| Purpose: In this paper,by observing the clinical effect and influence on related inflammatory factors about the treatment of liver and kidney Yin deficiency type of rheumatoid arthritis by bushen tongluo decoction.To explore clinical effect of bushen tongluo decoction in further understand laboratory index value to the diagnosis of rheumatoid arthritis,provide clinical basis for the diagnosis and treatment of rheumatoid arthritis.Methods: Collecting 64 rheumatoid arthritis patients in the rheumatology outpatient department of Shanghai hospital of traditional Chinese medicine,who met the criteria of TCM diagnosis and TCM diagnosis of liver-kidney Yin deficiency.In the treatment group,bushen tongluo decoction + methotrexate were given;Control group methotrexate.The course of treatment was 12 weeks.After 12 weeks,compare two groups of clinical symptoms and signs(including count of joint swelling,count of joint tenderness,rest pain,patients with the overall evaluation of disease activity,doctors with the overall evaluation of disease activity),joint function assessment,clinical effect evaluation,symptoms of TCM,TCM integral improvement and laboratory index(blood sedimentation,c-reactive protein,rheumatoid factor,ring citrulline peptide antibodies,interleukin 1?,interleukin 2 recptor,interleukin 6 and interleukin 8,interleukin 10,tumor necrosis factor alpha),security index(WBC,RBC,hemoglobin,platelet,cereal third transaminase,creatinine),The therapeutic effect was evaluated by comparing the changes of clinical and laboratory indexes after treatment.Results: 1.A total of 64 RA patients with liver and kidney Yin deficiency were included in this study,and 61 patients were finally completed,including 31 patients in the treatment group and 30 patients in the control group.2.the treatment group and control group joint tenderness count,joint swelling count,rest pain,patients with the overall evaluation of disease activity,doctors with the overall evaluation of disease activity,the inprovement joint function assessment of patients,after statistics analysis,after the treatment two groups have obvious difference(P < 0.05),treatment group was better than that of control group(P < 0.05);3.The laboratory indexes of CRP,ESR,RF,anti-CCP antibody,IL-6 and TNF-? of the two groups were significantly lower than those of the control group after treatment(P<0.05),as well as the treatment group was better than the control group(P<0.05).IL-1?,IL-2R,IL-8 and IL-10 were not significantly reduced in either group(P > 0.05).4.The effective rate of ACR20 in the two groups was similar(P>0.05),the treatment group was 80.63%.5.TCM syndrome volume in the treatment group decreased significantly compared with that in the control group(P<0.05),and the effective rate of the treatment group was better than control group(P<0.05),the treatment group was 83.37%,and the control group was 50.00%.6.Both groups had no effect on safety indexes(P > 0.05).Conclusion: 1.Bushentongluo decoction combined with methotrexate is more effective in treating rheumatoid arthritis of liver-kidney yin deficiency type,which is worthy of clinical popularization and practice.2 Bushentongluo decoction combined with methotrexate in the treatment of rheumatoid arthritis of liver-kidney yin deficiency type can reduce the level of CRP,ESR,RF,anti-CCP antibody and IL-6,TNF-?.It is suggested that in addition to CRP,ESR,RF,anti-CCP antibody,IL-6,TNF-? may also be involved in the pathogenetic process of rheumatoid arthritis of liver-kidney yin deficiency type. |
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