Clinical Observation of Qifu Huazhuo Decoction in Treating Intermittent and Chronic Gout / 中国实验方剂学杂志

Objective:To observe the efficacy and safety of Qifu Huazhuo decoction in treating intermittent and chronic gout. Method:A total of 160 eligible patients with intermittent and chronic gout were divided into intervention group and control group according to treatment methods， 80 cases in each group. Qifu Huazhuo decoction combined with febuxostat was given in intervention group by oral administration， while the patients in control took febuxostat combined with sodium bicarbonate tablet. After twelve weeks of treatment in both groups， the onset frequency of gout， the degree of joint pain， the levels of uric acid， creatinine， alanine transaminase in the blood， number of cases to use analgesics and adverse events were recorded compared before and after treatment. Twelve weeks follow-up was also conducted after the treatment. Result:The total effective rate was 91.25% （73/80） in intervention group， higher than 83.75% （67/80） in control group， with a significant difference between two groups （χ2=0.16， P<0.05）. Intervention group was superior to control group in improvement of onset frequency of gout， joint pain （P<0.05）， and blood uric acid （P<0.05）. There was no significant difference between two groups in blood creatinine and alanine transaminase. The number of patients using analgesics was less in intervention group （P<0.05）. In terms of adverse reactions， there were two cases of fever， two cases of abnormal liver function， six cases of abnormal kidney function and three cases of gastrointestinal reaction after the treatment in intervention group. While for control group， there were one case of fever， two cases of abnormal liver function， eight cases of abnormal kidney function and five cases of gastrointestinal reaction， without significant differences between two groups. Conclusion:The Qifu Huazhuo decoction can effectively reduce the onset frequency of gout and the degree of joint pain in intermittent and chronic phases， effectively control the level of blood uric acid， and reduce the number of cases using analgesics， with less adverse reactions， so it is suitable for clinical use.

Treatment of Refractory Rheumatoid Arthritis by Huayu Tongbi Recipe Combined Methotrexate / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of Huayu Tongbi Recipe (HTR) combined methotrexate (MTX) in treating refractory rheumatoid arthritis (RRA).</p><p><b>METHODS</b>Totally 167 RRA patients were assigned to the treatment group (73 cases) and the control group (94 cases) according to different therapeutic methods. Patients in the treatment group were treated with HTR combined MTX, while those in the control group were treated with leflunomide (LEF) combined MTX. Clinical signs and symptoms, RF, CRP, ESR, disease activity score 28 (DAS28), and safety indicators were compared between the two groups before treatment, at week 12 and 24 after treatment. The efficacy and safety indices were also evaluated.</p><p><b>RESULTS</b>At week 12 after treatment the total effective rate was 82.2% (60/73 cases) in the treatment group and 79.8% (75/94 cases) in the control group, showing no statistical difference between the two groups (chi2 = 0.15, P > 0.05). At week 24 after treatment the total effective rate was 78.1% (57/73 cases) in the treatment group and 755% (71/94 cases) in the control group, showing no statistical difference between the two groups (chi2 = 0.15, P > 0.05). There was statistical difference in the total effective rate between week 24 and week 12 in the control group (chi2 = 0.49, P < 0.05). Clinical signs and symptoms, RF, CRP, ESR, and DAS28 were significantly improved in the two groups after 12- and 24-week treatment (P < 0.01). There was no statistical difference in the improvement at week 12 after treatment between the two groups (P > 0.05). There was statistical difference in time of morning stiffness, tender joint numbers, swollen joint numbers, patient global assessment, RF, CRP, and DAS28 at week 24 after treatment between the two groups (P < 0.05). Besides, adverse reactions occurred less in the treatment group than in the control group (P < 0.01).</p><p><b>CONCLUSION</b>The efficacy of HTR combined MTX was equivalent to that of LEF (10 mg per day) combined MTX, but with more stable therapeutic effects and less adverse reactions.</p>

Regulatory roles of compound danshen in the downstream path of cyclooxygenases in rheumatoid arthritis patients' synovium / 中国中西医结合杂志

Rheumatoid arthritis (RA) belongs to Bi syndrome (arthralgia) in Chinese medicine. Till now there lacks effective therapeutic methods. Recently cyclooxygenases (COXs) inhibitors, having regulator roles for many pro-inflammatory cytokines, have been widely used in RA treatment. But due to existing cardiovascular risks, researches on targeting the downstream specific factors of COXs have been under discussion. Considering the key role of blood stasis syndrome (BSS) in the pathology of RA and the fact that thromboxane A2 (TXA2) plays a pivotal role in BSS, we theoretically explored possible regulatory roles of Compound Danshen, a representative therapy in blood activating stasis removing method in the downstream path of COXs in synovial cells of RA. We proposed a brand new research direction of RA researches.