Purpose:Numerous studies have suggested that exosomes are associated with rheumatic diseases, but no bibliometric analysis has been performed. This study presents the first comprehensive bibliometric analysis aiming to evaluate the current research hotspots and to anticipate future trends. Methods:An electronic search was conducted in the Web of Science Core Collection (WOSCC) using exosome and rheumatic disease-specific terminology to identify eligible studies published from January 1, 2000 to October 19, 2024. Only English-language articles and review articles were selected for bibliometric analysis. Data analysis and visualization were conducted using CiteSpace 6.2.R3, VOSviewer 1.6.18, and the Bibliometrix R package. Results:A total of 1,251 publications with 49,374 citations were extracted from the WOSCC database. Both publication and citation frequency increased steadily. 255 different countries or regions, 4,413 institutions and 7,213 authors contributed to the field. China and the USA are the leading countries and Shanghai Jiao Tong University has a significant influence. Théry C is the most frequently co-cited researcher. Most papers are published in Frontiers in Immunology, while Stem Cell Research & Therapy has the highest citations. Research is primarily concentrated in cell biology, immunology, and experimental medicine. Exosm, mesenchymal stem cells (MSCs), autoimmunity, regeneration, and others are major areas of research in this field. Research hotspots primarily focus on the diagnostic potential and therapeutic applications of exosomes in osteoarthritis and rheumatoid arthritis. Exosomes derived from MSCs and their cargo, such as microRNAs (miRNAs), have the potential to serve as biomarkers and therapeutic vehicles in these diseases. Conclusion:This study firstly quantifies and identifies the current status and research frontiers of exosomes in RDs by using bibliometric analysis, which may provide valuable insights for researchers to navigate trends and emerging applications into the field.

Rheumatoid arthritis (RA) is a chronic, highly disabling autoimmune disease. Although modern medical treatments have made progress, challenges such as suboptimal efficacy, relapse, difficulties in comorbidity management, and side effects persist. Traditional Chinese medicine (TCM) demonstrates unique advantages in the treatment of RA throughout the entire course of the disease, particularly in early intervention, consolidation during remission, reducing the side effects of Western medicines, and preventing relapse. Based on this, the article explores the research paradigm and scientific and technological strategic approaches for RA, which is recognized as a disease with clinical advantages in TCM. It proposes a three‐pronged approach: optimizing the integrated traditional Chinese and Western medicine diagnostic and treatment system, strengthening comprehensive prevention and control of RA‐related complications and comorbidities, and establishing a chronic disease management system for RA based on TCM theories. Through the synergy of clinical and basic research, the aim is to clarify the advantageous aspects of TCM in RA diagnosis and treatment, develop effective treatment protocols, enhance RA prevention and management, and underscore the value of TCM.

Purpose:Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by significant disability, with effective management of disease activity and pain constituting critical clinical objectives. The herbal formulation Bushen Quhan Zhiwang Decoction (BQZD) has demonstrated potential efficacy in symptom alleviation, suggesting a promising role in achieving sustained clinical remission in RA. The present study aims to systematically evaluate the efficacy and safety profile of BQZD for managing RA disease activity and pain relief. Patients and Methods:This randomized, double-blind, placebo-controlled, single-center clinical trial will enroll a total of 72 RA patients, randomly assigning them into either the intervention group (n=36) receiving BQZD or the placebo control group (n=36). Participants will consume either BQZD or placebo (100 mL, twice daily) over a 12-week intervention period. Clinical assessments are scheduled at enrollment and subsequently at 4-week intervals, continuing through the 16-week mark post-intervention initiation. The primary outcome measure is the Disease Activity Score for 28 joints (DAS28). Secondary outcome variables include visual analogue scale (VAS) pain scores, mechanical pain threshold (MPT), central sensitization inventory (CSI), patient-reported outcomes (PROs), Traditional Chinese medicine (TCM) symptom scores, and biomarkers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Safety endpoints will encompass monitoring of hematological parameters, urinalysis results, and adverse events. Discussion:This study seeks to generate robust clinical evidence verifying the therapeutic efficacy and safety of BQZD for alleviating pain and achieving deep remission in RA patients. These findings are anticipated to facilitate broader integration of traditional herbal medicine within clinical practice. Additionally, this research endeavors to provide clinically relevant insights into precision treatments for RA by integrating traditional Chinese medicine and Western medical approaches, and aims to lay foundational evidence for future investigations into underlying regulatory mechanisms and potential therapeutic targets of TCM.

