Clinical Observation Of Simiaosan Jiawei In The Treatment Of Rheumatoid Arthritis Of Dampness-heat Blockage Type

Objective:To observe the clinical efficacy and safety of Simiaosan Jiawei in the treatment of rheumatoid arthritis of dampness-heat blockage type and optimize the clinical treatment plan.Method:80 patients with rheumatoid arthritis of dampness-heat blockage type were randomly divided into control group(40 cases)and observation group(40 cases)for 12 weeks.The control group began to take methotrexate tablets 7.5 mg qw orally,and then increased by 2.5 mg per week to 15 mg qw maintenance treatment;diclofenac sodium sustained release tablets 75 mg qd,only when joint pain,pain relief stop taking.On the basis of the treatment of the control group,the observation group was treated with Simiaosan Jiawei decoction orally,one dose a day.The clinical symptoms,signs,ESR,CRP,RF,anti-CCP antibody,TCM syndrome score,DAS28 score,blood routine,urine routine,fecal routine,liver and kidney function,electrocardiogram and other safety indexes were recorded before and after treatment.The clinical efficacy and safety were evaluated by statistical methods.Result:1.This clinical study included 80 patients,78 patients completed clinical observation,1 case in the control group and 1 case in the observation group.The rate of abscission was 2.5%.2.After 6 and 12 weeks of treatment,ESR,CRP,RF,anti-CCP antibody,joint tenderness,joint swelling,DAS28 score and TCM symptom score of the two groups were significantly lower than those before treatment(P < 0.05).There was no significant difference between the two groups after 12 weeks of treatment except for the reduction of anti-CCP antibody(P = 0.070 > 0.05).The difference was significant(P < 0.05).3.The total effective rate of the observation group was 89.74%,better than that of the control group(71.79%,P=0.046 < 0.05);the total effective rate of the observation group was 94.87%,significantly better than that of the control group(69.23%,P=0.001 < 0.05).4.The duration and dosage of diclofenac sodium sustained-release tablets in the observation group were significantly less than those in the control group(P = 0.000 < 0.05).5.In terms of safety biochemical indicators,there was no significant difference in WBC,ALT,AST,BUN and Cr between the two groups after 2,6 and 12 weeks of treatment(P > 0.05),and PLT of the two groups was lower than that before treatment(P < 0.05);there was no significant difference between the two groups after 2,6 and 12 weeks of treatment(P > 0.05).6.The incidence of adverse reactions was 10.26% in the observation group and 12.82% in the control group.There was no significant difference between the two groups(P=1.000>0.05).Conclusion:On the basis of methotrexate and diclofenac sodium,the addition of Simiaosan Jiawei in the treatment of rheumatoid arthritis of dampness-heat blockage type can obviously alleviate the clinical symptoms and signs of patients and reduce ESR,CRP,RF and anti-CCP antibodies.It is superior to western medicine methotrexate and diclofenac sodium in improving joint tenderness,joint swelling,DAS28 score and TCM syndrome score,and does not increase the incidence of adverse reactions.The results show that Simiaosan Jiawei has the advantages of enhancing curative effect and safety,and it is worth further expanding the sample study.