Meta-analysis Of Treating Rheumatoid Arthritis Mainly With Wenyang Huoxue Method

Purpose:To evaluate the efficacy and safety of the treatment of rheumatoid arthritis mainly by warming Yang and activating blood circulation.Method:By searching databases such as VIP,Wanfang,CNKI,Pubmed and Cochrane Library,the Chinese keywords were rheumatoid arthritis,warming Yang and promoting blood circulation,clinical observation.the English keywords included rheumatoid arthritis,warm yang invigorate the circulation of blood and so on.According to the inclusion and exclusion criteria,the records of the included literatures were analyzed,and the Cochrane Library bias risk assessment table was used to evaluate the quality of the included literatures.Moreover,RevMan5.4 software was used to analyze the heterogeneity and validity of the meta-analysis.When the heterogeneity was large,subgroup analysis and sensitivity analysis were performed on the results,and forest map and funnel plot were used to visually present the analysis results.Results:A total of 19 literatures were included,involving a total of 15 07 cases,including 759 cases in the experimental group and 748 cases in the control group.The following results were obtained through meta-analysis:(1)Overall clinical efficacy of patients:OR=4.66,9 5%CI[3.3 9,6.42],Z=9.45,p<0.0000 1;Reduce erythrocyte sedimentation rate:SMD=-8.12,CI=[-11.42,-4.82],Z=4.82,P<0.00001;Decreased C-reactive protein:SMD=-1.27,CI=[-1.66,-0.87],Z=8.32,P<0.00001,decreased rheumatoid factor index:SMD=-1.19,CI=-1.60,-0.79],Z=5.79,P<0.00001;Reduce morning stiffness time:SMD=-1.30,CI[-1.78,-0.81],Z=5.26,P<0.00001;Decreased the number of joint tenderness:MD=-2.65,CI[-3.73,-1.57],Z=4.83,P<0.00001;The number of decreased joint swelling:MD=-1.63,CI[-2.18,-1.08],Z=5.82,P<0.00001;DAS28 score:MD=-0.99,CI[-1.42,-0.56],Z=4.53,P<0.00001;Improved anti-CCP antibody levels:SMD=-0.78,CI[-1.02,-0.53],Z=6.25,P<0.00001;Reduction of adverse reactions:RR=0.47,CI[0.36,0.62],Z=5.31,P<0.00001.(2)Publication bias analysis.Funnel plot was drawn according to the indexes of the included literature.The graph was not completely symmetric,suggesting the existence of certain publication bias.Conclusion:It was found in this study that,compared with the control group,warming Yang and activating Blood circulation in the treatment of Yang-deficiency and blood-stasis type rheumatoid arthritis could reduce erythrocyte sedimentation rate,C-reacti ve protein,rheumatoid factor,Anti-ccp antibody,reduce morning stiffness time,joint tenderness,joint swelling and DAS28 score,and improve the overall clinical efficacy with fewer adverse reactions and better safety.