School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350003, China.
Chin J Integr Med. 2012 Apr;18(4):256-61. doi: 10.1007/s11655-011-0793-0. Epub 2011 Aug 18.
To investigate the effects of Qingre Huoxue Decoction , clearing heat and promoting blood flow; QRHXD), on the radiographic progression in patients with rheumatoid arthritis (RA) by X-ray imaging.
Eighty-six patients with active RA diagnosed as damp-heat and blood stasis syndrome were randomized into a QRHXD group and a QRHXD plus methotrexate (MTX) group, with 43 cases in each group. After one-year of treatment, 21 cases in each group (42 in total) were evaluated. Radiographs of hands were obtained at the baseline and after 12 months of treatment. Images were evaluated by investigators blinded to chronology and clinical data, and assessed according to the Sharp/Van der Heijde methods.
High intrareader agreements were reached (mean intraobserver intraclass coefficients: 0.95). No significant change in any imaging parameters of joint destruction was observed at 12 months in either group; and the differences between the two groups were not significant (P>0.05). The mean of the changing score in the QRHXD group was 3.5 ± 4.1, and 2.4 ± 3.5 in the QRHXD+MTX group, while the baseline radiographic score of patients in the QRHXD group was relatively higher (18.9 ± 19.1 vs. 14.0 ± 14.0). The mean rates of the changing scores of the two groups were similar (0.24 ± 0.28 vs. 0.25 ± 0.44, P=0.40). The severity of progression in the two groups was also similar (P=0.46), 7 cases without radiographic progression in the QRHXD group and 8 in the QRHXD+MTX group, 3 cases with obvious radiographic progression in the QRHXD group and 1 in the QRHXD+MTX group.
Radiographic progression of RA patients in both groups is similar, indicating that the QRHXD Decoction has a potential role in preventing bone destruction.
通过 X 射线成像研究清热活血方（QRHXD）对类风湿关节炎（RA）患者放射进展的影响。
86 例符合湿热瘀阻证的活动期 RA 患者随机分为 QRHXD 组和 QRHXD 加甲氨蝶呤（MTX）组，每组 43 例。治疗 1 年后，每组各有 21 例（共 42 例）进行评估。在基线和治疗 12 个月时拍摄手部 X 光片。图像由对病程和临床数据不知情的研究者进行评估，并根据 Sharp/Van der Heijde 方法进行评估。
观察者内评估具有高度一致性（平均观察者内组内相关系数：0.95）。两组在 12 个月时均未观察到任何关节破坏影像学参数的显著变化，且两组间差异无统计学意义（P＞0.05）。QRHXD 组的改变评分均值为 3.5±4.1，QRHXD+MTX 组为 2.4±3.5，而 QRHXD 组患者的基线放射评分相对较高（18.9±19.1 vs. 14.0±14.0）。两组的改变评分均值率相似（0.24±0.28 vs. 0.25±0.44，P=0.40）。两组的进展严重程度也相似（P=0.46），QRHXD 组无放射进展 7 例，QRHXD+MTX 组 8 例；QRHXD 组有明显放射进展 3 例，QRHXD+MTX 组 1 例。
两组 RA 患者的放射进展相似，表明清热活血方在预防骨质破坏方面具有潜在作用。
