OBJECTIVETo observe the clinical efficacy differences on rheumatoid arthritis treated with acupoint application of(preparation ofmedicine), tender point herbal application and leflunomide.

METHODSNinety-six patients were randomized into an acupoint herbal application group, a tender point herbal application group and a leflunomide group, 32 cases in each one. In the acupoint herbal application group,paste was used at Dazhui (GV 14), Mingmen (GV 4), Zusanli (ST 36) and the local points on themeridians around the knee joint. In the tender point herbal application group, the self-preparedmedicine was used at tender points, 4 to 6 h each time, at the interval of 7 days. In the leflunomide group, leflunomide was applied for oral administration, 50 mg on each of the first 3 days, once a day; 20 mg each time 3 days later, once a day. The treatment for 1 month made one session in the three groups, and continuous three sessions of treatment were required. The clinical symptoms, laboratory indices such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and the total score of symptoms were observed before and after treatment in the patients of three groups. The efficacy was evaluated in the 3 groups.

RESULTSThe total effective rate was 87.5% (28/32) in the acupoint herbal application group and was 90.6% (29/32) in the leflunomide group, better than 68.8% (22/32) in the tender point herbal application group (both<0.05). After treatment, the clinical symptoms, laboratory indices and the total score of symptoms were all improved as compared with those before treatment in the three groups (all<0.05). Among the three groups, the results of pain, swelling, tenderness and the total score of symptoms as well as ESR and RF in the acupoint herbal application group and the leflunomide group were all better than those in the tender point herbal application group (<0.05,<0.01). Blister and pruritus occurred in 2 cases in each of the acupoint herbal application group and the tender point herbal application group. Nausea and poor appetites in 2 cases, dizziness and lassitude in 1 case and skin rashes in 1 case occurred in the leflunomide group.

CONCLUSIONSThe improvements in the symptoms of rheumatoid arthritis and laboratory indices in the acupoint herbal application ofare better than those in the treatment with tender point herbal application. The efficacy of it is similar to that of leflunomide, without adverse reactions such as nausea, poor appetite, dizziness and lassitude.