| Objective: This project is based on the observation of changes insymptoms of rheumatoid arthritis secondary to osteoporosis(syndrome of Kidney-yang deficiency)under the treatment of Peibu Shenyang decoction comineded with MTX,such as symptom relief,laboratory indicators,efficacy indicators,bone density,bone metabolism-related indicators,and serum inflammatory factors,which is provide real and reliable data support for determining the effectiveness of this method.Methods: 62 patients with RA secondary to OP who came to the Department of Rheumatology of Henan Provincial Hospital of Traditional Chinese Medicine from November 2019 to November 2020 were selected and SPSS 22.0 was used for the included experimental subjects Completely randomized grouping,31 cases in the observation group and 31 cases in the control group.The group of control:10 mg of methotrexate tablets orally,once a week(the first dose is 7.5 mg,and the dose is adjusted at any time according to personal tolerance and response to the drug.The general dose is 7.5 mg-15 mg,and the maximum dose can be adjusted to 20 mg);Calci600mg orally,once a day;Alfacalcidol 0.25 ug orally,once a day.The observation group: Methotrexate tablets 10mg/time orally,once a week(the first dosage is 7.5mg,the dosage is adjusted at any time according to personal tolerance and reaction to the drug,the general dosage is 7.5mg-15 mg,the maximum dosage can be adjusted to20mg);Peibushenyang decoction;(Usage: once in the morning and after dinner,200 ml each time,decoction in water)When necessary(VAS score of 4 points or more),the two groups were given celecoxib capsules orally;Record and assess the status in symptom improvement,curative effect indicators,bone density,bone metabolism-related indicators and serum inflammatory factors in the two groups respectively,and use spss22.0 statistical analysis software for data analysis.Results:1.The general information of the two groups of patients,such as gender,the duration of disease,age,etc.,have been statistically analyzed,P>0.05,so there is no significant difference between the two groups of data,and comparative analysis can be carried out;2.After 12 weeks of treatment,the symptoms of joint tenderness and joint swelling in the treatment group and the control group were all lessened than before,and the degree of reduction in the treatment group was higher than that in the treatment group(P<0.05).The difference was clear;The morning stiffness time,VAS score and other related indicators all decreased at different levels after treatment.The decrease level of the treatment group was obvious(P<0.05)and the difference was significant after statistical processing;3.After 12 weeks of treatment,the ESR,CRP,and BALP levels of the treatment group and the control group all were decreased.Compared with the control group,the treatment group has statistically significant differences in reducing the level of inflammation indicators and improving the activity of osteoblasts;4.The patient’s levels of 25-OH-D,OCN,blood calcium,BMD,etc.were significantly higher than before treatment.The improvement in the treatment group was superior to the control group after statistical comparison(P<0.05),and the difference was clear;5.After 12 weeks of treatment,the scores of TCM syndromes and DAS28 in the two groups decreased,and the decrease in the treatment group was more obvious(P<0.05),and the discrepancy was clear;6.In terms of clinical effectiveness,after 12 weeks,the treatment group was cured 9.68%,effective 41.94%,markedly effective 41.94%,2 cases were ineffective,6.45%,control group cured 0 cases,effective 32.26%,markedly effective 38.71%,9cases of ineffective 29.03%,The total effective rate of the treatment group was93.55% and the control group was 70.97%.The results indicated that the overall response rate was higher in the treatment group compared to the control group(P<0.05),and the discrepancy was significant.Conclusion:1.Peibu Shenyang Decoction combined with MTX can significantly alleviate the clinical symptoms of patients with RA secondary to OP,reduce ESR,CRP,BALP levels,increase the indicators of 25-OH-D,osteocalcin,blood calcium etc,and enhance bone mineral density.There are clear differences.2.Peibushenyang decoction has significant effects in improving clinical laboratory indicators and improving clinical efficacy.It is also flexible in medication,low in adverse reactions,easy for patients to take for a long time,and is worthy of generalization and application. |
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