Objective To study the efficacy and safety of Qingwei Tongluo Decoction(清 胃通络汤)combined with methotrex-ate in the treatment of acute rheumatoid arthritis.Methods A total of 110 patients with acute onset of rheumatoid arthritis admit-ted to the hospital from February 2020 to March 2022 were randomly divided into study group and control group,with 55 cases in each group.The control group was treated with methotrexate,and the study group was treated with Qingwei Tongluo Decoction on the basis of the control group.The two groups were treated for 8 weeks.The TCM syndrome scores,rheumatoid arthritis activity scale(disease activity score 28,DAS28),visual analogue scale(V AS),follicular helper T cells(Tfh),interleukin-21(IL-21),rheumatoid factor(RF),erythrocyte sedimentation rate,hemorheology,safety and clinical efficacy were compared between the two groups.Results After treatment,the TCM syndrome scores of the two groups were decreased(P＜0.05),and the scores of the study group were lower(P＜0.05).After treatment,the DAS28 score and VAS score of the two groups were decreased(P＜0.05),and the score of the study group was lower(P＜0.05).After treatment,the levels of Tfh,IL-21 and RF and erythrocyte sedimentation rate were decreased in the two groups(P＜0.05),and even lower in the study group(P＜0.05).After treatment,fibrinogen,plasma viscosity,hematocrit and high shear viscosity of whole blood were decreased in the two groups(P＜0.05),and even lower in the study group(P＜0.05).There was no difference in the total incidence of adverse reactions between the two groups(P＞0.05).The total effective rate of the study group(96.36％,53/55)was higher than that of the control group(81.82％,45/55)(P＜0.05).Conclusion Qingwei Tongluo Decoction combined with methotrexate is effective in the treatment of rheumatoid arthritis in the acute attack stage,which can improve the clinical symptoms and the hemorheology of patients,reduce the inflammatory reaction and the proportion of Tfh cells,and is safe and reliable.
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