Introduction Rheumatoid arthritis (RA) is a progressive inflammatory autoimmune disease characterised by chronic systemic inflammation, which can cause swelling, stiffening and destruction of articular cartilage and bone. Early diagnosis and treatment of RA can improve outcomes and slow the progression of joint damage. Preliminary exploratory research had hinted an expected effect of modified Zhiwang decoction (MZWD) in treating early RA. However, few randomised clinical trials have evaluated the effectiveness of MZWD in early RA. Therefore, a parallel-group randomised controlled trial was designed to evaluate the efficacy and safety of MZWD combined with methotrexate (MTX) on early RA.Methods and analysis This is a prospective, parallel-group, single-centre randomised controlled clinical study. A total of 150 patients will be randomly assigned to either the treatment (n=75) or control group (n=75). The treatment group will receive MZWD and MTX, and the control group will receive MTX for 12 weeks. The primary outcome of this study is Disease Activity Score-28, and the secondary outcomes are Fatigue Scale-14, Visual Analogue Scale pain scores and traditional Chinese medicine symptom scores. Safety outcomes, including adverse events and results of ECG and laboratory tests, will be monitored.Ethics and dissemination Ethics approval was obtained from the Clinical Research Ethics Committee of the China-Japan Friendship Hospital (no. 2022-KY-124) on 8 July 2022. The findings will be disseminated in peer-reviewed publications.Trial registration number ClinicalTrials.gov Registry (NCT05508815).

The rising costs of cancer care and subsequent medical financial hardship for cancer survivors and families are well documented in the United States. Less attention has been paid to employment disruptions and loss of household income after a cancer diagnosis and during treatment, potentially resulting in lasting financial hardship, particularly for working-age adults not yet age-eligible for Medicare coverage and their families. In this article, the authors use a composite patient case to illustrate the adverse consequences of cancer diagnosis and treatment for employment, health insurance coverage, household income, and other aspects of financial hardship. They summarize existing research and provide nationally representative estimates of multiple aspects of financial hardship and health insurance coverage, benefit design, and employee benefits, such as paid sick leave, among working-age adults with a history of cancer and compare them with estimates among working-age adults without a history of cancer from the most recently available years of the National Health Interview Survey (2019–2021). Then, the authors identify opportunities for addressing employment and health insurance coverage challenges at multiple levels, including federal, state, and local policies; employers; cancer care delivery organizations; and nonprofit organizations. These efforts, when informed by research to identify best practices, can potentially help mitigate the financial hardship associated with cancer.

