title: Meridian-sinew release therapy for the treatment of refractory rheumatoid arthritis.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of Meridian-sinew Release therapy in Chinese patients with refractory active Rheumatoid Arthritis (RA).
  
  
  BACKGROUND
  Few studies focused on the effect of combination of Meridian-sinew Release therapy and Methotrexate (MTX) on refractory active RA of Chinese patients.
  
  
  METHODS
  Eighty refractory active rheumatoid arthritis patients were randomized to receive Meridian-sinew Release+MTX 10 mg (n=40), MTX 10 mg (n=40) every week for 12 weeks. The primary end point was the proportion of patients achieving ≥20% improvement in the American College of Rheumatology criteria (ACR20) at week 12. Secondary efficacy endpoints included 28-joint disease activity score with ESR (DAS28-ESR), simplified disease activity index (SDAI), clinical disease activity index (CDAI) and Health Assessment Questionnaire-Disability Index (HAQ-DI).
  
  
  RESULTS
  Week 12 ACR20 response rates were significantly greater in Meridian-sinew Release+MTX group (30/38 (78.9%)) than in MTX group (19/37 (51.3%)), (P<0.001), as were ACR50 and ACR70 response rates. Patients treated with Meridian-sinew Release+MTX were significantly more likely to achieve clinical remission, using various definitions, at 12 weeks versus MTX alone. A larger percentage of Meridian-sinew+MTX patients than MTX alone patients were in states of low disease activity or remission for DAS28-ESR, SDAI and CDAI after 12 weeks of treatment.
  
  
  CONCLUSIONS
  Our study suggests that Meridian-sinew Release therapy was well tolerated and efficacious in improving clinical outcomes in Chinese patients with refractory active RA.
authors: Department of Traditional Chinese Medicine, Guangzhou General Hospital of Guangzhou Military Command Guangzhou 510010, China ; Guangzhou University of Traditional Chinese Medicine Doctor Guangzhou 510405, China.
authors: Zhihuang
authors: Z
authors: Chen
authors: Department of Traditional Chinese Medicine, Guangzhou General Hospital of Guangzhou Military Command Guangzhou 510010, China.
authors: Song
authors: S
authors: Wei
authors: Department of Traditional Chinese Medicine, Guangzhou General Hospital of Guangzhou Military Command Guangzhou 510010, China.
authors: Jian
authors: J
authors: Liu
authors: Department of Traditional Chinese Medicine, Guangzhou General Hospital of Guangzhou Military Command Guangzhou 510010, China.
authors: Weifeng
authors: W
authors: Sun
authors: Department of Traditional Chinese Medicine, Guangzhou General Hospital of Guangzhou Military Command Guangzhou 510010, China.
authors: Dandan
authors: D
authors: He
authors: Department of Traditional Chinese Medicine, Guangzhou General Hospital of Guangzhou Military Command Guangzhou 510010, China.
authors: Jing
authors: J
authors: Guo
keywords: Meridian-sinew release therapy; meridian-sinew knife; meridian-sinew scope; rheumatoid arthritis