A Clinical Study On The Treatment Of Two Kinds Of Inflammatory Arthropathy By A Shuganyunpi Method Guided By The Theory Of "Treating Different Diseases With Same Method"

Objective: This study applies a method of Shuganyunpi to treat rheumatoid arthritis(RA)and ankylosing spondylitis(AS)under the guidance of a “treating different disease with same method” theory.The aim is to explore the feasibility of applying this theory to the treatment of inflammatory arthropathy.By summarizing this method,it may provide a new idea in treating rheumatism,especially inflammatory arthropathy.Methods: We sampled a total of 72 cases in the rheumatism department and inpatient of Long Hua Hospital Shanghai University of TCM from January 2017 to November 2018,including 36 RA patients and 36 AS patients,whom be with liver-spleen disharmony.Each group was treated with Shu Gan Yun Pi Fang combined with conventional medical therapy,and each course of treatment lasted 12 weeks.Before and after treatment,the following items were observed: the TCM syndrome integral,the therapeutic effect assessment indices of disease(RA group:DAS28,ACR20,ACR50;AS group:ASDAS,ASAS20,ASAS40),the inflammation markers(ESR,CRP)and the security indicators(blood routine,urine routine,liver and kidney functions),to evaluate the clinical efficacy and safety of treating this two kinds of inflammatory arthropathy by Shu Gan Yun Pi Method.Results: 1.Curative effect of TCM syndrome: After treatment,the TCM syndrome integral and TCM syndrome integral(3 symptoms)of each groups were significantly improved(P < 0.001).The total effective rate was 91.7% in RA group and 88.9% in AS group.The difference between before and after treatment was statistically significant(P<0.05),and the overall improvement of RA patients was more significant than that of AS.2.Curative effect of disease: RA group: DAS28 in all patients were decreased after 12 weeks of treatment,and the total remission rate of DAS28 was 63.9%.After treatment,the count of tender and swollen joint,the patients' self-evaluation of pain and overall condition,the doctors' overall condition score and health assessment questionnaire were significantly improved compared with those before treatment(P < 0.001).There were 24 patients reached in the ACR20 standards(66.7%)and 6 patients reached in the ACR50 standards(16.7%).AS group: ASDAS in 29 patients were decreased after 12 weeks of treatment-,including 10 patients with clinical important improvement and 1 patient with significant improvement.After treatment,the overall evaluation of patients' conditions,spinal pain score,BASFI score and spinal inflammation score were significantly improved compared with those before treatment(P <0.001).There were 19 patients reached in the ASAS20 standards(61.1%)and 4 patients reached in the ASAS40 standards(11.1%).There was no significant difference of the compliance rate of ACR20/ASAS20 between the two groups(P > 0.05).3.Inflammatory markers: After treatment,the numbers of patients with high ESR in each group was significantly lower than before treatment(P<0.05).ESR values improved in both groups,and the ESR of AS group was obviously superior to it of RA group,the differences were statistically significant(P<0.05).The CRP improvement was not significant between before and after treatment in both groups(P > 0.05).4.Safety evaluation: During the observation period,no significant adverse reactions occurred in the two groups.Conclusion: The Shuganyunpi Method can improve the TCM syndrome integral of both RA and AS patients with liver-spleen disharmony.It can improve arthritic symptoms,such as the joint pain,the joint swelling,the joint tenderness,the joint restricted activities and the morning stiffness.Meanwhile,It can improve the disease-associated evaluation,the patients' physical function and quality of life.It also was proved to be a safe method.Furthermore,the feasibility of treatment had been proved effectively.