The Clinical Effect Of Duhuojijietang On Patients With Rheumatoid Arthritis And Anemia And Its Influence On T Lymphocyte Subsets

Objective:This research is about to observe the effect of Duhuo Jisheng Decoction on Hemoglobin(Hb),Erythrocyte Sedimentation Rate(ESR),C-reaction Protein(CRP)of patients with Rheumatoid Arthritis(RA)and Anemia,thus to evaluate the value of Duhuo Jisheng Decoctionimpersonality and mechanism by observing the influence on T lymphocyte subsets cells,which would provide clinical basis for its further application in RA patients with anemia.Methods:60 RA patients with anemia from inpatients and outpatients of the First Hospital of Hunan University of Chinese Medicine were randomly divided into two groups,each group consists of 30 patients.The control group was given Duhuo Jisheng Decoction,Methotrexate(MTX,(10mg Q7d)),Leflunomide(LEF,10 mg Qd)and Folic Acid Tablet(10mg Q7d).The treatment group was given Ferrous Sulfate,MTX,LEF and Folic Acid Tablet.Two groups were treated for a period of 8 weeks which are divided into two period.Then observe and analyse the changes of rest pain,time of morning stiffness,grasp force,tender joint count(TJC),swollen joint count(SJC),scores of HAQ,rheumatoid factor(RF),ESR,CRP,T lymphocyte subsets cells(CD4~+?CD8~+?CD4~+/CD8~+ratio)and adverse events.Results:The total effective show that the effective rate in the control group was63.33%,4 cases recurred,6 cases of excellence,9 cases of validity and 11 cases of invalidity,while the rate is 90%in the treatment group,7 cases recurred,11 cases of excellence,9 cases of validity and 3 cases of invalidity.There was significant difference between the two groups(P<0.05).The differences between two groups in rest pain,time of morning stiffness,grasp force,TJC,SJC were statistically significant before and after treatment(P<0.05).The evaluation index in two groups were statistically significant after treatment(P<0.05).The content of Hb in two groups increased after treatment while the level of PLT,RF,ESR and CRP decreased statistically significant(P<0.05).Hb increased while the level of PLT,RF,ESR and CRP decreased statistically significant after treatment group(P<0.05).Symptoms of fatigue,palpitations,shortness of breath,lack of food,dizziness and pale complexion in the treatment group were significantly relieved in both group(P<0.05).Symptoms of palpitations,shortness of breath in the control group also relieved.There was significant difference between the two groups(P<0.05).The quality of life scores of the treatment group after treatment significantly improved in both group as dressing and grooming,getting up,eating,walking,personal hygiene,picking things up,clenching,and activities.There was significant difference before and after the treatment(P<0.05).The quality of life scores of the control group also significantly improved(P<0.05).There was significant difference between the two groups after treatment(P<0.05).There was no significant difference of the percentage of CD8+cells,CD4+cells,ratio of CD4+/CD8+before the treatment(P>0.05);While the percentage of CD8+cells increased in both group,CD4+cells and ratio of CD4+/CD8+significantly compared with before(P<0.05).There was significant difference in two groups after treatment(P>0.05).Conclusion:DuhuoJishengDecoction is more effective than Ferrous Sulfate Sustained-release Tablets for anemia of RA patients.It shows better effect in improving the immune function,both in relieving symptoms and controlling the activity.The possible mechanism was adjusting the immune function of patients with anemia,so as to regulate hematopoietic factor and restore the hematopoietic function effectively.