Clinical Study on Bitongding Capsule Combined with Leflunomide Tablets in Treatment for Rheumatoid Arthritis

CHENG Jun-min; WANG Gang; MA Zhi-yi; WANG Jin-jun

doi:10.13730/j.issn.1009-2595.2017.12.006

Abstract：Objective To analyze the clinical efficacy of Bitongding capsule and leflunomide tablets for treatment of rheumatoid arthritis (RA) patients,and the influence on serum tumor necrosis factor alpha(TNF-α),interleukin-4(IL-4) and interleukin-10(IL-10).Methods A total of 60 RA patients in authors' hospital from April to September in 2017 were divided into treatment group,control group and blank group according to the medication situation of the patients,each group with 20 cases.The treatment group was given Bitongding capsule and leflunomide tablets,the control group was given leflunomide tablets,and the two groups were treated for 12 weeks.The blank group,the RA patients that diagnosed but not given drugs yet.C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),antibodies against cyclic citrullinated peptide(anti-CCP) and rheumatoid factor (RF) were measured by biochemical analyzer,and the clinical effects of treatment group and control group were evaluated by the Americian College of Rheumatology (ACR) standard,disease activity score 28(DAS 28) score and effective rate of traditional Chinese medicine syndrome.The levels of serum cytokines TNF-α,IL-4 and IL-10 were tested by the method of enzyme-linked immunosorbent assay.Results The levels of ESR,CRP,anti-CCP decreased in blank group,control group and treatment group in turn (P＜0.01),but had no significant difference in RF among three groups (P＞0.05).ACR 20 and ACR 50 in treatment group were better than those in control group (P＜0.05),but ACR 70 had no significant difference (P ＞ 0.05),DSA 28 scores of control group and treatment group decreased significantly than these of blank group (P ＜ 0.01),and treatment group decreased significantly than control group (P ＜0.05).The effective rate of traditional Chinese medicine syndrome in treatment group (90％) was significantly higher than that in control group (75％) (P＜0.05).In terms of serum cytokines,the serum TNF-α levels in blank group,control group and treatment group decreased in turn,and the expressions of IL-4 and IL-10 increased in turn,there were significantly different among three groups (P＜0.05 or 0.01).Conclusion Combining Bitongding capsule with leflunomide tablets for RA treatment can improve the clinical symptoms and biochemical indexes of patients,and inhibit the production of inflammatory cytokines.