Clinical Observation Of Modified Shuanghe Decoction Combined With Western Medicine In Treating Rheumatoid Arthritis Of Phlegm And Blood Stasis Obstruction Syndrome

Objective: By observing the clinical efficacy of Shuanghe Decoction combined with Western medicine in the treatment of rheumatoid arthritis patients with phlegm and blood stasis obstruction syndrome,it provides a basis for the treatment of RA with phlegm and blood stasis obstruction syndrome in the integrative medicine.Methods: A total of 60 patients with rheumatoid arthritis who had been diagnosed as phlegm-stasis obstruction syndrome were collected from the outpatient department and inpatient Department of the First Affiliated Hospital of Guangxi University of Chinese Medicine from 2021-02-03 to2021-11-30.They were randomly divided into treatment group and control group(30 cases in each group).The control group was given Meloxicam tablets(7.5mg BID)+ Methotrexate tablets(10mg QW)+Leflunomide tablets(10mg QD)for oral treatment,and the treatment group was given shuanghe decoction plus or minus treatment on the basis of the control group for 12 weeks.The laboratory indicators(CRP,ESR,RF),improvement of joint symptoms and signs(joint swelling number,joint tenderness number,VAS score),disease activity degree(DAS28score),TCM syndrome score and curative effect improvement of the two groups were observed to evaluate the clinical efficacy of Shuanghe Decoction plus And minus western medicine in treating RA with phlegm and stasis syndrome.Results:(1)Comparison of disease efficacy between the two groups :the total effective rate was 85.71 % in the treatment group and 67.86 % in the control group,the difference was statistically significant(P < 0.05).(2)Comparison of VAS score and DAS28 score between the two groups : VAS score and DAS28 score of the two groups after treatment were lower than those before treatment,and the differences were statistically significant(P < 0.05).VAS score and DAS28 score of the treatment group after treatment were significantly lower than those of the control group,and the differences were statistically significant(P < 0.05).(3)The number of joint tenderness and swelling in the two groups were compared : the number of joint tenderness and joint swelling in the two groups were lower than those before treatment,the difference was statistically significant(P < 0.05),and the number of joint tenderness and joint swelling in the treatment group were significantly lower than those in the control group,the difference was statistically significant(P <0.05).(4)Comparison of CRP,ESR and RF levels between the two groups : CRP,ESR and RF levels in the two groups after treatment were lower than those before treatment,and the differences were statistically significant(P < 0.05).CRP,ESR and RF levels in the treatment group were significantly lower than those in the control group,and the differences were statistically significant(P < 0.05).(5)Comparison of TCM syndrome scores between the two groups : After treatment,the scores of joint pain,joint swelling,joint tenderness,adverse joint flexion and extension,morning stiffness and subcutaneous nodules in the two groups decreased,and the difference was statistically significant(P <0.05).The scores of joint pain,joint swelling,joint tenderness,adverse joint flexion and extension,morning stiffness and subcutaneous nodules in the treatment group were significantly lower than those in the control group,and the difference was statistically significant(P < 0.05).(6)Comparison of medication safety between the two groups : There were 6cases of adverse events in the two groups,including 1 case of adverse events in the treatment group,patients with diarrhea,spontaneous remission,the incidence of adverse events in the treatment group was3.6 %;there were 5 adverse events in the control group,including 1patient with mild liver dysfunction,4 patients with anorexia and occasional abdominal distension.The incidence of adverse events in the control group was 17.9 %,and there was no significant difference between the two groups(P > 0.05).Conclusion:The clinical efficacy of Shuanghe Decoction combined with western medicine in the treatment of RA with phlegm-stasis obstruction syndrome is remarkable,which can effectively relieve joint symptoms and signs,reduce inflammatory response and disease activity,and the efficacy is better than that of western medicine alone.