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Journal of Chinese Integrative Medicine ›› 2006, Vol. 4 ›› Issue (4): 348-354.doi: 10.3736/jcim20060406

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

Effects of traditional Chinese medicine for invigorating spleen to resolve dampness and dredging collaterals on patients with rheumatoid arthritis and anemia

Jian Liu, Hua Li, Xi Chen   

  1. Department of Rheumatology, First Hospital, Anhui College of Traditional Chinese Medicine, Hefei, Anhui Province 230031, China
  • Online:2006-07-31 Published:2006-07-15

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Objective

To observe the clinical effects of Xinfeng Capsules (XFC), a traditional Chinese medicine for invigorating the spleen to resolve dampness and dredging collaterals, on patients with rheumatoid arthritis (RA) and anemia, and to investigate its mechanism.

Methods

Forty patients with RA and anemia were divided into three groups: XFC-treated group (n=20), Tripterygium glycosides Tablets (TGT)-treated group (n=10) and methotrexate (MTX)-treated group (n=10). The patients in each group took corresponding medicine for three months. The response rates of the three groups were evaluated after treatment. The general symptoms and specific signs and symptoms of RA were observed before and after the treatment. The indexes of blood routine examination and some other laboratory indexes such as erythrocyte sedimentation rate (ESR), and blood levels of rheumatoid factor (RF), iron, C-reaction protein (CRP), immunoglobins (Ig), complements 3 and 4, tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) and erythropoietin (EPO) were all examined and compared before and after treatment.

Results

The total response rate in the XFC-treated group was similar to those both in the TGT-treated and MTX-treated groups. The effects on relieving specific symptoms of RA in the three groups were also similar. The ESR and serum levels of RF, CRP, IgG, IgA and IgM were all decreased after treatment as compared with those before treatment in the three groups, and there were no significant differences among those laboratory indexes in the three groups after treatment. The XFC displayed more obvious effects on improving the general symptoms of patients with RA and anemia, increasing the blood levels of hemoglobin, iron and IL-10, while decreasing the serum level of TNF-α and regulating the serum EPO level, as compared with those in the TGT-treated and MTX-treated groups.

Conclusion

The XFC for invigorating the spleen to resolve dampness and dredging collaterals was developed on the basic principle of regulating spleen.It can obviously improve the symptoms and laboratory indicators of RA. Such effects may be related to maintaining the balance of cytokines, regulating the serum level of EPO and increasing the serum iron level in patients with RA and anemia.

Key words: Rheumatoid arthritis, Anemia, Xinfeng Capsules, Tripterygium wilfordii, Methotrexate, Clinical trials

CLC Number: 

  • R593.22

Table 1

Therapeutic outcomes of patients with RA in three groups"

Group n Clinical recovery Significant response Partial response Non-response Total response rate
XFC-treated 20 1 (5%) 13 (65%)* 4 (20%) 2 (10%) 90%
TGT-treated 10 0 2 (20%) 6(60%) 2 (20%) 80%
MTX-treated 10 1 (10%) 5 (50%) 3 (30%) 1 (10%) 90%

Table 2

Specific signs and symptoms of patients with RA before and after treatment in three groups（ヌ±S）"

Group n Joint pain Joint swelling Duration of
morning stiffness (h)		 Fifteen-meter
walking time (s)
Number of joints Score Number of joints Score
XFC-treated
Before treatment 20 8.45±1.85 5.67±2.03 5.31±1.82 4.88±1.86 2.65±1.78 27.93±5.31
After treatment 20 4.85±1.93* 2.00±1.78* 2.56±1.63* 1.69±1.54* 0.97±0.77* 18.40±3.70*
TGT-treated
Before treatment 10 8.55±2.30 5.40±2.37 5.60±1.07 5.40±2.37 2.82±1.64 27.40±5.12
After treatment 10 5.25±1.79* 2.40±1.89* 2.50±0.85* 2.10±2.02* 1.08±0.91* 18.60±2.76*
MTX-treated
Before treatment 10 8.64±1.80 5.10±2.02 5.40±1.26 5.10±2.02 2.47±1.48 28.10±6.31
After treatment 10 4.82±1.48* 2.70±1.70* 2.20±1.14* 2.40±1.89* 1.04±0.84* 18.90±2.77*

