Search JIM Advanced Search

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

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
[1] 吕爱平, 李梢, 王永炎 . 从主观症状的客观规律探索中医证候分类的科学基础[J]. 中医杂志, 2005,46(1):4-6
[2] 查青林, 林色奇, 吕爱平 . 多元统计分析在中医证候研究中的应用探析[J]. 江西中医学院学报, 2004,16(6):79-80
[3] Albert DA, Huang G, Dubrow G , et al.Rheumatoid arthritis: the status and future of combination therapy. Proceedings of a meeting. Chatham, Massachusetts, USA, July 13-15, 1995[J]. J Rheumatol Suppl, 1996,44 1-110
[4] Criteria for improvement in rheumatoid arthritis: alternatives to the American college of rheumatology 20[J]. J Rheumatol, 2004,31(5):856-866
[5] 董新民 . 类风湿性关节炎的中医病因病机探讨[J]. 南京中医药大学学报, 1996,12(4):9-10
[6] 张承福 . 类风湿性关节炎病机特点与治法探讨[J]. 湖南中医药导报, 1998,4(8):10-11
[7] 汪明忠 . 类风湿性关节炎786例病因病机分析[J]. 新中医, 1989,21(9):10-11
[8] 季守贤, 胡芳 . 类风湿性关节炎的中医证候分析[J]. 长春中医学院学报, 1995,11(3):33
[9] 肖长虹, 胡文 . 试论类风湿性关节炎中医研究的思路与方法[J]. 新中医, 1997,29(11):2-5
[10] 谢洁行, 吕薇 . 雷公藤有效成份与其主要药效关系的探索[J]. 吉林中医药, 1997,17(4):43-44
[11] 刘强, 周莉玲, 李锐 . 雷公藤制剂研究概况[J]. 中国药学杂志, 1997,32(2):68-72
[12] 朱良春 . 医学微言·益肾蠲痹丸治疗顽痹200例的疗效观察(第1版)[M]. 北京: 人民卫生出版社, 1998,( 第1版):69-74
[13] 杨明信 . 碥石集·痹症研究的回顾和展望(第1版)[M]. 吉林: 吉林科学技术出版社, 1999,( 第1版):62-67
[14] 吕爱平, 王安民, 曾晓莲 . 益肾蠲痹丸对大鼠实验性痹证影响的病理学研究[J]. 中医杂志, 1988,29(6):49-51
[15] 董明心 . 益肾蠲痹丸治疗类风湿性关节炎[J]. 中国民间疗法, 1999,7(6):25-26
[16] 王绍海 . 乌头汤加味治疗类风湿性关节炎[J]. 天津中医学院学报, 2000,19(1):26-27
[17] 程建萍, 林洁 . 加味乌头汤治疗类风湿性关节炎42例临床观察[J]. 浙江中医杂志, 1999,34(8):355
[18] 卢春玲, 王珲 . 乌头汤化裁治疗类风湿性关节炎初探[J]. 中国民间疗法, 1999,7(8):43
[19] 施旭光, 杨经远 . 中西药合用治疗类风湿性关节炎112例疗效观察[J]. 上海中医药杂志, 1999,32(12):28-29
[20] 韩振贵, 马玉琛, 韦达 , 等. 中药内外合用治疗类风湿性关节炎临床观察[J]. 河北中医, 2000,22(12):906-907
[21] 杨中杰 . 桂枝芍药知母汤加减治疗急性期类风湿性关节炎280例[J]. 河南中医药学刊, 1999,14(2):46-47
[22] 王吕成 . 桂枝芍药知母汤加减治疗类风湿性关节炎34例[J]. 四川中医, 2000,18(5):22-23
[23] 房莉萍 . 桂枝芍药知母汤加减对类风湿性关节炎近期疗效观察[J]. 江苏中医, 2000,21(4):11-12
[24] American college of rheumatology subcommittee on rheumatoid arthritis guidelines. Guidelines for the management of rheumatoid arthritis: 2002 update[J]. Arthritis Rheum, 2002,46(2):328-346
doi: 10.1002/(ISSN)1529-0131
[25] 吕爱平, 朱良春 . 再论证候研究思路与方法[J]. 中国中医基础医学杂志, 2004,10(8):1-2, 7
[26] Lu AP, Zhang SS, Zha QL , et al. Correlation between CD4, CD8 cells infiltration in gastric mucosa, Helicobacter pylori infection and symptoms in patients with chronic gastritis[J]. World J Gastroenterol, 2005,11(16):2486-2490
doi: 10.3748/wjg.v11.i16.2486
[27] 查青林, 林色奇, 何羿婷 , 等. 从主观症状因子分析的结果看中医辨证的数学逻辑——附469例RA多中心临床病例分析[J]. 江西中医学院学报, 2005,17(1):75-77
[28] 易家康 . 人类疾病进入个性化治疗时代[J]. 世界科学, 2001,21(3):19-20
[29] Guthrie E, Creed F, Fernandes L , et al. Cluster analysis of symptoms and health seeking behaviour differentiates subgroups of patients with severe irritable bowel syndrome[J]. Gut, 2003,52(11):1616-1622
doi: 10.1136/gut.52.11.1616
[30] 张琴, 张文彤, 魏建军 , 等. 公因子和聚类分析联合在肝炎后肝硬化证候分类研究中的应用[J]. 中西医结合学报, 2005,3(1):14-18
[31] Li S, Lu AP, Zhang L , et al. Anti-Helicobacter pylori immunoglobulin G(IgG) and IgA antibody responses and the value of clinical presentations in diagnosis of H. pylori infection in patients with precancerous lesions[J]. World J Gastroenterol, 2003,9(4):755-758
