[Cold reducing acupuncture as adjunctive therapy for wrist joint disorder of active rheumatoid arthritis with dampness-heat obstruction：a randomized controlled trial].

Objective: To compare the clinical efficacy between cold reducing acupuncture combined with western medication and western medication alone for wrist joint disorder of active rheumatoid arthritis (RA) with dampness-heat obstruction.

Methods: A total of 80 patients with wrist joint disorder of active RA with dampness-heat obstruction were randomly divided into a combination group (40 cases, 3 cases dropped out) and a western medication group (40 cases, 3 cases dropped out). The western medication group was treated with methotrexate tablets, 15 mg each time, once a week. The combination group was treated with cold reducing acupuncture at bilateral Hegu (LI 4), Houxi (SI 3), Waiguan (TE 5), etc. on the basis of the western medication group, once a day, 5 times a week. Both groups were treated for 8 weeks. The pain visual analogue scale (VAS) score, swelling score, morning stiffness score, Cooney wrist joint function score, ultrasound of wrist joint and serum level of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) before and after treatment were compared in the two groups.

Results: After treatment, the pain VAS scores, swelling scores, morning stiffness scores, grey scale ultrasound (GSUS) grade of synovitis, power doppler ultrasound (PDUS) grade of synovitis of wrist joint and serum levels of CRP and ESR in the two groups were reduced compared with those before treatment (<0.05), the Cooney wrist joint function scores were increased compared with those before treatment (<0.05); the pain VAS score, swelling score, PDUS grade of synovitis of wrist joint and serum level of CRP and ESR in the combination group were lower than those in the western medication group (<0.05), the Cooney wrist joint function score was higher than that in the western medication group (<0.05).

Conclusion: Cold reducing acupuncture combined with western medication could improve clinical symptoms and joint function, reduce inflammatory response in patients with wrist joint disorder of active RA with dampness-heat obstruction, and the efficacy is better than that of western medication alone.