Observation On The Efficacy And Safety Of Duanteng Yimu Decoction Combined With Iguratimod In The Treatment Of Active RA

ObjectiveInvestigating the efficacy and safety of Duanteng Yimu decoction combined with iguratimod in the treatment of active rheumatoid arthritis(RA)by collecting the medical records of outpatients and inpatients in the Department of Rheumatology of our hospital from January 1,2017 to November 30,2020,so as to provide a new treatment scheme for RA patients of non reproductive age and /or RA patients with contraindications to traditional DMARDs.MethodsA total of 74 patients who met the research requirements were searched through the system of Jiahe outpatient and inpatient department of our hospital.According to the medication plan,36 cases were selected into Duanteng Yimu decoction combined with iguratimod group(treatment group)and 38 cases in Iguratimod group(control group).The basic information of patients was collected,and the level of RF、CRP、ESR,DAS28-ESR score,patients VAS score and GH score at week 0,6 and 12 were recorded.The clinical efficacy and safety were compared at 6 and 12 weeks after treatment.Results1.The effective rates of Duanteng Yimu decoction combined with iguratimod group at6 and 12 weeks were 36.11% and 80.56% respectively;and that of Iguratimod group were28.95% and 71.05% respectively;the effective rates of Duanteng Yimu decoction combined with iguratimod group at each time point were higher than those of Iguratimod group,but the difference was not statistically significant(P > 0.05).2.The DAS28-ESR scores of the two groups after 6 weeks and 12 weeks of treatment when compared with those at week 0,and after 12 weeks of treatment when compared with those at week 6 were statistically significant(P<0.01).In the treatment group,there were significant differences in RF,CRP and ESR levels after 12 weeks of treatment when compared with week 0(P<0.05),and in RF and CRP levels after 12 weeks of treatment when compared with week 6(P<0.05),and in RF and ESR levels after 6 weeks of treatment when compared with week 0(P<0.05).The ESR level of the control group after12 weeks of treatment was significantly different from that at week 0(P<0.05).However,there was no significant difference in RF,CRP and ESR levels between the two groups at different time points(P>0.05).3.There were significant differences in TJC,SJC,VAS score and GH score in both groups after 6 weeks and 12 weeks of treatment when compared with week 0,and after 12 weeks of treatment when compared with week 6(P<0.01).The difference of TJC level between the two groups was statistically significant after 12 weeks of treatment(P<0.05),while SJC,VAS score and GH score was not at each time point of treatment(P > 0.05).4.There were no obvious liver and kidney function,abnormal stool routine and adverse reactions in both groups.The the difference of blood system abnormalities incidence in the two groups at week 0 compared with week 12 was statistically significant(P <0.05),the control group had significant statistical significance(P < 0.01);after 12 weeks of treatment,the blood system abnormalities were significantly different from those at 6 weeks in the control group(P < 0.05).There were no significant differences in the incidence of anemia between at week 0 and 12,week 6 and 12 in the treatment group(P > 0.05),and significant differences in the control group(P<0.01);there were no significant differences in blood system abnormalities and anemia between the two groups at week 0 and after 6weeks of treatment(P > 0.05).There was no significant difference in blood system abnormality and anemia between the two groups at different treatment time points(P >0.05).Conclusion1.There was no difference in the efficacy and safety of Duanteng Yimu decoction combined with iguratimod in the treatment of active RA compared with iguratimod group.2.Both groups could significantly improve the DAS28-ESR score,clinical symptoms and quality of life of patients with active RA.3.The treatment group could effectively reduce ESR,RF,CRP levels in patients with active RA.The effect of control group was not obvious4.The improvement of anemia in the control group was more obvious than that in the treatment group.