银屑病关节炎临床分析及中医病机证型探讨

Clinial Analysis of Psoriatic Arthritis and Exploration on its Syndromos According to Pathogenesis

目的:分析银屑病关节炎的临床表现、中医证候及证型特点、探讨病机。方法:收集19例银屑病关节炎住院患者完整详细的临床资料进行回顾性分析。结果:全部病例男女比例相近,高发年龄及发病方式与文献相符;脊柱关节炎型、残毁性关节炎型比例偏高;16例有外周关节炎,以D IP多见;18例关节炎发作时皮损加重;89.47%银屑病为寻常型,47.36%有甲病变;17例血沉、C反应蛋白或血小板明显升高,16例免疫球蛋白增高;14例有关节肿胀、疼痛、局部发热、皮疹泛发色鲜红,皮肤潮红,舌质红、苔黄厚腻证候;证型:湿热瘀阻型13例,痰瘀互阻型4例,阴虚血燥型2例。结论:银屑病关节炎活动期以关节肿痛发热、皮疹鲜红,舌质红、苔黄厚腻为证候特点,湿热瘀阻型最多见,湿热、热毒、血热、血瘀为主要病机。

To analyze the clinical manifestations, characteristic of TCM syndromes and syndrome -type of psoriatic arthritis （ PsA）, present the pathogenesis of the disease. Methods ： The clinical data of 19 cases of PsA in Beijing Hospital of Traditional Chinese Medicine from 2004 to 2007 was analyzed retrospectively. Results ： There was no difference on gender in the group. The age vulnerable and invasion way were accord with other literatures. The proportion of the joint of vertebral column - type and the arthritis mutilans -type was little high; 16 cases had peripheral arthritis and the distal interphalangeal joint was the most common form of it; the skin lesions aggravated during arthritis attacks in 18 cases;89.47% of the patients was psoriasis vulgaris; 47.36% of the patients had nail lesions; ESR ,CRP or PLT were increased obviously in 17 cases; immunoglobulln was increased in 16 ca- ses ; 14 cases had the symptom of arthrocele, articulus pain, local pyrexia, generalized and bright red skin rash, erubescence, red tongue,the yellowish and thick greasy fur of tongue. Syndrome - type of psoriatic arthritis ： 13 cases were damp - heat - stagna- tion -type, 4 eases were phlegm -stasis blocking type,2 eases were YIN -deficiency and blood- dryness type. Conclusion： The symptom characteristic of active stage of PsA was arthrocele,articulus pain, local pyrexia, bright red skin rash, red tongue,the yellowish and thick greasy fur of tongue. The damp - heat - stagnation - type was the most common type. The main pathogenesis of the psoriatic arthritis is damp -heat, pyretic toxicity, heat in blood and heat in blood.