This study aims to investigate the therapeutic effect of Wangbi Tablets(WBT)on the inflammation in the rat model of collagen-induced arthritis(CIA)with the syndrome of kidney deficiency based on the cyclic guanosine monophosphate-adenosine monophosphate synthase(cGAS)-stimulator of interferon genes(STING)signaling pathway.Eighteen rats were randomly chosen from 24 SPF-grade rats for the modeling of CIA with the syndrome of kidney deficiency.The 24 SPF-grade rats were randomized into 4 groups:control(normal rats),model(CIA with syndrome of kidney deficiency),model+WBT(M+WBT),and model+methotrexate(M+MTX).The syndrome score of kidney deficiency and arthritis index were recorded.The serum levels of interleukin-18(IL-18)and interleukin-1β(IL-1β)were measured by enzyme-linked immunosorbent assay(ELISA).Hematoxylin-eosin staining and safranin O-fast green staining were employed to observe the pathological status of ankle joints,synovium,and cartilage.Immunohistochemistry(IHC)was used to detect the expression of polymerase beta(Polβ)and cGAS in rats.The protein levels of polymerase beta(Polβ),cGAS,STING,phospho-STING(p-STING),nuclear factor-kappa B(NF-κB),phospho-NF-κB(p-NF-κB),interferon regulatory factor 3(IRF3),gasdermin-D(GSDMD),GSDMD N-terminus(GSDMD-NT),and cysteinyl aspartate specific proteinase-1(caspase-1)were determined by Western blot.Terminal-deoxynucleoitidyl transferase-mediated dUTP nick end labeling(Tunel)was employed to examine the apoptosis in the articular joints of rats.The results showed that compared with the control group,the model group showed obvious symptoms and signs of kidney deficiency and arthritis.The ankle joint deformity,mental condition,and coat color were improved by WBT.Compared with the model group,WBT alleviated the symptoms and signs of kidney deficiency and arthritis.Compared with the control group,the modeling elevated the serum levels of IL-18 and IL-1β,which were reduced by WBT,especially the level of IL-18.Compared with the control group,the model group showed a large number of inflammatory cells and damage of the cartilage layer in ankle joint,while WBT alleviated the pathological damage.Compared with the control group,the modeling significantly up-regulated the protein levels of cGAS,IRF3,p-NF-κB/NF-κB,caspase-1,and cleaved-caspase-1 and slightly up-regulated the protein levels of p-STING/STING,GSDMD,and GSDMD-NT.Compared with the model group,WBT significantly up-regulated the protein level of Polβ,significantly down-regulated the protein levels of cGAS,IRF3,GSDMD,and GSDMD-NT,and caspase-1,and slightly down-regulated the protein levels of p-STING/STING,p-NF-κB/NF-κB,and cleaved-caspase-1.Compared with the control group,the model group demonstrated decreased apoptosis in the ankle joint,synovium,and neovascularized endothelium,while WBT mitigated these situations.In conclusion,WBT has a therapeutic effect on CIA rats with the syndrome of kidney deficiency.Specifically,WBT may up-regulate the expression of Polβ in the ankle joint and inhibit the cGAS-STING signaling pathway to down-regulate the expression of executive protein of pyroptosis and reduce the release of cytokines,thus inhibiting inflammation and slowing down the progression of bone destruction.

类风湿关节炎(rheumatoid arthritis,RA)是一种以滑膜增生和血管翳形成为主要病理特征的对称性、破坏性自身免疫性结缔组织病,主要患病人群为中老年女性[1],中国大陆RA总患病人群达500万[2].RA因其多关节受累、致残率高、以及多脏器受累[3]等特点,极大影响患者的身心健康和生活质量,目前可通过达标治疗(treat-to-target)有效缓解症状和控制病情[4].中西医治疗RA均强调目标管理下的病情缓解,在缓解短期疼痛和长期获益方面各有优势[5].

目的 观察补肾治尪汤对类风湿关节炎(rheumatoid arthritis,RA)骨侵蚀的临床疗效.方法 纳入50例辨证属肝肾不足证的RA患者,随机分为治疗组和对照组各25例.治疗组患者用补肾治尪汤联合传统改善病情抗风湿药(conventional disease modifying anti-rheumatic drugs,cDMARDs)治疗,对照组患者用cDMARDs治疗,疗程均为12个月.分别收集2个组患者治疗前后双手腕X线片,由2位放射科医师采用盲法以改良Sharp评分(modified total sharp score,mTSS)法对所有X线片进行评分.观察mTSS变化、放射学进展率,以mTSS增加≥0.5分判断为放射学进展,以中医证候积分和有效率为临床疗效评价标准.结果 共42例患者完成研究,其中治疗组22例,对照组20例.2位放射科医师评分一致性高,观察者内相关系数为0.90.2个组患者治疗前后关节间隙狭窄变化值、骨侵蚀变化值及mTSS变化值比较,差异无统计学意义(P＞0.05).治疗组患者放射学进展率低于对照组,差异有显著统计学意义(P＜0.01).2个组患者治疗后中医证候积分均较治疗前显著改善,差异均有统计学意义(P＜0.01);治疗组有效率优于对照组,但差异无统计学意义(P＞0.05).结论 补肾治尪汤中西医结合治疗RA,放射学进展率低于对照组,提示补肾治尪汤具有延缓RA骨侵蚀的作用.

