| Objective: Combined with the theory of dampness causing arthralgia in traditional Chinese medicine,from the perspective of patients,through the investigation and analysis of rheumatoid arthritis patients filling in the "Patient Report Outcome" and other scales,evaluate the clinical efficacy of adding Wubi Decoction to RA patients on the premise of taking basic drugs and the intervention effect of relevant factors affecting the clinical remission of RA patients,and provide theoretical basis for optimizing the treatment plan of RA patients,improving the clinical remission rate of RA patients and the effectiveness of chronic disease management.Methods: From January 2022 to October 2022,60 inpatients and outpatients of the Rheumatology Department of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine were collected.Western medicine took rheumatoid arthritis as the first diagnosis,and traditional Chinese medicine took the Wangbi-Wind damp paralysis type as the diagnosis.They were randomly divided into control group and treatment group,with 30 patients in each group.The control group took methotrexate(MTX)as the basic drug.If the joint swelling and pain were obvious,oral celecoxib capsules could be added;The treatment group was treated with Wubi Decoction on the basis of western medicine in the control group.Take 4weeks as a course of treatment.After a total of 3 courses of reatment,compare the efficacy and mood improvement of patients before and after treatment.DAS28 was used to evaluate the improvement of the patient’s condition,Patient outcome report scale was used to evaluate patients ’self-evaluation of the condition.HAQ scale was used to evaluate the improvement of patients ’ quality of life.PSQI scale was used to evaluate patients ’ sleep quality.HADS scale and FAI scale were used to evaluate the improvement of patients ’ bad mood.At the same time,the changes of laboratory indexes and safety indexes of patients were evaluated,so as to comprehensively evaluate the improvement effect of Wubi Decoction on the condition,mood and sleep of RA patients.Results:(1)Laboratory indicators: ESR and CRP of patients in both groups decreased after treatment compared with those before reatment(P<0.05),and the treatment group decreased more significantly than the control group(P<0.05).(2)Comparison of VAS score and DAS28 score between the two groups :The VAS score and DAS28 score of the two groups after treatment were lower than those before treatment,the difference was statistically significant(P<0.05),and the VAS score and DAS28 score of the treatment group after treatment were significantly lower than those of the control group,the difference was statistically significant(P<0.05);(3)Comparison of the number of joint tenderness and swelling in the two groups : After treatment,the number of joint tenderness and swelling in the two groups were lower than before,and the difference was statistically significant(P<0.05).The number of joint tenderness and swelling in the treatment group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).(4)Comparison of the total TCM points of patients in both groups: after treatment,the total TCM points of both groups decreased compared with before,and the difference was statistically significant(P<0.05);the total points of the treatment group were significantly lower than those of the control group,and the difference was statistically significant(P<0.05).(5)Comparison of HAQ,HADS,FAI and PSQI between the two groups:After treatment,the HAQ,HADS and PSQI of the two groups were improved compared with the previous one,the difference was statistically significant(P<0.05);There was no significant difference in FAI before and after treatment(P>0.05).(6)Comparison of RA-PRO between the two groups: After treatment,the RA-PRO score of the two groups was significantly lower than that before treatment,with a statistically significant difference(P<0.05).The score of the treatment group was significantly lower than that of the control group,with a statistically significant difference(P<0.05).(7)Comparison of the total curative effect of traditional Chinese medicine :the total effective rate of the control group was 82.76 %;the total effective rate of the treatment group was 95.66 %.Compared with the control group,the therapeutic effect of traditional Chinese medicine in the treatment group was higher,and the difference was statistically significant(P<0.05).(8)Safety evaluation after medication : 2 cases of diarrhea and fatigue in the control group,1 case of nausea and vomiting,which could be alleviated after medication;in the treatment group,2 cases had diarrhea,nausea and vomiting;there was no significant difference between the two groups(P>0.05).Conclusion(s): 1.Wubi decoction combined with methotrexate in the treatment of rheumatoid arthritis,which belongs to Wind-damp paralysis type,has a good clinical effect,and the total effect is better than that of methotrexate alone treatment group,and high safety.2.Wubi decoction combined with methotrexate treatment can significantly improve the clinical outcomes reported by patients with rheumatoid arthritis,relieve patients’ anxiety and depression,and improve sleep quality and quality of life. |
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