Table 3

General symptoms of patients with RA before and after treatment in three groups (Cases)"

Group n Fatigue Pale or dim complexion Pale lips Palpitation Pale tongue
XFC- treated
Before treatment 20 18 9 12 16 14
After treatment 20 6**△△▲▲ 3*△ 4*△▲ 9* 6*
TGT-treated
Before treatment 10 8 3 5 7 5
After treatment 10 7 5 6 6 6
MTX-treated
Before treatment 10 9 4 7 9 6
After treatment 10 9 6 7 8 6

Table 4

Blood routine examination for patients with RA and their serum iron concentration before and after treatment in three groups（ヌ±S）"

Group n WBC count
(×109/L)		 RBC count
(×109/L)		 Hb (g/L) PLT count
(×109/L)		 Serum iron
(μmol/L)
XFC-treated
Before treatment 20 5.49±2.10 3.58±0.41 98.60±12.59 219.29±109.44 4.80±1.99
After treatment 20 6.56±1.74**▲ 3.93±0.55**△△▲▲ 110.10±13.70**△△▲▲ 206.21±72.65* 6.03±2.57**
TGT-treated
Before treatment 10 6.49±1.86 3.69±0.42 100.56±8.16 259.14±130.44 4.01±2.51
After treatment 10 5.35±1.52 3.59±0.55 96.67±10.58* 262.14±104.71 5.16±3.06
MTX-treated
Before treatment 10 6.15±1.00 3.87±0.28 102.89±12.18 255.33±165.22 3.70±1.60
After treatment 10 5.95±2.02 3.72±0.40 100.78±18.39 242.67±156.90 4.74±1.79**

Table 5

ESR and blood levels of RF, CRF and immunoglobulins of patients with RA before and after treatment in three groups（ヌ±S）"

Group n RF (×103 U/L) ESR (mm/h) CRP (mg/L) IgG (g/L) IgA (g/L) IgM (g/L)
XFC-treated
Before treatment 20 155.76±151.74 64.82±35.01 16.63±6.42 18.84±7.09 3.43±1.41 1.86±1.00
After treatment 20 76.94±61.17** 42.41±32.47** 5.37±3.34** 13.76±3.58** 2.65±1.26* 1.22±0.51**
TGT-treated
Before treatment 10 157.33±94.07 88.11±27.39 15.32±5.32 17.03±2.79 3.14±0.90 1.96±0.97
After treatment 10 91.22±61.37** 72.33±21.04* 5.70±3.26** 11.30±3.36** 2.00±0.91** 1.43±0.66*
MTX-treated
Before treatment 10 162.89±161.54 73.56±31.39 16.78±5.31 19.59±5.25 3.84±1.44 1.87±0.61
After treatment 10 102.56±98.21* 53.33±17.97* 7.04±2.91** 14.38±3.60** 2.06±0.69** 1.02±0.31**

Table 6

Serum levels of C3, C4, EPO, TNF-α and IL-10 of patients with RA before and after treatment in three groups（ヌ±S）"

Group n C3 (mg/L) C4 (mg/L) EPO (U/L) TNF-α (ng/L) IL-10 (ng/L)
XFC-treated
Before treatment 20 1346.0±450.5 246.8±88.4 39.36±31.44 94.12±69.33 51.45±23.17
After treatment 20 1493.9±406.3* 275.1±99.1* 16.54±10.76** 51.23±38.31** 95.92±76.63**
TGT-treated
Before treatment 10 1154.1±280.5 230.2±58.9 38.03±26.94 95.46±62.44 54.64±29.47
After treatment 10 1329.4±356.0 277.6±83.2 52.39±33.86**△△ 54.17±38.51* 77.96±50.97*
MTX-treated
Before treatment 10 1069.3±244.4 169.4±56.4 42.36±28.29 89.37±48.70 53.87±31.73
After treatment 10 1310.9±283.2 261.9±69.9* 32.09±20.00*△△ 51.24±36.31** 81.37±67.90*
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