BACKGROUND Eosinophilic fasciitis（EF） is a rare connective tissue disease that can cause swelling and sclerosis of the extremities, and special attention is needed to differentiate EF from systemic sclerosis. Misdiagnosis or omission markedly delays treatment of EF, and severe skin sclerosis in advanced stages can cause joint contracture and tendon retraction, worsening the patient’s prognosis and quality of life.CASE SUMMARY We report a case of EF in a young woman diagnosed by tissue biopsy, confirming the difficulty of differential diagnosis with scleroderma.CONCLUSION Focusing on skin manifestations, completing tissue biopsy and radiography can help diagnose EF effectively. Clinicians should enhance their understanding of the differences between EF and scleroderma, and early diagnosis and standardized treatment can improve the prognosis of patients with EF.

Abstract Introduction Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that may lead to bone erosion and disability. Although there are many biological therapies in RA treatment nowadays, such as etanercept and tofacitinib, there are still a considerable number of patients who cannot achieve clinical deep remission, which makes patients feel pain and stiffness of joints. As a traditional Chinese medicine preparation, Wangbi granule showed a synergistic role with methotrexate in the treatment of RA patients with “kidney deficiency and dampness” or “stasis blocking channels”. Therefore, it is a promising therapeutic strategy for the clinical deep remission of RA. In this study, Wangbi granule will be used as the test drug. The investigators conduct this study to evaluate the efficacy and safety of Wangbi granule in the treatment of patients who have not achieved deep remission despite the use of methotrexate and tofacitinib. Methods and analysis Two parallel randomized, triple-blind, placebo-controlled trials will be conducted. In six study centers, 340 eligible RA patients will be recruited and randomly allocated to either the intervention group or the control group (in a 1:1 ratio). They will receive Wangbi granule or Wangbi placebo 12.0 g each time, three times a day for 12 weeks. The primary outcome is the disease activity score derivative for 28 joints (DAS28). Secondary outcomes are patient-reported outcomes, American College of Rheumatology 50% response criteria (ACR50), fatigue scale-14 (FS-14), visual analogue scale for pain (VAS), health assessment questionnaire disability index (HAQ-DI) and biomarkers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Expected outcomes The success of this study will provide strong evidence to confirm the efficacy and safety of Wangbi granule in the treatment of RA. Trial registration The trial has been registered in the ClinicalTrials Registry (NCT05540938, Date: 09/15/2022, https://clinicaltrials.gov/ct2/show/NCT05540938)

Fibroblast-activated protein-α (FAP) is a type II integrated serine protease expressed by activated fibroblasts during fibrosis or inflammation. Fibroblast-like synoviocytes (FLSs) in rheumatoid arthritis (RA) synovial sites abundantly and stably overexpress FAP and play important roles in regulating the cellular immune, inflammatory, invasion, migration, proliferation, and angiogenesis responses in the synovial region. Overexpression of FAP is regulated by the initial inflammatory microenvironment of the disease and epigenetic signaling, which promotes RA development by regulating FLSs or affecting the signaling cross-linking FLSs with other cells at the local synovium and inflammatory stimulation. At present, several treatment options targeting FAP are in the process of development. This review discusses the basic features of FAP expressed on the surface of FLSs and its role in RA pathophysiology and advances in targeted therapies.

Objectives This study aimed to evaluate the efficacy and safety of tofacitinib for the treatment of anti–melanoma differentiation–associated 5 gene (anti-MDA5) antibody–positive dermatomyositis (DM). Methods This study included 52 patients with anti-MDA5 antibody–positive DM (MDA5+DM) who were treated with tofacitinib and followed up. Clinical and laboratory data of these patients were recorded between January 2019 and June 2022. SPSS was used for all statistical analyses. Results The mean age of patients with MDA5+DM was 45 ± 12.4 years, and the median disease duration was 6.5 months (range, 3–13 months). The mean dosage of glucocorticoids was 34.7 ± 20.9 mg/d at the initiation of tofacitinib therapy. Overall, 47 patients were followed up for a mean duration of 7.8 ± 6.2 months. We found that the clinical symptoms of 28 patients (59.6%) were improved, but 1 patient (2.1%) died because of severe infection. Moreover, complications occurred in 25 patients (53.2%), among whom 19 patients had infections. Older age and C-reactive protein levels close to the upper value in reference range at the initial treatment were found to be the potential risk factors of infection. Furthermore, patients with cutaneous ulcers were found to have a lower risk of infection. Conclusion Tofacitinib can be used as a potential therapeutic option for MDA5+DM. The occurrence of infection requires special attention during treatment, particularly in patients with older age and C-reactive protein levels close to the upper value in reference range.

