Clinical Research On The Treatment Of Rheumatoid Arthritis With Abnormal Lipid Metabolism By Expelling Wind And Removing Dampness,resolving Phlegm And Removing Blood Stasis

Objective:To observe the clinical efficacy of expelling wind and removing dampness,resolving phlegm and removing blood stasis in the treatment of rheumatoid arthritis complicated with abnormal lipid metabolism.To explore the correlation between inflammation,disease activity and blood lipids,and to provide a basis for further study of blood lipid metabolism and cardiovascular disease risk in patients with RA.Methods:A total of 60 patients with rheumatoid arthritis were collected according to the criteria for inclusion and exclusion,and were divided into a control group and a treatment group of 30 cases according to a randomized controlled trial.The treatment regimen of the control group was Methotrexate 10 mg,once a week and celecoxib 0.2 g,once a day.The patients in the treatment group were treated with Huazhuo Xiaoyu Tongluo recipe one dose twice daily in addition to the control group.The above schemes were treated for 12 weeks.The basic information of the patients and the four diagnoses of TCM were collected.The number of tenderness joints,swollen joints,scores of various symptoms and clinical indexes before and after treatment were recorded.The curative effect was evaluated by the standard of curative effect evaluation,and the correlation between blood lipid index and ESR,CRP,DAS28 was analyzed.Results:This study finally completed the clinical observation of 59 patients,including 30 cases in the treatment group and 29 cases in the control group.There were no statistical differences in general data,clinical indexes and all kinds of scores between the two groups before treatment.1.The number of tender joints,swollen joints,DAS28,VAS and HAQ scores in the treatment group were significantly reduced after treatment,which had more obvious improvement except the number of swollen joints(P<0.01 P<0.05).2.After treatment,RF,CRP,ESR,total scores of TCM syndromes and individual scores except joint deformation in the treatment group were lower than those before treatment.The improvement of ESR,total score of TCM syndrome and some individual scores of TCM syndrome in the treatment group was better(P<0.01、P<0.05).3.The blood lipid parameters of the treatment group were significantly improved after treatment except TG,and the curative effect of TC,HDL-C and TC/HDL-C in the treatment group had more advantages(P<0.01、P<0.05).4.The total effective rate of TCM syndrome was 96.7%in the treatment group and 82.8%in the control group.The treatment group was better in improving TCM syndromes(P<0.05).The number of cases meeting the ACR20 standard in the treatment group was higher,and there was significant difference in ACR20 standard between the two groups(P<0.05).5.There were different degrees of positive correlations between ESR and TC,TC/HDL-C;CRP and TC,TC/HDL-C(P<0.01、P<0.05).DAS28 was positively correlated with TC(P<0.05).CRP and HDL-C had a negative correlation(P<0.05).6.In terms of safety,A small number of patients in the two groups had mild adverse reactions,including leukopenia,liver function damage and gastrointestinal discomfort.Conclusion:Compared with western medicine alone,the method of expelling wind and removing dampness,resolving phlegm and removing blood stasis combined with methotrexate and celecoxib has more advantages in relieving clinical symptoms,reducing inflammatory indexes and disease activity,and regulating blood lipid metabolism.And part of the lipid level has a certain degree of correlation with inflammatory indicators and disease activity,which is worthy of further clinical promotion and research.