doi: 10.3748/wjg.v9.i4.755
[32] Lu AP, Jia HW, Xiao C , et al. Theory of traditional Chinese medicine and therapeutic method of diseases[J]. World J Gastroenterol, 2004,10(13):1854-1856
doi: 10.3748/wjg.v10.i13.1854
[1] Chiung-Hui Huang, Mei-Ling Yeh, Fang-Pey Chen, Daphne Wu. Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial. Journal of Integrative Medicine, 2022, 20(4): 321-328.
[2] Ye-juan Jia, Tian-yu Li, Peng Han, Yu Chen, Li-jia Pan, Chun-sheng Jia. Effects of different courses of moxibustion treatment on intestinal flora and inflammation of a rat model of knee osteoarthritis. Journal of Integrative Medicine, 2022, 20(2): 173-181.
[3] Ju-Yeon Park, Young-Won Kwon, Sun-Ah Kim, Sun-Dong Park, Chang-Hyun Kim, Jin-Hee Kim, Ju-Hee Lee. Polyherbal formula SC-E3 inhibits rheumatoid arthritis activity in a mouse model of type-II collagen-induced arthritis. Journal of Integrative Medicine, 2021, 19(3): 265-273.
[4] Johannes Loeser, Brigitte Layer, Christopher Plata, Klaus-Maria Perrar, Tim Hucho, Rebecca Kulbida. Hirudotherapy attenuates arthritic pain in patients with various chronic pain syndromes: A retrospective analysis. Journal of Integrative Medicine, 2020, 18(5): 425-433.
[5] Sandip B. Bharate, Vikas Kumar, Sonali S. Bharate, Bikarma Singh, Gurdarshan Singh, Amarinder Singh, Mehak Gupta, DeepikaSingh, AjayKumar, Surjeet Singh, Ram A. Vishwakarma. Discovery and preclinical development of IIIM-160, a Bergenia ciliata-based anti-inflammatory and anti-arthritic botanical drug candidate. Journal of Integrative Medicine, 2019, 17(3): 192-204.
[6] Ya-ru Huangfu, Wei Peng, Bao-jun Guo, Zhi-fu Shen, Li Li, Shi-wei, Liu, Hui Zheng, You-ping Hu. Effects of acupuncture in treating insomnia due to spleen-stomach disharmony syndrome and its influence on intestinal microbiome: Study protocol for a randomized controlled trial. Journal of Integrative Medicine, 2019, 17(3): 161-167.
[7] Katy Andrade Monteiro Zacaron, Nélia da Silva Mendes, Yuri Cotta e Silva, Giancarlo Lucchetti. Effects of laying on of hands with and without a spiritual context on pain and functionality of older women with knee osteoarthritis: Study protocol for a randomized controlled trial. Journal of Integrative Medicine, 2018, 16(2): 106-112.
[8] Hidetoshi Mori, Hiroshi Kuge, Shunji Sakaguchi, Tim Hideaki Tanaka, Junji Miyazaki. Determination of symptoms associated with hiesho among young females using hie rating surveys. Journal of Integrative Medicine, 2018, 16(1): 34-38.
[9] Kyeong Mee Park, Tae Hwan Cho. Therapeutic effect of acupuncture point injection with placental extract in knee osteoarthritis. Journal of Integrative Medicine, 2017, 15(2): 135-141.
[10] Susana Seca, Sebastian Kirch, António S.Cabrita, Henry J.Greten. Evaluation of the effect of acupuncture on hand pain, functional deficits and health-related quality of life in patients with rheumatoid arthritis—A study protocol for a multicenter, double-blind, randomized clinical trial. Journal of Integrative Medicine, 2016, 14(3): 219-227.
