Summarization Of Academic Thought And Clinical Experience Of Treating Rheumatoid Arthritis From "double Poison Theory"

Objectives:Based on the academic thought of Professor YING SENLIN’s "double toxin theory",this paper summarized the etiology and pathogenesis of the treatment of rheumatoid arthritis,the principle of treatment based on syndrome differentiation and the thinking of prescription medication.Believe in active rheumatoid arthritis is caused by "double poison",by observing the "double clear solution poison" or methotrexate treatment of the disease,compared with patients before and after the change of symptom,laboratory indicators,improve survival quality and discussed under the guide of the theory of "double poison" double poison "solution" of actual clinical curative effect.Summarize the experience of treating rheumatoid arthritis with "double toxin theory",and provide beneficial reference for clinical treatment.Methods:1.Theoretical research: Through collecting and sorting out Professor Ying Senlin ’s clinical experience for many years,this paper summarized Professor Ying Senlin’s academic thoughts on the treatment of rheumatoid arthritis from the "double-toxin theory".This paper expounds the whole process of the proposal,formation and development of the "double toxin theory" from the perspectives of etiology and pathogenesis,treatment based on syndrome differentiation and clinical application.2.Clinical study: Patients with rheumatoid arthritis(dampness-heat obstruction syndrome)meeting the inclusion criteria were collected and divided into the experimental group and the control group by random number table method,including32 cases in the experimental group and 29 cases in the control group.The control group was treated with methotrexate,and the experimental group was treated with "Qingjie Shuangdu Formula",an empirical prescription for dampness and heat obstruction syndrome formulated by the supervisor based on "Shuangdu Theory".The clinical effects were observed before treatment,at the 6th week in treatment and at the12 th week after treatment.Effective rate,TCM symptom score,DAS28 score,VAS score,HAQ health assessment questionnaire,TCM symptom grading quantification,application of NSAIDs,laboratory indicators and ADR monitoring were observed respectively.SPSS25.0 software was used for statistical analysis.Results:1.Theoretical research :(1)The core of "double toxin theory" lies in "internal and external double toxin theory".According to its nature,it can be divided into "exogenous evil toxin" and "endogenous hidden toxin".(2)Professor Ying Senlin summed up the theory of "double poison" from the three aspects of "poison,evil and stasis",explained the significance of the theory of double poison from the aspects of etiology and pathogenesis,clinical experience,and paid attention to the combination of insecticides,vine and grass in clinical experience.The treatment of rheumatoid arthritis with "Qingjie Shuang Du" method has enriched the diagnosis and treatment ideas and improved the clinical efficacy.2.Clinical study :(1)In terms of clinical efficacy,after 12 weeks of treatment for rheumatoid arthritis,the effective rate of 32 cases in the experimental group was 100%,and that of 29 cases in the control group was 96.55%.Although there was no significant statistical difference,the efficacy of the experimental group was slightly better than that of the control group.The curative effect of TCM syndrome was better in the experimental group than in the control group.DAS28 decreased significantly in both groups,indicating significant improvement in both groups.The overall efficacy of the experimental group was generally better than that of the control group,or the statistical results of the experimental group and the control group were similar,indicating that "Qingjie Shuangdu Formula" performed better than the control group in the treatment process.(2)In terms of laboratory indicators,the control group improved ESR better than the experimental group.The C-reactive protein of experimental group was significantly better than that of control group.There was no significant difference in rheumatoid factor and anti-cyclic citrullic acid antibody between the two groups after treatment.The results of the two groups of data in improving the laboratory indicators are similar,and there is no significant difference between the two groups of data.(3)In terms of symptoms and signs,the main indexes of joint tenderness score,joint swelling score,joint range of motion and joint skin temperature in the experimental group had advantages;The joint pain score,morning stiffness score,test group and control group were basically similar.It indicates that "Qingjie Shuangdu Formula" is better or roughly similar to the control group in improving the main indicators of symptoms and signs.The secondary indicators were also roughly the same,indicating that "Qingjie Shuangdufang" was generally similar to the control group in improving the secondary indicators of symptoms and signs.(4)HAQ index,HAQ disability index "Qingjie Shuangdufang" improved better;There was no significant difference in the improvement of HAQ discomfort index between the two groups.After calculating the total score of HAQ index,the experimental group was better than the control group.It indicates that "Qingjie Shuangdu Prestige" has advantages in improving the survival of patients.(5)The drug reduction of NSAIDs in the experimental group was higher than that in the control group,so the experimental group was better than the control group.(6)Adverse reaction analysis showed that the incidence of adverse reactions in the test group was about 9.4%;The rate of adverse reactions in the control group was about37.9%,and the degree of adverse reactions in the test group was less than that in the control group.Conclusions:1.Theoretical research: as a new theory of Bi disease,"double toxin theory" provides a new idea for the treatment of rheumatoid arthritis in traditional Chinese medicine.It combines traditional medical treatment with modern medical theory,combines Chinese and Western syndrome differentiation and treatment,and expands the idea of diagnosis and treatment.It enriches the theoretical basis of rheumatoid arthritis and improves the clinical efficacy to a large extent.2.Clinical research :(1)Based on the theory of "double toxin theory" of my tutor,I firstly used the theory of "removing exogenous evil toxin and resolving endogenous latent toxin" to treat rheumatoid arthritis.Targeting treatment methods were adopted for different syndromes,and medication was added or reduced "according to the person,according to the syndrome and according to the time",with satisfactory clinical effects.(2)Compared with traditional methotrexate,"Qingjie Shuangdu Formula" is generally similar in terms of total effective rate in the treatment of dampness and heat obstruction syndrome of active rheumatoid arthritis,and "Qingjie Shuangdu Formula" is superior to methotrexate in terms of TCM syndrome score and VAS score.The DAS28 score of "Qingjie Shuangdufang" group showed significant improvement.(3)In the laboratory indicators,"Qingjie Shuangdu Formula" was basically similar to the methotrexate group.Due to the nature of rheumatoid arthritis,the disease is complex and changeable,and the delay is difficult to cure,so further research is needed to improve the laboratory indicators.(4)In terms of safety,it has better effect than methotrexate alone.