Objective We aimed to explore the delaying effect of Bushen Zhiwang Decoction（a compound prescription for tonifying the kidney and treating arthritis） on bone destruction in rheumatoid arthritis（RA） patients with a pattern of deficiency of both liver and kidney based on the modified total Sharp score（mTSS）.Methods A total of 170 RA patients with a pattern of deficiency of both liver and kidney attending the Department of TCM Rheumatism of the China-Japan Friendship Hospital from September 2020 to September 2021 were prospectively enrolled in this randomized controlled trial. A stochastic grouping method was used to assign patients to the experimental group or the control group. Patients in the experimental group were treated with Bushen Zhiwang Decoction combined with regular doses of conventional synthetic disease-modifying antirheumatic drugs（cDMARDs）, and patients in the control group were treated only with regular doses of cDMARDs. The observation period was 12 months. The mTSS was used as the main index to observe the degree of bone destruction in both groups after treatment.Results A total of 153 patients completed the final observation（76 in the experimental group and 77 in the control group）. There were no significant differences in baseline characteristics between the two groups. After 12 months of treatment, patients in the experimental group showed a more significant improvement in erythrocyte sedimentation rate and traditional Chinese medicine syndrome score compared to patients in the control group（P＜0.05）. Radiographic evaluation revealed an increase in mTSS in both groups, but the increase in mTSS was significantly smaller（P＜0.01） in the experimental group. Radiological progression of bone destruction occurred in 59 patients（77.6%） in the experimental group, a much lower proportion than in the control group（75 patients, 97.4%）（P＜0.01）. Visualization of the proportional distribution showed that mTSS growth values were consistently lower in the experimental group than in the control group.Conclusion Treatment with Bushen Zhiwang Decoction combined with cDMARDs can effectively delay the progression of bone destruction in RA patients with a pattern of deficiency of liver and kidney.

Rheumatoid arthritis (RA) is a chronic, progressive inflammatory and systemic autoimmune disease resulting in severe joint destruction, lifelong suffering and considerable disability. Diverse prescriptions of traditional Chinese medicine (TCM) containing Epimedii Herba (EH) achieve greatly curative effects against RA. The present review aims to systemically summarize the therapeutic effect, pharmacological mechanism, bioavailability and safety assessment of EH to provide a novel insight for subsequent studies. The search terms included were "Epimedii Herba", "yinyanghuo", "arthritis, rheumatoid" and "Rheumatoid Arthritis", and relevant literatures were collected on the database such as Google Scholar, Pubmed, Web of Science and CNKI. In this review, 15 compounds from EH for the treatment of RA were summarized from the aspects of anti-inflammatory, immunoregulatory, cartilage and bone protective, antiangiogenic and antioxidant activities. Although EH has been frequently used to treat RA in clinical practice, studies on mechanisms of these activities are still scarce. Various compounds of EH have the multifunctional traits in the treatment of RA, so EH may be a great complementary medicine option and it is necessary to pay more attention to further research and development.

