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Journal of Chinese Integrative Medicine ›› 2005, Vol. 3 ›› Issue (6): 432-437.doi: 10.3736/jcim20050604

• Original Clinical Research • Previous Articles     Next Articles

Correlations of clinical symptoms and treatment efficacy in patients with rheumatoid arthritis treated with Chinese herbal drugs or Western medicine

Ai-ping Lv1, Yi-ting He2, Qing-lin Zha3, Xiao-ping Yan4, Li Su5, Yue-jin Song6, Sheng-ping Zeng7, Wei Liu8, Xing-Hua Feng9, Xian Qian10, Wan-hua Zhu11   

  1. 1. Institute of Basic Theory, China Academy of Traditional Chinese Medicine, Beijing 100700, China
    2. Department of Clinical Epidemiology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong Province 510120, China
    3. National Center of Pharmaceutical Engineering Research, Jiangxi College of Traditional Chinese Medicine, Nanchang, Jiangxi Province 330006, China
    4. Department of Rheumatology, China-Japan Friendship Hospital, Beijing 100029, China; etc.
    5. Department of Rheumatology ,Longhua Hospital , Shanghai Universi ty of Traditional Chinese Medicine, Shanghai 200032 , China
    6. Hubei Academy of Traditional Chinese Medicine, Wuhan, Hubei Province 430074 , China
    7. Department of Rheumatology , Aff iliated Hospital , Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province 610075 , China
    8. Department of Rheumatology , First Hospital , Tianjin College of Traditional Chinese Medicine, Tianjin 300193 , China
    9. Department of Rheumatology , Guang’anmen Hospital , China Academy of Traditional Chinese Medicine, Beijing 100053 , China
    10. Department of Rheumatology , Jiangsu Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu Province 210029 , China
    11. Nantong Liangchun Clinical Research Institute of Traditional Chinese Medicine, Nantong, Jiangsu Province 226000 , China
  • Received:2005-06-03 Online:2005-11-20 Published:2005-11-20
  • Contact: Ai-ping Lv E-mail:lap@jzjt.com

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Objective

To evaluate the correlations between clinical symptoms and treatment efficacy in patients with rheumatoid arthritis (RA).

Methods

Four hundred and thirteen patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine-treated group with 204 cases and Chinese herbal drug-treated group with 209 cases. Eighteen clinical symptoms were evaluated before and after treatment. The Western medicine therapy included voltaren extended release tablets, methotrexate and sulfasalazine. The Chinese herbal drug therapy included glucosidorum Tripterygii totorum tablets and Yishen Juanbi Tablets combined with treatment based on syndrome differentiation. The American college of rheumatology 20 (ACR20) was used as efficacy evaluation criteria.

Results

In the Chinese herbal drug-treated group, clinical symptoms such as arthralgia and tenderness of joints were positively correlated with the efficacy after 12-week treatment, while frequent urination at night was negatively correlated. In the same group, tenderness of joints and fever were positively correlated with the efficacy after 24-week treatment, while deep-colored and turbid urine was negatively correlated. In the Western medicine-treated group, tenderness of joints and thirst were positively correlated with the efficacy after 12-week treatment, while vertigo was negatively correlated. And in the same group, tenderness of joints was positively correlated with the efficacy after 24-week treatment, while heaviness of limbs was negatively correlated to the efficacy. The statistical results showed that the treatment efficacy was improved when the correlated symptoms were included in the indications.

Conclusion

The treatment efficacy of RA is correlated with some symptoms, so further studies should proceed on these correlations in order to achieve better treatment outcome.

Key words: Arthritis, Rheumatoid, Regression analysis, Symptoms, Treatment outcome

CLC Number: 

  • R593.22

Tab 1

Regression analysis of relationships between clinicalsymptoms and treatment efficacy after 12-week treatment in Chinese herbal drug-treated group"

Clinical symptom OR 95% confident interval P
Difficult flexion and
stretch of joints		 0.52 0.02-0.31 0.02
Arthralgia 2.07 0.01-1.19 0.01
Tenderness of joints 3.35 0.00-1.79 0.00
Numbness of limbs 1.40 0.21-0.83 0.21
Heaviness of limbs 0.66 0.12-0.39 0.12
Fatigue 1.54 0.10-0.92 0.10
Frequent urination at night 0.51 0.00-0.32 0.00

Tab 2

Regression analysis of relationships between clinical symptoms and treatment efficacy after 24-week treatment in Chinese herbal drug-treated group"

Clinical symptom OR 95% confident interval P
Difficult flexion and
stretch of joints		 0.57 0.36-0.91 0.02
Tenderness of joints 2.44 1.36-4.39 0.00
Fever 1.95 1.12-3.39 0.02
Thirst 1.30 0.85-1.99 0.23
Vertigo 0.72 0.49-1.06 0.10
Deep-colored and turbid urine 0.59 0.34-1.01 0.05

Tab 3

Regression analysis of relationships between clinical symptoms and treatment efficacy after 12-week treatment in Western medicine-treated group"

Clinical symptom OR 95% confident interval P
Difficult flexion and
stretch of joints		 2.59 0.67-9.98 0.17
Tenderness of joints 2.36 1.50-3.72 0.00
Fever 0.48 0.18-1.23 0.13
Thirst 2.34 1.20-4.58 0.01
Vertigo 0.49 0.25-0.96 0.04
Deep-colored and turbid urine 0.51 0.23-1.14 0.10

Tab 4

Relationships between treatment efficacy (ACR20) and multiple combination of clinical symptoms in Western medicine-treated gruop"

Score of tenderness of joints Thirst Vertigo n Efficacy after 12-week
treatment (%)		 Efficacy after 24-week
treatment (%)
≤1 No No 34 26.47 (9/34) 58.82 (20/34)
Yes 10 0.00 (0/10) 30.00 (3/10)
Yes No 21 14.29 (3/21) 33.33 (7/21)
Yes 22 36.36 (8/22) 54.55 (12/22)
≥2 No No 30 36.67 (11/30) 73.33 (22/30)
Yes 24 33.33 (8/24) 87.50 (21/24)
Yes No 38 68.42* (26/38) 71.05 (27/38)
Yes 25 28.00 (7/25) 60.00 (15/25)

Tab 5

Regression analysis of relationships between clinical symptoms and treatment efficacy after 24-week treatment in Western medicine-treated group"

Clinical symptom OR 95% confident interval P
Difficult flexion and
stretch of joints		 1.49 0.90-2.45 0.12
Tenderness of joints 2.07 1.20-3.59 0.01
Cold joints 1.31 0.84-2.05 0.23
Heaviness of limbs 0.54 0.34-0.87 0.01
Fatigue 1.39 0.87-2.22 0.16
Cold limbs 1.52 0.86-2.69 0.15
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