Pattern Differentiation in Traditional Chinese Medicine Can Help Define Specific Indications for Biomedical Therapy in the Treatment of Rheumatoid Arthritis

The Journal of Alternative and Complementary Medicine, 05/29/2012

Lu C et al. – Traditional Chinese Medicine (TCM) pattern differentiation based on symptoms can help identify a subset of patients with Rheumatoid Arthritis (RA) that will more likely respond to biomedical therapy, consisting of diclofenac, methotrexate, and sulfasalazine.

Methods

  • This study uses data from a previous multicenter randomized–controlled clinical trial.
  • One hundred and ninety–four (194) patients were treated with biomedical combination therapy (diclofenac, methotrexate, and sulfasalazine).
  • ACR20 response at 12 weeks and 24 weeks was used for evaluation of efficacy.
  • Eight (8) symptoms, which are the most important for establishing TCM cold and hot patterns in patients with RA, were analyzed in this study.
  • TCM patterns were obtained using factor analysis of the eight symptoms.
  • Thirst, vexation, hot feeling in the joints, turbid yellow–colored urine, and fever were classified as factor 1.
  • Cold feeling in the whole body, cold feeling in the limbs, and cold feeling in the joints were classified as factor 2.
  • The classification into factor 1 and 2 is similar to TCM hot pattern and cold pattern differentiation, since the symptoms in factor 1 and 2 are the key symptoms in TCM hot and cold patterns, respectively.
  • The effective rates in patients with different TCM patterns were analyzed with the χ2 method.

Results

  • At 12 weeks, ACR20 response in patients treated with the biomedical combination therapy was 36.08%.
  • At 24 weeks, ACR20 response was 69.59%.
  • Based on the eight symptoms used in factor analysis, the effective rates in the patients with cold pattern and hot pattern were 51.67% and 29.09%, respectively, after 12 weeks of treatment; and 88.52% and 55.36%, respectively, after 24 weeks of treatment.

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