Clinical Observation On The Treatment Of Rheumatoid Arthritis Associated With Nonspecific Interstitial Pneumonia With Kechuan Fuyuan Formula

Objective: To explore the clinical efficacy and safety of Kechuanfuyuan formula in the treatment of rheumatoid arthritis complicated with non-specific interstitial pneumonia,and to provide clinical basis for the treatment of rheumatoid arthritis complicated with non-specific interstitial pneumonia with traditional Chinese medicine.Methods: In this study,72 patients with rheumatoid arthritis complicated with non-specific interstitial pneumonia of Qi-deficiency and blood-stasis type in Rheumat ology Center of Yunnan Hospital of Traditional Chinese Medicine were included an d randomly divided into two groups at a ratio of 1:1,with 36 patients in each grou p.Control group received basic treatment and oral Leflunomide(LEF),and the obs ervation group unomide was combined with Kechuanfuyuan prescription,followed u p for 12 weeks.The changes of lung function indexes,inflammatory factor levels,6-minute walking test(6MWT),percutaneous oxygen saturation(SPO2),TCM syndr ome scores and other indexes before and after treatment were observed and recorde d in the two groups,and the corresponding data were statistically analyzed.Results:1.Baseline data: Before treatment,there were no statistical differences in age,gender,course of disease,lung function,inflammatory indicators,TCM syndrome scores and other aspects between the two groups(P>0.05),indicating comparability between the two groups.2.After 12 weeks of treatment,FVC%,FEVI% and DLCO% in the observation group were all increased compared with before treatment,with statistical significance(P<0.05),while there was no statistical significance in the control group before and after treatment,and the difference between the two groups after treatment was significant.The improvement of lung function related indexes in the observation group was significantly better than that in the control group.3.After treatment,ESR in observation group only had statistical difference(P<0.05);There was no significant difference between the control group and the control group after treatment(P>0.05).After 12 weeks of treatment,there were significant differences in TNF-α and CRP between observation group and control group(P<0.01).Comparison between groups showed statistically significant differences in the two indexes(P<0.05),CRP and TNF-α were decreased in both groups,but the reduction degree of observation group was significantly better than control group.After treatment,there was significant difference in IL-1β in observation group(P<0.01),but no statistical difference in control group.There was a significant difference in IL-1β between the two groups after treatment(P<0.01),and the efficacy of IL-1β in the observation group was better than the control group.4.There was a significant difference in CCP in the observation group after treatment(P<0.01),but no significant difference in the control group.There was no statistical difference in CCP between the two groups after treatment.There was no significant difference in CCP improvement between the observation group and the control group.5.In SPO2,there was a significant difference in the observation group after treatment(P<0.01),while there was no statistical difference in the control group.After treatment,the difference between the two groups was significant(P<0.01).The results indicated that SPO2 in the observation group was significantly higher than that before treatment,and the therapeutic effect was significantly better than that in the control group.There were significant differences in the walking distance of 6 minutes after treatment between the two groups(P<0.01).The results indicated that the 6-minute walking distance of both groups was prolonged after treatment,and the curative effect of the observation group was significantly better than that of the control group.In dyspnea index,the difference between groups after treatment was significant(P<0.01).Combined with the population distribution at all levels,it can be seen that the improvement of the observation group was better than the control group.6.TCM syndrome scores in both groups decreased after treatment,and the difference between groups was statistically significant(P<0.05).The total effective rate of TCM syndrome efficacy in the observation group and the control group was 90% and 43.3%,respectively.7.Safety indicators: No significant abnormalities were found in vital signs,three routine procedures,liver function,kidney function and electrocardiogram in the two groups,and no adverse events occurred during the observation period.Conclusion:1.Kechuanfuyuan formula combined with leflunomide can control the condition of patients with rheumatoid arthritis with good safety.2.Kechuanfuyuan formula combined with leflunomide can effectively improve the pulmonary function,clinical manifestation of traditional Chinese medicine,inflammation and hypoxia state of the patients,compared with pure Western medicine treatment can better alleviate rheumatoid arthritis and non-specific interstitial pneumonia.3.Kechuanfuyuan formula combined with leflunomide in the treatment of qi-deficiency and blood-stasis type of rheumatoid arthritis with non-specific interstitial pneumonia,the clinical efficacy and safety of good,worthy of further study.