ABSTRACT
Objective:The current study aimed to compare the efficacy of Wutou Decoction (WTD) & Methotrexate (MTX) in treating early active rheumatoid arthritis (RA) patients. Methods:A total of 224 early active RA patients who underwent WTD & MTX or MTX alone treatment for 12 weeks in ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, from Jul 2015 to Jun 2017, were retrospectively enrolled. Then the patients were divided into united group ( n=131) and MTX group ( n=93) according to their treatments. At time of Week 0, Week 4, Week 8, Week 12, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), disease activity score in 28 joints (DAS28), Health Assessment Questionnaire (HAQ) were collected and assessed. And the clinical remission rate, low disease activity (LDA) rate and total effective rate were calculated. Results:At Week 8 and Week 12, compared with MTX group, the CRP ( t values were 2.100 and 2.488, respectively), ESR ( t values were 2.130 and 2.777, respectively), DAS28 ( t values were 2.886 and 3.718, respectively), and HAQ ( t values were 2.144 and 2.362, respectively) in the united group were significantly decreased ( P<0.05 or P<0.01). At Week 12, clinical remission rate [12.2% (16/131) vs. 4.3% (4/93); χ2=4.188, P=0.041], LDA rate [38.9% (51/131) vs. 25.8% (24/93); χ2=4.207, P=0.040] in the united group were significantly higher than those in the MTX group. At Week 8, total effective rate [37.4% (49/131) vs. 21.5% (20/93); χ2=6.450, P=0.011] in the united group was significantly higher than that of MTX group; and at Week 12, total effective rate [72.5% (95/131) vs. 52.7% (49/93); χ2=9.316, P=0.002] in the united group was also higher than that of the MTX group. Conclusions:WTD in combination with MTX presents better efficacy in decreasing inflammation level and disease activity, and in improving quality of life as well as total effective rate of RA patients compared with MTX.
ABSTRACT
Objective To compare the efficacy of the conventional PPD skin test and a new enzymelinked immunospot assay(TSPOT-TB)for diagnosing latent tuberculosis infection(LTBI)in patients with rheumatic diseases.Methods Two hundred and sixty rheumatic patients were enrolled,and all were screened for LTBI based on clinical history,chest X-ray,PPD skin test or TSPOT.Results The positive rate of TSPOT assay was 24.1%and that of PPD skin test was 39.4%.The overall concordance rate between the 2tests was 61.0%.Among PPD negative patients (n=149).29 were TSPOT(+)(19.5%).Among PPD(+)patients(n=98),69 were TSPOT(-)(70.0%).The patients who got BCG vaccination or had history of tuberculosis infection showed a significantly higher rate of positive result of PPD skin test than those who did not (P<0.05 or P<0.01).While in TSPOT assay,the BCG vaccination or history of tuberculosis infection did not show influence on TSPOT results(P>0.05).Of the 127 patients who received biological agents after screening for LTBI,9 patients were pretreated with isoniazide.Twenty-seven patients stopped biological agent treatment because of the positive results of PPD or TSPOT.Twenty three patients who had positive PPD but negative TSPOT results received biological agent treatment without isoniazide,and none of them developed active tubereulosis after 6 to 18 months of follow-up.Conclusion BCG vaccination affects the result of PPD test in rheumatic patients,but has no influence on TSPOT results.The infection rate of latent tuberculosis of rheumatic patients in our research is 23.8%detected by TSPOT.