Clinical Observation On Rheumatoid Arthritis Treated By Modified Gui-zhi-shao-yao-zhi-mu Decoction

Rheumatoid arthritis (RA) is considered a chronic, systemic, inflammatory autoimmune disease. Synovial joints are principally attacked which often leads to the destruction of articular cartilage and even ankylosis of the joints. About 1%of the population is afflicted by it, aind women are two to four times more often than men. Up to date, the precise pathogenesis of it remains unclear. Various treatments are available while DMARDs are required to inhibit or halt the underlying immune process and prevent long-term damage, so it is suggested to use them as early as possible. In recent times, understandings to the cellular and molecular mechanisms of RA have facilitated the progress of the target therapy and increased treatment options. RA belongs to the Bi-syndrome of the scope of Chinese medicine. The causes of it usually are innate body weakness and wind, cold, dampness and heat attack to block meridians and result in qi stagnation and blood stasis. Because of the duration of the disease, it is very easy to become the syndrome of intermingled heat and cold, as well as the syndrome of intermingled phlegm and blood stasis. Applying Western medicine along with Chinese medicine generally has greater effectiveness. By combining their respective advantage, it has not only short-term and rapid effects, but also the long-term stable condition, less adverse reactions, and patients'tolerance.Objective:To observe the effectness of the modified Gui-zhi-shao-yao-zhi-mu Decoction in the treatment of rheumatoid arthritis (the syndrome of intermingled heat and cold combined with the syndrome of intermingled phlegm and blood stasis). To evaluate the clinical efficacy and safety of the decoction with the comparison between the treatment group and the control group.Method:Based on the clinical test principles,40 cases of RA patients are participated in the study. All of them meet the requirements of RA diagnosis and belong to the cold-heat complicated syndrome with phlegm-blood stasis syndrome type of Traditional Chinese Medicine (TCM). Participants are divided into two groups randomly,20 in the treatment group which methotrexate 10mg,po,qw+NSAID(diclofenac)75mg,po,qd+the modified Gui-zhi-shao-yao-zhi-mu Decoction are given, and 20 in the control group which methotrexate10mg,po,qw+NSAID (diclofenac)75mg,po,qd are given. The length of the treatment plan for both groups is 8 weeks.Results:The total effective rates of the treatment group and the control group are 95%and 75%, respectively, which has significant difference between two groups. All of the clinical and TCM symptoms of both groups are significantly improved after treatment. The symptoms of the treatment group are much better improved than those of the control group. Those laboratory indexes of both groups significantly become better after treatment, and there has significant difference between two groups. For both groups, no serious adverse effects are found.Conclusion:The treatment group has greater results than the control group in general. It means the combination of the modified Gui-zhi-shao-yao-zhi-mu Decoction and the Western medicine have better clinical efficacy and safety in treating RA with the cold-heat complicated syndrome with phlegm-blood stasis syndrome than simply using Western medicine.