| 1 Objective According to the theory of Tranditional Chinese Medicine (TCM), summing up TCM's recognize on Rheumatoid Arthritis (RA), advancing TCM's pathologic mechanism, therapeutic principle and method. Observing the effect of Strengthening the spleen-Resolving dampness-Promoting collaterals method on RA and inquiring into the mechanisms on the treatment of RA based on "Spleen".2 Methods2.1 Theory research: To sum up TCM's recognize on the symptoms correlated with RA and advance TCM's pathologic mechanism of RA; To sum up the tutor's experience on the treatement of RA and draft the therapeutic method and prescription梄infeng Capsule (XFC,ff JxlJKH) on RA based on "Spleen".2.2 Clinical research: 40 cases of RA were randomly divided into two groups. The treatment group (n=20) was treated with XFC for three months as a therapeutic course. The control group (n=20) was treated with tripterygium wilfordii polycoside tablet (TPT, If ^H^^M") for three months as a therapeutic couse. Two groups were treated for one course all. The targets included clinical curative effects, CRP, RF, OKT4, OKT8, OKTVOKTg, cytokin (CK), vascular endothelial growth factor (VEGF) were observed.2.3 Experimental researchTest 1: Sixty rats were randomly divided into normal control group, model group, XFC group and TPT group, 15 in each. Complete adjuvant 0.1 ml was injected into right posterior metatarsus of rats subcutaneously to induce inflammation, except that in the normal control. The ultrastructural change including mitochondria swelling, vacuolation and ridge pathologic change of synoviocyte, thymus-lymphocyte, splenic lymphocyte and gastric mucosa cell was observed by transmission electron microscopy (TEM). The mitochondria lesion rate (MLR) of each group was then calculated.Test 2: 50 rats were averagely divided into normal control group, model control group, XFC treated group, TPT treated group, methotrexate (MTX, f Hi ^^) treated group. Except for the rats of normal control group, the others were intracutaneously injected with 0.05 ml of Freung's complete adjuvant in the right hindlimb. The body weight (BW), arthritis index (AT), serum cytokine and VEGF levels of each rat were assayed.Test 3:60 rats were randomly divided into the normal group, the model group, the MTX group, the TPT group and the XFC group. Except for the rats in the normal group, animals were modeled to adjuvant arthritis (AA) with Freund's complete adjuvant, and the latter three groups were treated with MTX, TPT and XFC respectively. The expressions of fas, fasL and bcl-2 in rats' synovia! membrane and thymus-lymphocyte were determined using immunohisto chemistry (IHC) technique.The apoptosis of every group's synovial membrane and thymus-lymphocyte were observed usingTEM. The apoptotic percentage of the synoviocyte, thyms-lymphocyte and gastric-mucosa cell ofAA were measured by flow cytometry (FCM) using mitochondrial membrane potential (MMP),terminal deoxynucleotidyl transferase mediated DUTP nick end labeling (TUNEL) and AnnexinV/PI.3 Results3.1 The results of theory research: TCM's pathotogic mechonism of RA was qi-blood deficiency, dis harmony between nutritive-qi and defensive-qi; deficiency of the spleen and stomach, stagnancy of pathogenic damp; accumulation of phlegm and stasis, block of meridians and collaterals. Spleen deficiency played an important role in the invasion of RA. The therapeutic principle in TCM of RA was supporting vital-qi, tonifying qi-blood; protecting spleen and stomach, reinforcing acquired constitution; dispelling phlegm and resolving dampness, relieving the secondary in an urgent case; restoring menstrual flow and activating energy flow, expelling joint. The therapeutic method of treating RA based on "Spleen" was strengthening spleen and tonifying qi, resolving dampness and activating collaterals. The prescription of treating RA was XFC.3.2 The results of clinical research: The effects of XFC was similar to TPT in the total effective rate, improving the joint symptoms et al.
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