清热通络方治疗活动期类风湿关节炎湿热阻络证患者的临床研究OA

Objective To observe the clinical efficacy of clearing heat and dredging collateral method for rheumatoid arthritis(RA)at the active stage with dampness-heat blocking collateral syndrome.Methods Sixty RA patients at the active stage with dampness-heat blocking collateral syndrome admitted to the Seventh Ward of Rheumatology Immunology,Xi'an No.5 Hospital from August 2022 to July 2023 were selected and divided into a control group and a treatment group using a random number table method,with 30 cases in each group.Both groups received conventional Western medicine treatment,while the treatment group additionally received Qingre Tongluo Formula.After treatment for 4 weeks,parameters below were compared between the two groups:clinical efficacy,symptoms and signs[swollen joint counts(SJC),average grip strength of both hands,tender joint counts(TJC),morning stiffness duration,and visual analog scale(VAS)scores],laboratory indicator[erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),anti-cyclic citrullinated peptide antibodies(anti-CCP antibodies),and C-reactive protein(CRP)]levels,rheumatoid arthritis patient-reported outcome(RA-PRO)scores,disease activity score of 28 joints(DAS28),traditional Chinese medicine(TCM)syndrome scores,and the incidence of adverse reactions.Results After treatment,TJC,SJC,morning stiffness duration,and VAS scores were reduced while the average grip strength of both hands was increased in both groups(P<0.05),with these changes being more significant in the treatment group(P<0.05).RF,ESR,CRP,and anti-CCP antibodies were decreased in both groups(P<0.05),with these levels being significantly lower in the treatment group(P<0.05).Similarly,RA-PRO,DAS28,and TCM syndrome scores were decreased in both groups(P<0.05),with these scores being significantly lower in the treatment group(P<0.05).The total clinical effective rate was 96.67%(29/30)in the treatment group,which was higher than 73.33%(22/30)in the control group(P<0.05).Additionally,the incidence of adverse reactions was 13.33%(4/30)in the treatment group,lower than 26.66%(8/30)in the control group,without significant differences(P>0.05).Conclusion For RA at the active stage with dampness-heat blocking collateral syndrome,the clearing heat and dredging collateral method achieves a satisfactory therapeutic effect.With a high safety profile,Qinre Tongluo Decoction,based on conventional Western medicine treatment can better improve the clinical symptoms and signs,enhance clinical efficacy,reduce disease activity and inflammatory response,while the efficacy of this combined treatment can be evaluated from dimensions such as somatosensory,physical function,and psychological health.