Clinical Observation On The Treatment Of Knee Joint Lesions Of Rheumatoid Arthritis With Dampness And Heat Syndrome By Needle Knife Combined With Chinese Medicine(Si Miao Pill)

Objectives:By observing the therapeutic effect of acupuncture combined with traditional Chinese medicine Simuwan in the treatment of rheumatoid arthritis knee joint disease,explore a more cost-effective method to treat rheumatoid arthritis and improve knee function.Methods: The patients were admitted to the Department of Rheumatology from the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from March 2017 to January 2019.60 patients with wet rheumatoid arthritis and knee joint disease were classified into observation group and control by random number table.30 patients in each group,the observation group and the control group were given Chinese medicine Si Miao Wan Jia Wei Fang(Atractylodes 15 g,Chuan Niu Ke 20 g,Coix seed 30 g,Cork 12 g,swollen wind 30 g,Lonicera japonica 30 g,S.sinensis 15 g,bandit 30 g,tangerine peel12g),the course of treatment is 4 weeks,the observation group is treated with a needle knife in the knee joint,once a week for a total of 4 treatments.Before and after treatment,statistical software(SPSS22.0)was used to score TCM syndromes(joint swelling,pain,flexion and extension,joint tenderness,thirst,sweating,etc.),lysholm knee function score(swelling,pain,climbing stairs,Axon,shackle,support,stability,squat),ACR20,ACR50,HAQ,CRP,ESR,RF,anti-CCP antibody,DAS28 score for statistical analysis of data,objective evaluation of needle knife combined with Chinese medicine Si Miao pill plus flavor treatment The effect of rheumatoid arthritis involving knee joint disease.Results:(1)Before treatment,the two groups of patients in gender,age,duration,knee involvement(unilateral or bilateral)and disease course,RA joint function grading,knee X-ray grading,lysholm knee function score,TCM syndrome score,main symptoms There were no significant differences in efficacy index,ESR,CRP,RF,anti-CCP antibody and DAS28 scores(P>0.05),which were comparable.(2)After treatment,the evaluation of TCM syndrome efficacy was compared in the observation group.Among the 30 patients,8 were effective,16 were effective,6 were ineffective,and the total effective rate was 80.0%.In the control group,30 patients were markedly effective and 19 were effective.There were 10 cases with ineffectiveness,and the total effective rate was 66.7%.The difference between the groups was statistically significant(P<0.05).(3)In the improvement of ACR20 and ACR50,the observation group achieved 12 cases of ACR20 improvement,4 cases of ACR50 improvement,14 cases of ACR20 improvement,and 0 cases of ACR50 improvement.The difference between the groups was statistically significant(P<0.05).The observation group was superior to the control group.(4)In terms of improving TCM syndrome scores,the observation group had statistically significant differences before and after treatment(P<0.05).There was no significant difference between the control group and the control group before and after treatment(P>0.05).The differences were statistically significant(P<0.05).There was no significant difference in thirst,fever and sweat between the groups(P>0.05).The difference was statistically significant(P<0.05).(5)In the improvement of the main symptoms and efficacy indicators,the differences between the two groups before and after treatment were statistically significant(P <0.05);the comparison between groups was better than the control group(P <0.05).(6)In the improvement of Lysholm knee function score,the observation group had no statistically significant difference(P>0.05)except for the support and the lock(P>0.05).There was no significant difference in the control group,except for support,shackle,stair climbing,and squat(P>0.05).The difference of residual symptoms and total scores were statistically significant(P<0.05).The observation group was superior to the control group in improving swelling,pain,stair climbing,lameness,stability,squat symptoms and total score(P<0.05).(7)In terms of reducing ESR and CRP,there were significant differences between the two groups before and after treatment(P<0.05).There was no significant difference in the reduction of RF and anti-CCP antibodies(P>0.05).The observation group was lowering ESR.CRP was superior to the control group(P<0.05).(8)In the reduction of DAS28 score,the difference between the two groups before and after treatment was statistically significant(P<0.05),and the observation group was superior to the control group(P<0.05).(9)In the improvement of RA joint function,the observation group had a statistically significant difference before and after treatment(P<0.05).There was no significant difference between the control group and the control group before and after treatment(P>0.05).Control group(P<0.05).Conclusion:The combination of acupuncture and Chinese medicine Simiao Pills and Jiawei Recipe is effective in the treatment of rheumatoid arthritis,especially in improving knee function.The treatment is economical,safe,and traumatic.It is easy for patients to accept and is worthy of further clinical exploration and application.