Clinical Effect Of Qufeng Chushi Tongluo Decoction On Rheumatoid Arthritis And Its Effect On JAK2-STAT3 Signaling Pathway

Objective :To evaluate the clinical efficacy and safety of Qufeng Chushi Tongluo Decoction in the treatment of rheumatoid arthritis and its influence on JAK2-STAT3 signaling pathway,and to explore its mechanism,so as to provide a new direction for the development of TCM treatment of rheumatoid arthritis.Methods : 1.Case collection : According to the relevant standards,60 cases of hospitalized patients with rheumatoid arthritis diagnosed by western medicine and syndrome differentiation of traditional Chinese medicine were selected from Department of Rheumatology,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from February2020 to October2020.Before treatment,the gender,age,course of disease and basic disease score of the two groups were statistically analyzed,and it was found that the difference between the two groups was not statistically significant and comparable.2.Treatment plan : Two groups of subjects received differentiated treatment regimen based on the same basic treatment method,the treatment regimen for the control group was celoxib +methotrexate + folic acid tablets,and the treatment group was combined with Qufeng Chushi Tongluo Decoction on the basis of the control group.After 12 weeks of treatment,the clinical efficacy of the two groups was compared.3.Observation indexes :After 12 weeks of treatment,laboratory indexes(ESR,CRP,RF,IL-6,IFNγ,p-JAK2/ JAK2/p-STAT3/STAT3protein),symptom indexes(number of swollen joints,number of tender joints,morning stiffness time,VAS score,HAQ score,TCM syndrome integral quantization table),DAS28 score,safety index and adverse drug reactions were observed in the two groups.Results:1.Comparison of efficacy of TCM syndromes: After treatment,the scores of TCM syndromes in both groups were lower than those before treatment.The total effective rate of the treatment group was 96.67%,which was significantly better than that of the control group(80.00%),with statistical significance(P=0.003<0.05).2.Comparison of efficacy scores of DAS28: After treatment,the DAS28 scores of both the treatment group and the control group were decreased,and the total effective rate of the treatment group was higher than that of the control group,P<0.05,the difference was statistically significant,which proved that the treatment plan of qufengxushitongluo prescription combined with methotrexate was superior to the pure positive drug control group alone.3.Comparison of HAQ scores: After treatment,HAQ scores in the treatment group decreased more significantly than those in the control group(P<0.05),showing a statistically significant difference between the two groups,which proved that the treatment group had better efficacy in alleviating subjective symptoms and joint function of RA patients.4.Comparison of laboratory indicators: intra-group comparison showed that after treatment,the contents of ESR,CRP,RF,IL-6 and IFNγ in serum of the treatment group were decreased compared with before treatment,and the protein expressions of p-JAK2,JAK2,pSTAT3 and STAT3 in synovial fluid of the joint were decreased compared with before treatment,with statistical significance(P<0.05).In the control group,the levels of ESR,CRP,RF,IL-6 and IFNγ decreased after treatment(P<0.05),while the protein expressions of p-JAK2,JAK2,p-STAT3 and STAT3 had no significant changes(P>0.05).5.Comparison of ACR efficacy: the number of ACR50 and ACR70 cases in the treatment group was higher than that in the control group(P < 0.05),the difference was statistically significant,which proved that the treatment effect of the treatment group was better than that of the control group.6.Comparison of adverse reactions: there was no significant difference in the proportion of adverse reactions such as gastrointestinal discomfort,leucopenia,dizziness/headache and rash between the two groups(P>0.05).Therefore,Qufeng Chushi Tongluo Decoction would not increase the occurrence of adverse reactions.Conclusion: 1.The effect of Qufeng Chushi Tongluo Decoction combined with western medicine methotrexate on alleviating RA activity is stronger than that of western medicine alone,indicating that dispelling wind and desiccating humidity and tongluo prescription has a better effect in treating moderate and severe RA activity stage.2.The ACR efficacy score of the treatment group of Qufeng Chushi Tongluo Decoction combined with western medicine was higher than that of the control group of single western medicine,and the combined treatment of Chinese and western medicine for RA had better clinical efficacy,could relieve the clinical symptoms of patients more quickly and improve the quality of life of patients.3.Qufeng Chushi Tongluo Decoction can reduce the excessive expression of JAK2 and STAT3 protein by reducing the content of IL-6and INF-γ in serum and inhibiting the phosphorylation of JAK2 and STAT3,which provides a theoretical basis for the treatment of RA with Qufeng Chushi Tongluo Decoction.4.The adverse reactions in the treatment group treated with Qufeng Chushi Tongluo Decoction combined with western medicine were not increased compared with those in the control group treated with single western medicine.Qufeng Chushi Tongluo Decoction had low incidence of adverse reactions and good safety,which was worthy of clinical promotion.