C14. Clinical Observation of Magui Wenbi Granules in the Treatment of Rheumatoid Arthritis and Its Effect on IL-23 / IL-17 Axis

Abstract

Introduction: Maguiwenbi granules are modified from Professor Wang Lvqiu's Xinbitongling granules used to treat cold-damp arthralgia syndrome in active RA and achieved an excellent curative effect. Previous studies have found that Xinbitongling can inhibit the expression of RANKL and IL-17 in the serum of CIA rats and alleviate the bone destruction of RA. 

Objective: To observe the clinical efficacy of Magui Wenbi Granules in treating active rheumatoid arthritis (cold-dampness syndrome). 

Methods: 60 patients were collected according to the NAPA standard and randomly divided into a control group and a treatment group with 30 cases each. The control group received conventional treatment, and the treatment group was added with Maguiwenbi granules. The joint treatment period was 12 weeks. Record the number of joint tenderness, joint swelling, DAS28, ESR, CRP, RF, TCM syndrome score before and after treatment, serum IL-23 and IL-17A levels, and use TCM syndrome efficacy evaluation standard and ACR20/50/70 standard to evaluate Perform overall clinical efficacy.

Results: 59 patients, 1 excluded, 29 in the treatment group, and 30 in the control group. (1) The treatment group was significantly better than the control group in reducing the number of joint tenderness, swollen joints, DAS28, ESR, and TCM syndrome scores (P<0.01), and better than the control group in reducing IL-17A (P<0.05). However, there was no statistical difference between the two groups after treatment; (2) The total effective rate of TCM syndromes in the treatment group was 96.6%, and in the control group was 70.0%; the ACR20 and ACR50 of the treatment group were 96.6% and 24.1%, respectively, the ACR20 and ACR50 of the control group were 73.3% and 20.0%.

Conclusion: Maguiwenbi Granules combined with conventional regimens have a definite clinical effect in the treatment of RA. It can significantly relieve the patient's clinical symptoms, reduce disease activity, increase clinical remission rate, and reduce IL-23 and IL-17A levels. It may inhibit IL-23/IL-17 inflammation axis.