Clinical Study Of Qingbi Tablet Combined With Tofacitinib In The Treatment Of Refractory Rheumatoid Arthritis With Damp-Heat Obstruction Syndrome

Objective:To explore the efficacy and safety of Qingbi Tablet combined with Tofetib in the treatment of refractory rheumatoid arthritis（RRA）with damp-heat obstruction syndrome,in order to provide a new idea for the treatment of this disease with Qingbi Tablet.Methods:Sixty patients who met the inclusion criteria were selected and randomly divided into two groups:the experimental group（Qingbi Tablet Combined with Tofetib Tablets）and the control group（Tofetib Tablets）,with30 patients each,for a course of 12 weeks.Observe and compare the changes in syndrome scale scores,TCM efficacy,ACR20 compliance rate,DAS28,laboratory indicators,CPRI-RA^[1],and SF-36 scores of RRA patients with damp-heat obstruction type before and after treatment,and regularly monitor safety indicators.Use SPSS25.0 for data analysis to evaluate the therapeutic efficacy and safety of the program.Results:A total of 60 patients were included in the study,2 patients in the treatment group and 2 patients in the control group were lost to follow-up due to the failure of regular follow-up visits due to the epidemic.There were56 effective cases in the end,28 patients in the experimental group and 28patients in the control group.Statistical results:There was no statistical difference in the basic information and various indicators of the two groups of patients before treatment（P>0.05）;after treatment,various indicators were improved to varying degrees compared with before treatment（P<0.05）;96.43%was better than the control group 78.57%;the other observation indexes in the test group except ACR20 were significantly improved compared with the control group（P<0.05）.During the study period,no serious adverse reactions were seen in each group,and the incidence of adverse reactions in the experimental group（7.14%）was lower than that in the control group（10.71%）.Conclusion:1.Qingbi tablet combined with tofacitinib is significantly effective in the treatment of refractory rheumatoid arthritis with damp-heat blockage syndrome,can relieve clinical symptoms of patients,and improve DAS28 score and TCM syndrome score.2.This study can significantly reduce the expression levels of serum IL-6 and IL-33 in patients,suggesting that the program has a significant effect in alleviating inflammatory responses,and may reduce the release of pro-inflammatory factors and inhibit the immune inflammatory response of the body.3.The curative effect of the experimental group is better than that of the control group,and the incidence of adverse reactions is lower.