Analysis on clinical efficacy of Nanhu gel in treatment of rheumatoid arthritis and identification of its active ingredients

YUAN Yi; WANG Yuyu; WANG Jin; ZHAO Xiaofeng; ZUO Fangfang; XUAN Ya'nan; CHEN Ensheng; XIAO Changhong; LIU Qiang

doi:10.3969/j.issn.1674-3806.2025.07.09

Abstract：Objective To analyze the clinical efficacy of Nanhu gel in treatment of rheumatoid arthritis(RA)and to identify its active ingredients.Methods Using Franz diffusion devices with female nude mouse skin as the barrier and 75％ethanol solution as the receiving medium,thin-layer chromatography(TLC)was employed to identify active ingredients in the transdermal absorption solution of Nanhu gel.Sixty RA patients admitted to Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine from May 2017 to December 2021 were recruited and randomly divided into blank gel group,Nanhu gel group and Votalin(diclofenac sodium)group using random number table method,with 20 patients in each group.Blank gel,Nanhu gel,and Votalin cream were topically applied to the most significantly swollen joints(single joint)in the patients of each group,0.5-1.0 g per time(adjusting the dosage according to the joint circumference),massaging the joints where the medicine was applied for 1 to 2 minutes,once daily,for 7 consecutive days.The clinical efficacy,the onset time of the medication,Visual Analogue Scale(VAS)scores,joint circumference and inflammatory indicators were compared among the three groups.The occurrence of adverse reactions in the three groups during the treatment period was recorded.Results The results of TLC identification suggested that emodin,celastrol and myrrh essential oil in Nanhu gel could exert therapeutic effects through permeating the skin.After the treatment,the VAS scores in the Nanhu gel group were significantly lower than those in the Votalin group and the blank gel group(P＜0.05),and the onset time of the medication in the Nanhu gel group was significantly faster than that in the Votalin group and the blank gel group(P＜0.05).The total clinical effective rates in the Nanhu gel group,the Votalin group and the blank gel group were 90.00％,80.00％and 70.00％,respectively,and the differences were statistically significant among the three groups(P＜0.05).There were no statistically significant differences in the joint circumference,erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels among the three groups before and after treatment(P＞0.05).No drug-related adverse reactions were observed in the three groups during the treatment period.Conclusion Nanhu gel can effectively relieve the clinical symptoms of RA patients and has the advantages of good safety and rapid onset of action.Emodin,celastrol and myrrh essential oil are its main active ingredients.