Acupuncture Study on Rheumatoid Arthritis, Monitoring Microbiome and Blood

Inclusion Criteria:

• The patient should be diagnosed as the first or second stage of rheumatoid Arthritis (RA) and checked with X ray for additional diagnose.
• diagnosed for RA according to ACR(1987)
• the patient should be in the active stage of the disease, defined as：

1. swollen joints >3
2. tender joints > 5
3. any one of the following： (c1.) morning stiffness lasting more than 45 minutes (c2.) Erythrocyte Sedimentation Rate (ESR) >= 28mm/h (c3.) C-reactive protein (CRP)>= 12mg/L

• Should not be resistant to MTX nor leflunomide
• Blood test should satisfy:

1. Hemoglobin (Hb)>=85g/L
2. White cell >=3.5 10+9/L
3. Platelets >= 100 10+9/L
4. Liver function: serum alanine aminotransaminase (ALT), aspartate transaminase (AST) and total bilirubin (TBil) should be less than 1.5 times the upper limit ofnormal (ULN)
5. Kidney function: Serum creatinine (Cr) level should be less than ULN.
6. Pregnancy test should be negative

• should be positive for anti-cyclic citrullinated protein antibodies (anti-CCP).
• should agree to sign the informed consent

Exclusion Criteria:

• Serious diseases affecting liver, kidney, heart and lung, or diseases related tohematologic，endocrine and nervous systems. .
• Be treated by MTX or Leflunomide in the last 3 months.
• Be treated with cortical hormone （could be intramuscular injection, intravenousinjection or injection to articular cavity） in the last 4 weeks.
• Be treated with biological agents, such as antagonist of TNF-alpha,IL-6, and CD20 monoantibody in the last 3 months.
• Be treated by chronic medicine, such as immunosuppressive agent, Penicillamine,chloroquine and gold based Disease-modifying antirheumatic drugs (DMARDs) in the last 3 months.
• Pregnant and breast-feeding woman
• Having history of serious drug allergy
• In the acute or chronic phase of infection (such as lung diseases)
• Easy bleeding patients or patients with local skin infection (only for acupuncture)
• The patients cannot accept acupuncture (only for acupuncture)
• Be treated with acupuncture in the past 3 months（only for acupuncture）.
• No pregnant and breast-feeding woman.
• No history of serious drug allergy.