[11] MesfinYimam, Young-Chul Lee, Breanna Moore, Ping Jiao, MeiHong, Jeong-Bum Nam, Mi-Ran Kim, Eu-Jin Hyun, Min Chu, Lidia Brownell, Qi Jia. Analgesic and anti-inflammatory effects of UP1304, a botanical composite containing standardized extracts of Curcuma longa and Morus alba. Journal of Integrative Medicine, 2016, 14(1): 60-68.
[12] Anirudha A. Lande, Shirishkumar D. Ambavade, Uma S. Swami, Prafulla P. Adkara Prashant D. Ambavade, Arun B. Waghamare. Saponins isolated from roots of Chlorophytum borivilianum reduce acute and chronic inflammation and histone deacetylase. Journal of Integrative Medicine, 2015, 13(1): 25-33.
[13] Jian Liu, Chuan-bing Huang, Yuan Wang, Gui-qin Xu, Yuan-yuan Cheng, Yun-xia Feng, Lei Liu, Ya-jun Qi. Chinese herbal medicine Xinfeng Capsule in treatment of rheumatoid arthritis: Study protocol of a multicenter randomized controlled trial. Journal of Chinese Integrative Medicine, 2013, 11(6): 428-434.
[14] Feng-bin Liu, Zheng-kun Hou, Yun-ying Yang, Pei-wu Li, Qian-wen Li, Nelson Xie, Jing-wei Li, Xiang-jing Zeng. Literature review and analysis of the application of health outcome assessment instruments in Chinese medicine. Journal of Chinese Integrative Medicine, 2013, 11(3): 157-167.
[15] Martin Schencking, Stefan Wilm, Marcus Redaelli. A comparison of Kneipp hydrotherapy with conventional physiotherapy in the treatment of osteoarthritis: A pilot trial. Journal of Chinese Integrative Medicine, 2013, 11(1): 17-25.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Dong Yang, Yong-ping Du, Qing Shen, Wei Chen, Yan Yu, Guang-lei Chen. Expression of alpha-smooth muscle actin in renal tubulointerstitium in patients with kidney collateral stasis. Journal of Chinese Integrative Medicine, 2008, 6(1): 41-44
[2] Hai-feng Wei, Bai-liu Ya, Ling Zhao, Cui-fei Ye, Li Zhang, Lin Li. Evaluation of tongue manifestation of blood stasis syndrome and its relationship with blood rheological disorder in a rat model of transient brain ischemia. Journal of Chinese Integrative Medicine, 2008, 6(1): 73-76
[3] Xi Lin, Jian-ping Liu. Herbal medicines for viral myocarditis. Journal of Chinese Integrative Medicine, 2008, 6(1): 76
[4] Xi Lin, Jian-ping Liu. Tai chi for treating rheumatoid arthritis. Journal of Chinese Integrative Medicine, 2008, 6(1): 82
[5] Liang-ping Hu, Hui Gao. Discrimination of errors in statistical analysis of medical papers published in the first issue of 2006 in Journal of Chinese Integrative Medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 98-106
[6] Yan-bo Zhu , Qi Wang, Cheng-yu Wu, Guo-ming Pang, Jian-xiong Zhao, Shi-lin Shen, Zhong-yuan Xia , Xue Yan . Logistic regression analysis on relationships between traditional Chinese medicine constitutional types and overweight or obesity. Journal of Chinese Integrative Medicine, 2010, 8(11): 1023-1035
[7] Wei Xu, Meng Shi, Jian-gang Liu, Cheng-long Wang . Collagen protein expressions in ischemic myocardium of rats with acute myocardial infarction and effects of qi-tonifying, yin-tonifying and blood-activating herbs and detoxifying and blood-activating herbs. Journal of Chinese Integrative Medicine, 2010, 8(11): 1041-1047
[8] Tao Wang , Feng Qin. Effects of Chinese herbal medicine Xiaoyao Powder on monoamine neurotransmitters in hippocampus of rats with postpartum depression. Journal of Chinese Integrative Medicine, 2010, 8(11): 1075-1079
[9] Ying Xu , Chang-chun Zeng , Xiu-yu Cai , Rong-ping Guo , Guang Nie , Ying Jin. Chromaticity and optical spectrum colorimetry of the tongue color in different syndromes of primary hepatic carcinoma. Journal of Chinese Integrative Medicine, 2012, 10(11): 1263-1271
[10] Xiang-ying Mao , Qin Bian , Zi-yin Shen. Analysis of the osteogenetic effects exerted on mesenchymal stem cell strain C3H10T1/2 by icariin via MAPK signaling pathway in vitro. Journal of Chinese Integrative Medicine, 2012, 10(11): 1272-1278