Objective The clinical features of interstitial lung disease (ILD) in patients with dermatomyositis (DM) and negative myositis autoantibodies had not been exactly demonstrated previously. This study aimed to describe and expand the phenotype of interstitial lung disease (ILD) in this cohort of patients. Methods A total of 1125 consecutive Chinese patients with idiopathic inflammatory myopathies (IIM) between 2006 and 2020 were screened retrospectively. All proven cases of isolated ILD with both negative myositis-specific autoantibodies (MSA) and negative myositis-associated autoantibodies (MAA) were selected for inclusion. The clinical features and outcome among this group, MDA5+DM (DM patients with positive anti-MDA5 antibody) and ASS (patients with positive anti-aminoacyl tRNA synthetases antibodies were recorded and compared. Results Of 1125 IIM patients with an average follow-up of 6 years, 154 DM patients with negative MSA and MAA (MSA/MAA) were identified, with an ILD incidence of 46.8%. DM-ILD Patients with negative MSA/MAA presented younger age at onset (p<0.001), lower incidence of elevated CA153 (p=0.03) and fever (p=0.04)than those ILD patients with MDA5+DM and ASS.The estimated high-resolution computed tomography patterns of ILD showed non-specific interstitial pneumonia (66.6%), followed by organizing pneumonia in patients with negative MSA/MAA. OP pattern was more common in patients with MDA5+DM (69.7%), and the ratios of the OP (48.7%) and NSIP (51.3%) patterns were almost equal in patients with ASS. Of these DM-ILD patients with negative MSA/MAA, 25% developed rapidly progressive interstitial lung disease (RP-ILD). Patients with RP-ILD had a shorter disease duration (p=0.002), higher percentage of positive ANA(p=0.01) and organizing pneumonia patterns (p=0.04), elevated CYFRA211(p=0.04) and decreased FiO2/PaO2 (p<0.001) than those with chronic progressive ILD. The incidence of OP pattern in RP-ILD patients with negative MSA/MAA was lower than in those RPILD patients with MDA5+ DM (75%) and ASS (89%) (p=0.006). The cumulative 5- and 10-year survival rates in the DM-ILD patients with negative MSA/MAA were 91% and 88%, respectively, during the long-term follow-up study. And they had more favorable survival rate compared with ILD patients with MDA5+DM and ASS (p<0.001). An independent prognostic factor was identified as decreased PaO2/FiO2 (hazard ratio, 0.97; p=0.004]. Conclusions This study indicates DM-ILD patients with negative MSA/MAA had favorable long-term outcomes. Decreased baseline PaO2/FiO2 acted as an independent prognostic factor for this group of patients.

Abstract Objective To investigate the correlation between the triglyceride-glucose (TyG) index and rheumatoid factor levels and the existence of cardiovascular disease in patients in the rheumatoid arthritis population and to analyze their potential value in predicting the risk of cardiovascular disease. Methods Patients with rheumatoid arthritis treated by the Traditional Chinese Medicine Department of Rheumatism of the China-Japan Friendship Hospital from 2019–01 to 2021–12 were included in this retrospective study. Regression analysis was performed with multifactor-corrected multimodal logistic models to observe the correlation between the TyG index and rheumatoid factor and cardiovascular disease risk, construct predictive models and assess the potential predictive value of the variables on cardiovascular disease risk with receiver operating characteristic curves. The results were further corrected by sensitivity analysis and trend tests. Results A total of 418 patients with rheumatoid arthritis were included in the study. In the rheumatoid arthritis population, high rheumatoid factor (OR = 1.002, 95% CI = 1.001–1.002, P < 0.001), high TyG index (OR = 1.057, 95% CI = 1.008–1.109, P = 0.022), advanced age (OR = 1.080, 95% CI = 1.050–1.112, P < 0.001), and low physical activity (OR = 2.848, 95% CI = 1.195–6.785, P = 0.018) were independent risk factors for the existence of cardiovascular disease in patients. The combined coefficient calculated on the basis of the TyG index and rheumatoid factor was used to plot the receiver operating characteristic curve with an area under the curve of 0.791, which can be used to predict the potential risk of cardiovascular disease in patients with rheumatoid arthritis. Further sensitivity analysis found that the marker of focus remained associated with cardiovascular disease risk in a high-physical activity population with rheumatoid arthritis. The final trend test found a linear trend between the TyG index, rheumatoid factor levels and the risk of cardiovascular disease. Conclusion In the rheumatoid arthritis population, the TyG index and rheumatoid factor have some potential predictive value in determining the risk of cardiovascular disease, and the predictive efficacy is better when the two tests are combined.

