Clinical Observation Of Modified Huangqi Guizhi Wuwu Decoction Combined With Western Medicine In Treating Rheumatoid Arthritis Of Qi And Blood Deficiency Syndrome

Objective:To observe the clinical efficacy and safety of modified Huangqi Guizhi Wuwu decoction combined with western medicine in the treatment of rheumatoid arthritis(RA)patients with Qi and blood deficiency syndrome,and to provide reference for the treatment of RA with Qi and blood deficiency syndrome.Methods:From February 2021 to November 2021,60 patients with RA of deficiency of both qi and blood were selected from the outpatient and inpatient department of rheumatology in the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine.They were rand omly divided into treatment group and control group,with 30 patient in each group.The control group was treated with methotrexate tablets(10mg qw)+leflunomide tablets(10mg qd)+ meloxicam tablets(7.5mg bid),and the treatment group was treated with Huangqi Guizhi Wuwu Decoction in the control group.The total course treatment was 12 weeks.The pain score(VAS),symptoms and signs of affected joints,disease activity(DAS28,CDAI,SDAI),simplified health assessment questionnaire(HAQ),laboratory inflammatory indexes(ESR,RF,CRP),quantitative score of TCM syndromes,improvement ofcurativeeffect and incidence of adverse reactions were observed before and after treatment in the two groups,so as to evaluate the clinical efficacy of modified Huangqi Guizhi Wuwu decoction combined with western medicine in the treatment of RA patients with Qi and blo-od deficiency syndrome.Results:(1)The total effective rate of the treatment group was 86.2%,and that of the control group was 69.0%,which was significantly higher than that of the control group(P<0.05).(2)Comparison of VAS scores between the two groups before and after treatment : After treatment,the VAS scores of the two groups were lower than those before treatment,and the difference was statistically significant(P<0.05),and the treatment group was better than the control group,the difference was statistically significant(P<0.05).(3)Comparison of symptoms and signs of affected joints between the two groups before and after treatment : after treatment,the number of joint tenderness,joint swelling and morning stiffness time in the two groups were lower than those before treatment,the difference was statistically significant(P<0.05),and the improvement in the treatment group was better than that in the control group,the difference was statistically significant(P<0.05);(4)Comparison of disease activity and HAQ between the two groups before and after treatment : after treatment,DAS28,CDAI,SDAI and HAQ scores of the two groups were improved,and the difference was statistically significant(P<0.05),and the improvement of the treatment group was better than that of the control group,the difference was statistically significant(P<0.05);(5)Comparison of laboratory inflammatory indexes between the two groups before and after treatment : After treatment,the levels of CRP,ESR and RF in the two groups were improved compared with those before treatment,and the difference was statistically significant(P<0.05)level in the treatment group was better than that in the control group,the difference was statistically significant(P<0.05);(6)Comparison of TCM symptom scores between the two groups before and after treatment : After treatment,the scores of joint pain,joint tenderness,joint swelling,morning stiffness time,fatigue,poor appetite,palpitations,shortness of breath and dizziness in the two groups were lower than those before(P<0.05),and the decrease of syndrome score in the treatment group was better than that in the control group,the difference was statistically significant(P<0.05);(7)Comparison of the incidence of adverse reactions between the two groups : After treatment,there were 6cases of adverse reactions in the two groups,including 2 cases in the treatment group,the incidence of adverse reactions was 6.9%;there were 4cases in the control group,and the incidence of adverse reactions was 13.8%.There was no significant difference between the two groups(P>0.05).Conclusion: Modified Huangqi Guizhi Wuwu Decoction combined with western medicine in the treatment of RA with deficiency of both qi and blood syndrome can effectively relieve clinical symptoms,reduce adverse drug reactions,reduce laboratory inflammatory indexes,improve disease activity and quality of life,with definite clinical efficacy.