| Objective:The purpose of this clinical study is to observe the efficacy and safety of the method of clearing heat,removing dampness,blood stasis and dredging collaterals in the treatment of active rheumatoid arthritis with thrombocytosis,and to explore the correlation of platelet-related indexes,such as PLT,MPV,PDW,PCT and PLR,as well as their value in disease activity evaluation,and to offer ideas for further clinical and scientific research.Methods:Collecting 60 patients with active rheumatoid arthritis with thrombocytosis,in line with the principle of randomized controlled trials,they were divided into a 30 cases each group.Both groups underwent a 12-week clinical observation.Methotrexate and celecoxib were used in the treatment of the control group.In addition to the control group,the treatment group was treated with the method of clearing heat,removing dampness,blood stasis and dredging collaterals.The basic information of patients was collected,and the changes of clinical symptoms,laboratory indexes,inflammatory indexes,disease activity indexes and platelet-related indexes were observed before and after treatmen.Finally,statistical methods were used to analyze the method of efficacy of clearing heat and removing dampness,blood stasis and dredging collaterals in the treatment of rheumatoid arthritis with thrombocytosis and the effect of this method on platelet-related indexes,and to explore the correlation among PLT,MPV,PDW,PCT,PLR.And theirs correlation with inflammatory indexes and disease activity.Results:This clinical observation finally completed 58 patients with active rheumatoid arthritis with thrombocytosis,including 29 cases in each group.The main results were as follows:(1)The number of tenderness joints,swollen joints,HAQ,VAS,DAS28,ESR,CRP and RF in the treatment group were reduced than before(P<0.01).The treatment group was better at reducing the clinical observation indexes above(P<0.01,P<0.05).(2)In the treatment group,the TCM syndrome scores were lower than before(P<0.01),and was significantly lower than the control group(P<0.01).The treatment group could reduce all individual TCM scores(P<0.01,P<0.05),and was more expert in reducing the scores of joint pain,joint fever,joint swelling,joint tenderness,heavy limbs,and thirst(P<0.01,P<0.05).(3)The PLT,PLR and PCT in the treatment group were significantly lower than before(P<0.01).The PDW in the treatment group was higher than before(P<0.05).The treatment group had more advantages in decreasing PLT(P<0.05).(4)In the aspect of correlation study,PLT was negatively correlated with MPV and PDW,and positively correlated with PCT,PLR,ESR,CRP and DAS28(P<0.01,P<0.05).There was a negative correlation between MPV and CRP(P<0.05).PDW was negatively correlated with ESR,CRP and DAS28(P<0.01,P<0.05).There was a positive correlation between PCT and DAS28(P<0.05).PLR was positively correlated with ESR,CRP and DAS28(P<0 01,P<0 05).(5)In terms of clinical efficacy,the total effective rate of TCM syndrome was 96.55%in the treatment group and 75.86%in the control group(P<0.05).The treatment group had more advantages in achieving ACR20 remission rate(P<0.05).(6)In terms of safety observation,there was 1 case of mildly-elevated ALT in the treatment group and 1 case of gastrointestinal discomfort in the control group.which recovered after symptomatic treatment.And neither group had serious adverse reactions.Conclusion:The method of clearing heat,removing dampness,blood stasis and dredging collaterals with basic treatment of modern medicine is effective in treating active rheumatoid arthritis.Compared with basic treatment alone,which was better at relieving symptoms,decreasing inflammatory indexes,disease activity and PLT,which worthes clinical researches.In addition,platelet-related indexes are also related to inflammation and disease activity,which may be used as a reference for the evaluation of RA disease activity. |
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