Background:Rheumatoid arthritis(RA),a chronic autoimmune disease,has a high incidence and disability rate,causing patients significant discomfort.Although several medicines can be effective,they are also associated wi...Background:Rheumatoid arthritis(RA),a chronic autoimmune disease,has a high incidence and disability rate,causing patients significant discomfort.Although several medicines can be effective,they are also associated with significant adverse effects.In contrast,fumigation as one of the most often used traditional Chinese medicine(TCM)external therapy has shown both efficacy and safety with less side effect.In light of this,we comple-ment western medicine treatment with TCM fumigation therapy to improve patients’clinical efficacy,alleviate symptoms,and improve prognosis.Objective:To investigate the therapeutic effect of TCM fumigation and modern medicine combined therapy in treating RA patients with cold-dampness Bi syndrome.Methods:A single-center,randomized,controlled study was designed.From January 2022 to December 2022,a total of 60 RA patients with cold-dampness Bi syndrome were enrolled in the study.The control group(30 cases)received conventional modern medicine treatment with methotrexate for 4 weeks,while the observation group(30 cases)for 4 weeks received a combination of TCM fumigation treatment and conventional modern medicine.The effects of the two groups were comprehensively compared,including the changes in TCM symptom scores and laboratory indicators,as well as the use of visual analogue scale(VAS)and health status rating scale(HAQ)before and after treatment.Results:The total effective rate of the observation group was 93.3%,which was significantly higher than that of the control group,which is 70%(P<0.05).Before treatment,there were no significant differences in joint functional activity,pain visual analogue scale(VAS),health assessment questionnaire(HAQ-DI)and laboratory indexes between the two groups(P>0.05).After treatment,each group compared to their initial condition,respectively,showed major improvement of joint functional activity and significantly decreased VAS,HAQ-DI,and RA-related biomarkers(P<0.05);inter-group comparison of these indicators showed significanty further enhanced effect of TCM fumigation combined therapy on the RA-related biomarkers and joint functional activity of patients(P<0.05),yet the control group receiving only modern medicine showed better results of the VAS and HAQ-DI.Conclusion:The TCM fumigation combined therapy is effective to treat RA patients with cold-dampness Bi syn-drome,and to enhance their life quality,improving the joint function,and reducing inflammation.展开更多
The rare disease of chronic infantile neurological cutaneous and articular(CINCA)syndrome,is caused by the over-secretion of interleukin(IL)-1βdue to a gain-of-function NLRP3 gene mutation in the autosomal chromosome...The rare disease of chronic infantile neurological cutaneous and articular(CINCA)syndrome,is caused by the over-secretion of interleukin(IL)-1βdue to a gain-of-function NLRP3 gene mutation in the autosomal chromosome which often involves in eyes.In this report,we studied a 9-year-old girl with CINCA.The eyes were also involved and presented bilateral papilledema.Genetic testing revealed that the symptoms were caused by a novel gene mutation site(c.913G>A,p.D305N)in conservative domain exon-3 of NLRP3 which is gain-function gene of CINCA.The patient had the characteristic facial features,frontal fossa and saddle nose,manifested the generalized urticaria-like skin rash at two weeks after birth,periodic fever 6 months after birth,sensorineural deafness at 7 years old,and bilateral papilledema,aseptic meningitis and knee arthropathy at 9 years old.White cell counts,C-reactive protein increased and intracranial pressure raised to 300 mmH2O.The meningeal thickening enhanced by gadolinium in magnetic resonance imaging(MRI).Based on clinical features and genetic test,the girl was diagnosed bilateral papilledema secondary to CINCA and administered prednisone and lowered intracranial pressure medicine to resolve symptoms.With 3-year follow-up,patient had no inflammatory flare-up with visual acuity improvement.The finding of novel genetic mutation site(p.D305N)in NLRP3 gene expanded genotype spectrum associated with CINCA.This case also expanded the cause spectrum of papilledema and it highlighted systemic disease history for patients with bilateral papilledema.展开更多
基金This tudy was supported and funded by Science and Technology Project of Jiangxi Provincial Administration of Traditional Chinese Medicine(2021B117).
文摘Background:Rheumatoid arthritis(RA),a chronic autoimmune disease,has a high incidence and disability rate,causing patients significant discomfort.Although several medicines can be effective,they are also associated with significant adverse effects.In contrast,fumigation as one of the most often used traditional Chinese medicine(TCM)external therapy has shown both efficacy and safety with less side effect.In light of this,we comple-ment western medicine treatment with TCM fumigation therapy to improve patients’clinical efficacy,alleviate symptoms,and improve prognosis.Objective:To investigate the therapeutic effect of TCM fumigation and modern medicine combined therapy in treating RA patients with cold-dampness Bi syndrome.Methods:A single-center,randomized,controlled study was designed.From January 2022 to December 2022,a total of 60 RA patients with cold-dampness Bi syndrome were enrolled in the study.The control group(30 cases)received conventional modern medicine treatment with methotrexate for 4 weeks,while the observation group(30 cases)for 4 weeks received a combination of TCM fumigation treatment and conventional modern medicine.The effects of the two groups were comprehensively compared,including the changes in TCM symptom scores and laboratory indicators,as well as the use of visual analogue scale(VAS)and health status rating scale(HAQ)before and after treatment.Results:The total effective rate of the observation group was 93.3%,which was significantly higher than that of the control group,which is 70%(P<0.05).Before treatment,there were no significant differences in joint functional activity,pain visual analogue scale(VAS),health assessment questionnaire(HAQ-DI)and laboratory indexes between the two groups(P>0.05).After treatment,each group compared to their initial condition,respectively,showed major improvement of joint functional activity and significantly decreased VAS,HAQ-DI,and RA-related biomarkers(P<0.05);inter-group comparison of these indicators showed significanty further enhanced effect of TCM fumigation combined therapy on the RA-related biomarkers and joint functional activity of patients(P<0.05),yet the control group receiving only modern medicine showed better results of the VAS and HAQ-DI.Conclusion:The TCM fumigation combined therapy is effective to treat RA patients with cold-dampness Bi syn-drome,and to enhance their life quality,improving the joint function,and reducing inflammation.
文摘The rare disease of chronic infantile neurological cutaneous and articular(CINCA)syndrome,is caused by the over-secretion of interleukin(IL)-1βdue to a gain-of-function NLRP3 gene mutation in the autosomal chromosome which often involves in eyes.In this report,we studied a 9-year-old girl with CINCA.The eyes were also involved and presented bilateral papilledema.Genetic testing revealed that the symptoms were caused by a novel gene mutation site(c.913G>A,p.D305N)in conservative domain exon-3 of NLRP3 which is gain-function gene of CINCA.The patient had the characteristic facial features,frontal fossa and saddle nose,manifested the generalized urticaria-like skin rash at two weeks after birth,periodic fever 6 months after birth,sensorineural deafness at 7 years old,and bilateral papilledema,aseptic meningitis and knee arthropathy at 9 years old.White cell counts,C-reactive protein increased and intracranial pressure raised to 300 mmH2O.The meningeal thickening enhanced by gadolinium in magnetic resonance imaging(MRI).Based on clinical features and genetic test,the girl was diagnosed bilateral papilledema secondary to CINCA and administered prednisone and lowered intracranial pressure medicine to resolve symptoms.With 3-year follow-up,patient had no inflammatory flare-up with visual acuity improvement.The finding of novel genetic mutation site(p.D305N)in NLRP3 gene expanded genotype spectrum associated with CINCA.This case also expanded the cause spectrum of papilledema and it highlighted systemic disease history for patients with bilateral papilledema.