Correlations between symptoms as assessed in traditional chinese medicine (TCM) and ACR20 efficacy response - A comparison study in 396 patients with rheumatoid arthritis treated with TCM or Western medicine
Correlations between symptoms as assessed in traditional chinese medicine (TCM) and ACR20 efficacy response - A comparison study in 396 patients with rheumatoid arthritis treated with TCM or Western medicine
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DOI：
10.1097/rhu.0b013e31815d019b
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发表时间：
2007-12-01
影响因子：
3.4
通讯作者：
Lu, Cheng
中科院分区：
文献类型：
--
作者：
He, Yiting;Lu, Aiping;Lu, Cheng
目的：本研究旨在探讨传统中医药评价关节和非关节临床表现在预测类风湿关节炎疗效中的作用。方法：将396例患者随机分为西药组197例和中药组199例。在随机化前记录完整的体格检查和18种中医典型临床表现。WM治疗包括双氯芬酸长效片、甲氨蝶呤和柳氮磺胺吡啶。中药治疗采用雷公藤多甙片、托托片、益肾蠲痹片。采用美国流变学学会（ACR）反应标准进行疗效评价。结果：治疗24周时，西医组的ACR20和50应答率均高于中药组。在西医组中，89%达到ACR 20，而中医组中65.8%达到此反应。在西医组中，疗效与头晕的主观症状呈负相关，与入组时记录的关节压痛和口渴呈正相关。结论：与关节无直接关系的症状和中医症状可能对治疗效果有影响，并可能有助于指导具体治疗，值得进一步研究。
Objective: This research was designed to explore the role of joint and nonarticular clinical manifestations traditionally evaluated in Chinese herbal medicine in predicting efficacy of treatment for rheumatoid arthritis.Methods: Three hundred ninety-six patients were randomly divided to receive Western medicine (WM) therapy, 197 cases; and traditional Chinese herbal medicine (TCM), 199 cases. A complete physical examination and 18 clinical manifestations typically assessed in TCM were recorded before the randomization. The WM therapy included diclofenac extended action tablets, methotrexate, and sulfasalazine. The TCM therapy included Glucosidorum Tripterygll Totorum tablets and Yishen Juanbi tablets. The American College of Rheumatology (ACR) response criteria were used for efficacy evaluation. All data were analyzed using the SPSS1 1.5 statistical package.Results: ACR20 and 50 responses with WM treatment were higher at 24 weeks than in the TCM group. In the WM group, 89% achieved ACR20 whereas 65.8% on TCM reached this response In the WM group, efficacy was negatively related to subjective symptoms of dizziness, and positively related to joint tenderness and thirst as recorded at entry. In contrast, in the TCM group the efficacy was positively related to joint tenderness and joint pain, and negatively related to the joint stiffness and more nocturia.Conclusion: Symptoms including those not directly related to joints and those inquired about in TCM may have influence on the efficacy of therapy, and might merit further study to ascertain if they can be helpful to guide specific therapy.