumatoid arthritis,but the combined treatment of TCM and western medicine is more effective,can significantly improve TCM syndromes,relieve clinical symptoms,improve clinical effect,and can improve the quality of life of patients,which is worthy of clinical promotion.(2)Angelica Niantong Decoction combined with western medicine in the treatment of active RA can effectively reduce CRP,ESR inflammatory index levels,relieve disease activity,control disease development,and has low incidence of adverse reactions and good security.