| Evidence grading
method：
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According to the grading standard of clinical research evidence of traditional Chinese medicine:
Level I: Randomized controlled trials and their systematic review, N-of-1 trial systematic review.
Level II: non randomized clinical controlled trials, cohort studies, n-of-1 trials.
Level III: case-control study, prospective case series.
Level IV: standardized expert consensus, retrospective case series, historical controlled studies.
Level V: non standardized expert consensus, case report, experience summary. |
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Purpose of the guideline：
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Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease with aggressive, symmetric polyarthritis as the main clinical manifestation. It is a major and difficult disease in rheumatism. The etiology is complex, and it is related to many factors such as genetics, environment, sex hormones and so on.
The global prevalence of RA is 0.5% - 1%, and the prevalence in mainland China is 0.28% - 0.4%. The prevalence ratio of men and women is about 1:4. The disability rate of RA in 5-10 years is 60%, and the disability rate of RA in 30 years is more than 90%. A variety of complications such as heart disease, interstitial lung disease, osteoporosis, etc. are common, which seriously affect the labor force and quality of life of patients, and bring heavy economic burden to patients' families and society. It is of great significance for human health to explore and sort out RA diagnosis and treatment methods from multiple angles.
According to Mongolian medicine, people suffer from diseases because of abnormal changes in internal factors such as Heyi, Sheila, badakan, Qisu (blood), Sheila Wusu (yellow water), sticky or Haori damage (insects). Due to the influence of diet, daily life, season and other factors, any one or several of the above factors lose the normal state and the balance between each other, causing damage to human tissues and organs and resulting in disease. Mongolian medicine treatment of the disease is based on the principles of dryness, xieriwusu, clearing blood heat and syndrome differentiation. The recommended drugs are Elji genchus-25, senden-23, Chagan gugul-10, garidi-5, Saren Garidi, etc. However, at present, no standardized diagnosis and treatment scheme has been established for the prevention and treatment of tulai disease (rheumatoid arthritis) by Mongolian medicine, which is difficult to be recognized and applied in clinical practice.
In recent years, many international academic organizations in the field of Rheumatology have formulated or revised their own RA diagnosis and treatment guidelines, and China has also formulated relevant guidelines in combination with the national conditions and the actual situation of RA diagnosis and treatment. Mongolian medicine, as an important part of ethnic medicine, has certain advantages in the treatment of rheumatoid arthritis. It has accumulated rich clinical experience in the treatment of the disease, and has formed some unique therapies. Most of them are adapted to local conditions, select genuine medicinal materials, have little toxic and side effects, and are simple and inexpensive. Commonly used therapies include oral administration or oral administration combined with acupuncture, fumigation, blood pricking cupping, and fire therapy, which are very effective in improving symptoms and improving clinical efficacy. Although Mongolian medicine has certain advantages in the prevention and treatment of rheumatoid arthritis, and has a unique and complete understanding of it, it has not yet formed a standardized guide or recommendation or expert consensus, which is difficult to be recognized and applied in clinical practice. This consensus is committed to fully explore and give full play to the unique advantages of Mongolian medicine in the treatment of rheumatoid arthritis, aiming to provide clinicians with scientific and practical treatment suggestions to guide their clinical decision-making, so as to improve the prognosis and quality of life of patients. At the same time, it will help to enhance the influence and recognition of Mongolian medicine in the academic community. |
