Objective: To observe the clinical effects of Xinfeng Capsules (XFC), a traditional Chinese medicine for invigorating the spleen to resolve dampness and dredging collaterals, on patients with rheumatoid arthritis (RA) and anemia, and to investigate its mechanism.
Methods: Forty patients with RA and anemia were divided into three groups: XFC-treated group (n=20), Tripterygium glycosides Tablets (TGT)-treated group (n=10) and methotrexate (MTX)-treated group (n=10). The patients in each group took corresponding medicine for three months. The response rates of the three groups were evaluated after treatment. The general symptoms and specific signs and symptoms of RA were observed before and after the treatment. The indexes of blood routine examination and some other laboratory indexes such as erythrocyte sedimentation rate (ESR), and blood levels of rheumatoid factor (RF), iron, C-reaction protein (CRP), immunoglobins (Ig), complements 3 and 4, tumor necrosis factor-alpha (TNF-alpha), interleukin-10 (IL-10) and erythropoietin (EPO) were all examined and compared before and after treatment.
Results: The total response rate in the XFC-treated group was similar to those both in the TGT-treated and MTX-treated groups. The effects on relieving specific symptoms of RA in the three groups were also similar. The ESR and serum levels of RF, CRP, IgG, IgA and IgM were all decreased after treatment as compared with those before treatment in the three groups, and there were no significant differences among those laboratory indexes in the three groups after treatment. The XFC displayed more obvious effects on improving the general symptoms of patients with RA and anemia, increasing the blood levels of hemoglobin, iron and IL-10, while decreasing the serum level of TNF-alpha and regulating the serum EPO level, as compared with those in the TGT-treated and MTX-treated groups.
Conclusion: The XFC for invigorating the spleen to resolve dampness and dredging collaterals was developed on the basic principle of regulating spleen. It can obviously improve the symptoms and laboratory indicators of RA. Such effects may be related to maintaining the balance of cytokines, regulating the serum level of EPO and increasing the serum iron level in patients with RA and anemia.