Clinical Observation Of Heat-clearing,Dampness-draining And Arthralgia-relieving Decoction In The Treatment Of Damp-heat Obstruction Type Rheumatoid Arthritis

Objective: To evaluate the clinical efficacy and safety of heat-clearing,dampness-draining and arthralgia-relieving decoction by investigating the effects of the combined use of this decoction with conventional western drugs on the symptoms and signs,laboratory indexes,quantitative scores and safety indexes of patients with damp-heat obstruction type rheumatoid arthritis(RA),so as to provide reliable evidence for further clinical promotion and application of the decoction.Methods: A total of 65 patients were enrolled in this study according to inclusion criteria,and they were randomly divided into the control group(32 cases)and the treatment group(33 cases).The control group was given the methotrexate tablet(MTX)and Celecoxib capsule(Celebrex)orally.The treatment group took orally the heat-clearing,dampness-draining and arthralgia-relieving decoction besides MTX and Celebrex.The patients were observed for one course of treatment,i.e.,8 weeks.The swollen joint count(SJC),tender joint count(TJC),morning stiffness time,TCM syndrome score,visual analogue score(VAS)and disease activity score(DAS28)of the two groups of patients were recorded before and after treatment.Meanwhile,the changes of the erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)in laboratory indicators of the two groups were also detected.The improvement of TCM syndromes and disease activity was compared between the two groups.The clinical safety of the decoction was evaluated by the changes of blood routine and indexes related to liver and kidney function before and after treatment.The comparative analysis was carried out using SPSS22.0 statistical software.Results: 30 cases in the control group and 32 cases in the treatmentgroup completed the study in the end.The overall response rate of TCM syndromes was 80.0% in the control group and 93.8% in the treatment group,and there were differences between the two groups(P<0.05).The overall response rate of disease activity in the control and treatment groups were 40.0% and 62.5%,respectively,and there were differences between the two groups(P<0.05).In both groups,symptoms and signs before and after treatment showed significant differences(P<0.01).After treatment,SJC and TJC between the two groups were significantly different(P<0.01),while no difference in the morning stiffness time between the two groups was observed(P>0.05).In both groups,the laboratory indicators were significantly different before and after treatment(P<0.01).After treatment,there were differences among all the indexes between the two groups(P<0.05).Quantitative scores were significantly different in both groups before and after treatment(P<0.01).After treatment,TCM syndrome scores and DAS28 scores were significantly different between the two groups(P<0.01),and VAS scores were different between the two groups(P<0.05).In the aspect of safety,there was no significant change in blood routine and indicators related to liver and kidney function before and after treatment in both groups,and no difference was found between and within groups(P>0.05).The incidence of adverse reactions was 6.7% in the control group and 0.0% in the treatment group,showing no difference between the two groups(P>0.05).Conclusion: The combined use of heat-clearing,dampness-draining and arthralgia-relieving decoction and conventional western medicine can dramatically improve the symptoms and signs,laboratory indicators and quantitative scores of patients with damp-heat obstruction type RA.Its therapeutic effect is better than that of the single use of western medicine.Heat-clearing,dampness-draining and arthralgia-relieving decoction can greatly improve SJC,TCM syndrome score and DAS28,and effectivelyimprove laboratory indicators and VAS score.It causes no adverse reaction,worthy of further clinical promotion.