Clinical Observation of Yishen Zhuanggu Tongbi Decoction in the Treatment of Rheumatoid Arthritis

[Objective] To evaluate the therapeutic effect of Chinese herbal medicine of Yishen Zhuanggu Tongbi Decoction (YZTD), a formula mainly composed of Radix Aconiti Lateralis Preparata, Hema Epimedii, Fructus Psoraleae,Rhizoma Chuanxiong, Radix Angelicae Sinensis, Radix Angelicae Pubescentis and Radix Dipsaci, for rheumatoid arthritis (RA). [Methods] Forty-four cases of RA were randomized into two groups: group A ( n = 24) was treated with YZTD for oral use and with the residue of YZTD for external application; group B ( n = 20) was treated with diclofenac sodium. After 8-week treatment, function of joint, adverse reactions, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP) and immunoglobulins levels were observed. Continuous treatment was given for the effective cases and a follow-up was conducted for 1 - 3 years to observe its long-term effect. [ Results ] Pain, swelling, tenderness and morning rigidity of the joints were improved much more in group A than those in group B ( P 0.05); the effects of YZTD on ESR, CRP and IgG in group A were superior to those in group B ( P 0.01). The 3-year follow-up in the effective cases showed that 5 cases of 22 in group A relapsed, accounting 22.7%; 8 cases of 12 relapsed in group B, accounting 66.7%; the difference was statistically different between two groups ( P 0.05). During 8-week treatment, adverse reactions were found in 2 (8.33% ) cases of group A and in 6 (40% ) of group B, the difference being significant (P 0.05). [Conclusion] The effects of YZTD for oral use and external application is better than that of diclofenac sodium in relieving inflammation and pain, subsiding swelling and improving function of joint, the incidence of adverse reactions being low and the long-term effect being good.