Comparative studies on the effect of methetremate combined with leflunomide in the treatment of different syndromes of rheumatoid arthritis according to Traditional Chinese Medicine

【Objective】To compare methotrexate(MTX) combined with leflunomide(LEF) in the treatment of different syndromes of rheumatoid arthritis(RA) according to Traditional Chinese Medicine(TCM) syndrome differential standard and make sure whether the differences were significant.【Method】A total of 175 cases with moderate or severe RA according to TCM syndrome differential standard were divide into damp heat, cold dampness syndrome, syndrome of intermingled heat and cold, Phlegm each node syndrome, liver and kidney deficiency syndrome, five syndromes group. MTX combined with LEF oral treatment were given for 12 weeks. Baseline and swollen joint count, tenderness joint count, time of morning stiffness, pain score(VAS), erythrocyte sedimentation rate(ESR), rheumatoid factor(RF), C reactive protein(CRP), DAS28 score were observed after combined treatment for 12 weeks. Change of ACR20, ACR50 and ACR70 and adverse reactions after combined treatment were all observed and analyzed statistically.【Results】The number of swollen joints were reduced and VAS, ESR, RF, CRP were lowered in all treatment groups after 12 weeks, the differences were significant statistically(P 0.05). The time of morning joint stiffness was shortened in all groups except in phlegm each node syndrome group and liver and kidney deficiency group,the differences were significant statistically. The improvement of swollen joint count,tenderness joint point, time of morning stiffness, VAS, RF, DAS28, effective response rate, ACR20, ACR50, ACR70 improvement rate of damp heat, cold dampness syndrom, syndrom of intermingled heat and cold group after treatmentwere better than that in Phlegm each node syndrome group and liver and kidney deficiency syndrome group(P 0.05). The adverse reactions in all treatment groups were better than baseline but no significant statistically(P 0.05).【Conclusion】MTX combined with LEF in the treatment of moderate to severe RA has definit efficacy, no significant adverse reactions.The curative effect on damp heat, cold dampness syndrome, cold syndrome is better than that of phlegm and blood stasis syndrome and liver and kidney deficiency syndrome.