Objectives: To evaluate the effect of Yugengtongyu granules on reducing the incidence of adverse cardiovascular events and improving quality of life (QOL) in patients with stable coronary artery disease (SCAD). Methods: A double-blind randomized controlled trial was conducted among SCAD population. One hundred fourteen patients were randomly assigned to experimental group (n = 57) and control group (n = 57) following randomized block design. Combined with the basis of standard treatment of SCAD, the experimental group and control group received Yugengtongyu granules or placebo, respectively, twice daily for 6 months and were followed for another 1 year (18 months in total from enrollment). Major outcomes (any occurrence of cardiovascular death, nonfatal myocardial infarction, or coronary revascularization), minor outcomes (any occurrence of all-cause death, ischemic stroke, readmission due to unstable angina, heart failure, or malignant arrhythmia), and composite outcomes (union of major and minor outcomes) were used to evaluate prognosis; Seattle Angina Questionnaire (SAQ) was applied to evaluate QOL, and levels of low density lipoprotein-cholesterol (LDL-C) and high sensitive C reacting protein (HS-CRP) in serum were tested. Results: The incidence of composite outcomes in the experimental group was significantly lower than that in the control group (3 [5.2%] vs. 11 [19.2%], hazard ratio: 0.273, 95% confidence interval: 0.080-0.926, p = 0.022); major outcomes, minor outcomes, and independent events such as nonfatal myocardial infarction showed lowering trend in experimental group. Experimental group scored significantly higher than control group in four dimensions of SAQ: physical limitation, angina frequency, treatment satisfaction, and disease perception at the third- and sixth-month follow-up; there was no significant difference in serum level of LDL or HS-CRP at all scheduled timepoints. Conclusion: The addition of Yugengtongyu granules based on current standard treatment reduced the incidence of composite outcomes and improved QOL in patients with SCAD. The trial was registered in the Chinese Clinical Trial Registry (ChiCTR-TRC-13004370).

目的:系统评价中医补肾法治疗类风湿关节炎(rheumatoid arthritis,RA)的有效性与安全性.方法:计算机检索中国知网、中国生物医学文献、万方、维普、PubMed等数据库自建库至2021年1月收录的运用补肾法治疗RA的随机对照试验,制定相应的纳排标准筛选文献并提取数据,Meta分析使用RevMan5.3软件.结果:共纳入23个研究总计2338名患者,Meta分析结果显示与对照组比较,补肾治疗组可以显著提高有效率[危险度比(relative risk,RR)=1.22,95％置信区间(confidence interval,CI)(1.18,1.27),P<0.00001],降低RA患者血沉[均数差(mean difference,MD)=-7.31,95％CI(-9.03,-5.58),P<0.00001]、C-反应蛋白[MD=-5.92,95％CI(-7.47,-4.37),P<0.00001],提高25羟基维生素D水平[标准化均数差(standard mean difference,SMD)=0.74,95％CI(0.17,1.31),P=0.01],降低不良反应发生率[RR=0.43,95％CI(0.33,0.54),P<0.00001],差异有统计学意义,2组在血清破骨细胞分化因子、核因子κB受体活化因子配体方面比较无明显差异.结论:目前现有证据可以证明,较单纯西药相比补肾方药联合西药治疗RA可以提高有效率,减轻炎症程度,延迟骨破坏进展并降低不良反应发生率.

目的 观察活血祛瘀中药溻渍联合西药治疗强直性脊柱炎(AS)活动期的临床疗效及安全性.方法 将AS活动期患者随机分为西药组41例和中西医结合组45例.西药组给予来氟米特片口服,每次20 mg,每日1次;双氯芬酸钠胶囊口服,每次50 mg,每日2次,1周后按病情减量或停药,必要时临时加量.中西医结合组在西药组治疗的基础上加用活血祛瘀中药在疼痛部位溻渍治疗.两组均治疗3个月.比较两组治疗前后巴氏强直性脊柱炎功能指数(BASFI)、巴氏强直性脊柱炎疾病活动指数(BASDAI)、中医证候积分、红细胞沉降率(ESR)、C反应蛋白(CRP)、生活质量、不良反应,并进行临床疗效评价.结果 中西医结合组临床疗效总有效率为93.33％,明显高于西药组的70.73％(P＜0.05).两组治疗后BASDAI、BASFI、ESR、CRP、生活质量评分、中医证候积分均明显改善(P＜0.05),且中西医结合组改善情况均优于西药组(P＜0.05).两组不良反应比较差异无统计学意义(P＞0.05). 结论 活血祛瘀中药溻渍联合西药治疗AS活动期疗效确切,能提高生活质量,且无明显不良反应.