1.Correlation Between Cardiovascular Events and Traditional Chinese Medicine Syndrome in Patients with Rheumatoid Arthritis:A Cross-Sectional Study
Fuyuan ZHANG ; Quan JIANG ; Jun LI ; Yuchen YANG ; Xieli MA ; Tian CHANG ; Congmin XIA ; Jian WANG ; Xun GONG
Journal of Traditional Chinese Medicine 2025;66(15):1572-1578
ObjectiveTo explore the correlation between the occurrence of cardiovascular events in rheumatoid arthritis(RA) and traditional Chinese medicine(TCM) syndrome. MethodsThe cross-sectional study selected 6713 RA patients from 122 centres nationwide, in which general information such as name, gender, age, height, body weight, and course of disease were collected by completing a questionnaire; patients were classified into eight types of syndrome according to the information of their four examinations,i.e. wind-dampness obstruction syndrome, cold-dampness obstruction syndrome, dampness-heat obstruction syndrome, phlegm-stasis obstruction syndrome, stasis-blood obstructing collateral syndrome, qi-blood deficiency syndrome, liver-kidney insufficiency syndrome, and qi-yin deficiency syndrome. According to the occurrence of cardiovascular events, they were divided into the occurrence group and the non-occurrence group, and the condition assessment data and laboratory examination indexes were recorded. The test of difference between groups was used to analyse the possible risk factors for the occurrence of RA cardiovascular events, and binary logistic regression was used to analyse the correlation between TCM syndromes and RA cardiovascular events. ResultsA total of 6713 RA patients were included, including 256 cases in occurrence group and 6457 in non-occurrence group. There was no statistically significant difference between groups in terms of height, gender, insomnia, appetite, white blood cell(WBC), hemoglobin(HGB), platelets(PLT), rheumatoid factor(RF), anti-cyclic peptide containing citrulline(CCP), alanine aminotransferase(ALT), aspartate aminotransferase(AST), γ-glutamyl transpeptidase(GGT), urea creatinine(CREA), and glucose(GLU)(P>0.05). The TCM syndromes between groups showed significant statistic differences(P<0.05). Patients in occurrence group had longer disease duration, heavier body weight, and older age; more severe conditions such as disease activity(DAS-28), number of painful joints(TJC), number of swollen joints(SJC), health questionnaire scores(HAQ), visual analog scores(VAS), restlessness, and fatigue; higher blood sedimentation rate(ESR), low-density lipoprotein(LDL-C), triglyceride(TG), total cholesterol(TC), D-Dimer, and lower high-density lipoprotein(HDL-C)(P<0.05). The distribution of syndrome types showed that dampness-heat obstruction syndrome accounted for the largest proportion of patients in both groups and was higher in RA cardiovascular events. Logistic regression analysis showed that the occurrence of RA cardiovascular events was strongly associated with dampness-heat obstruction syndrome[OR=5.937, 95%CI (4.434, 7.949), P<0.001]. ConclusionThe occurrence of RA cardiovascular events were associated with TCM syndromes, and the probability of cardiovascular events in the RA patients with dampness-heat obstruction syndrome was 5.937 times higher than patients with other TCM syndromes.
2.Curative Effect of Tripterygium wilfordii Polyglycoside Tablets in Treatment of Rheumatoid Arthritis in Real World Based on Propensity Score Matching
Xieli MA ; Quan JIANG ; Xun GONG ; Congmin XIA ; Chuanhui YAO ; Tian CHANG ; Zixia LIU ; Yuchen YANG ; Jiameng LIU ; Zhengyao SHEN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):125-131
ObjectiveTo evaluate the clinical efficacy and safety of Tripterygium wilfordii polyglycoside tablets (TWP) in the treatment of rheumatoid arthritis (RA) in the real world. MethodDiagnosis and treatment data of patients with RA in Chinese medicine rheumatology registration research information platform information database (CERTAIN) from January 1,2019 to January, 2024 were collected. According to the inclusion and exclusion criteria, data were screened. The included data were divided into an exposure group and a control group according to the use of TWP or not. Propensity score matching (PSM) was used in both groups to keep the baseline balanced and comparable. The disease activity score (DAS28-ESR) of 28 joints based on the erythrocyte sedimentation rate (ESR)before and after treatment was compared between the two groups, as well as health assessment questionnaire (HAQ),visual analogue scale (VAS),tender joint count (TJC),swollen joint count (SJC), patient's global assessment (PGA),evaluator's global assessment (EGA),laboratory indexes, clinical curative effect, and adverse reactions. ResultA total of 3 978 patients were included,including 929 in the exposure group and 3 049 in the control group. Before PSM,there were significant differences in demographic information,DAS28-ESR score,PGA,EGA,HAQ,VAS scores,SJC, and TJC between the two groups (P<0.05). After successful PSM matching,922 patients in the exposure group and 922 patients in the control group were included. There was no significant difference in demographic information and DAS28-ESR between the two groups before treatment,and the differences in other indexes between the two groups decreased to varying degrees. After treatment,the DAS28-ESR,PGA,EGA,HAQ,SJC,TJC,VAS scores, ESR,and IgG immune index of the two groups were significantly lower (P<0.01). Compared with those in the control group after treatment,the DAS28-ESR,PGA,EGA,HAQ,VAS scores, and ESR in the exposure group after treatment decreased more significantly (P<0.05,P<0.01). There was no significant difference in TJC in the exposure group after treatment. However, TJC in the exposure group was significantly higher than that in the control group before treatment (P<0.05). In terms of TJC reduction,the exposure group performed better than the control group. There was no significant difference in SJC and IgG between the exposure group and the control group after treatment. After treatment,the clinical symptoms of poor appetite,insomnia and many dreams,upset,fatigue,and fear of wind and cold in the two groups were improved. Except that the proportion of women in the exposure group was higher than that in the control group (P<0.01),there was no significant difference in the incidence of other adverse reactions between the two groups after treatment. ConclusionTWP to treat RA can effectively reduce DAS28-ESR,PGA,EGA,HAQ,TJC,and VAS scores and improve the general symptoms. Except for the women at childbearing age with fertility requirements that TWP is not applicable,it shows good security.