Effects Of Chinese Herb Clearing Heat And Removing Dampness Combining With Western Medicine On Rheumatoid Arthritis Patients In Active Phase: A Systematic Review

Objective:To review systematically whether there is enough existing evidence about the curative effect and safety of Chinese Herb Clearing Heat and removing dampness combining with Western Medicine against rheumatoid arthritis (RA) patients in active phase and search an effective measure of integrated traditional and western medicine treating RA patients in active phase.Methods:Based on systematic review of International Cochrane Collaboration, we searched the Cochrane Controlled Trials Registration(CCTR), Medline, China National Knowledge infrastructure(CNKI), Chinese VIP database, Chinese Biomedical Literature Database(CBM) and WanFang Database of Dissertation using computer. And several Chinese journals related to traditional Chinese medicine(TCM) and RA in 2009 were searched by hand. All randomized controlled trials (RCT) and quasi-RCTs about effects and safety of Chinese herb Clearing Heat and removing dampness combining with Western Medicine on rheumatoid arthritis patients in active phase were collected. Two reviewers independently assessed the quality of including trials. Then data were analyzed using Revman 4.2.2 downloaded from the website of Cochrane collaboration.Results:13 Chinese RCTs and quasi-RCTs were included that all were assessed as C according to Revman 4.2.2 User Guide. The results of Meta-analysis indicated:(1)Compared Western Medicine alone, combining Chinese Herb Clearing Heat and removing dampness is better for RA patients in active phase on effective rate, joint pain or tenderness, joint swelling, morning stiffness, hand grip strength,HAQ,ESR,CRP,RF,IgG and reducing the incidence of adverse reactions;(2) But no significant difference was found in the improvement of articular dyskinesia,15 meter walking time, IgA and IgM.Conclusion:This study demonstrated that Chinese Herbs Clearing Heat and removing dampness combining with Western Medicine have an advantage over Western Medicine alone in RA patients in active phase. However the poor methodological quality of included studies seriously weakened the validity of the meta-analysis which were needed to further assess by the high quality and large sample sized RCTs.