Clinical observation of Wutou Decoction and Methotrexate for early active rheumatoid arthritis patients / 国际中医中药杂志

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.