类风湿关节炎中医证型临床分布规律研究

Research of clinical distribution law for rheumatoid arthritis in traditional Chinese medicine syndrome type

目的通过临床病例调查,运用现代数理统计方法对类风湿关节炎(RA)中医证候分布规律进行研究,从而发现RA常见证候、临床症状分布规律以及证候与症状之间的关系。方法运用临床信息采集表,对1 024例RA门诊患者进行流行病学横断面调查,分析RA一般症状及证候要素的分布规律和特征,收集临床资料和中医四诊所得证候资料,对RA症状、证型、舌象、脉象及证候要素等进行统计分析。结果关节压痛、关节肿胀、屈伸不利、恶风寒、腰膝痠软为RA常见的临床症状;舌质黯、淡、红为常见的舌象;苔白、白腻、黄为常见的舌苔;脉滑、濡细、弦为常见的脉象;脾肾亏虚证、痰湿阻络证、风寒湿痹证及湿瘀痹阻证为RA常见的证型。结论对RA证候、证候要素及症状等分布规律的研究,有利于临床上审证求因、治病求本,从而进一步提高辨证的准确性和临床治疗效果。

Objective To find out distribution law of the common syndrome,the clinical symptoms and relationship between syndrome and symptoms and research traditional Chinese medicine syndrome type law of rheumatoid arthritis（RA） by investigation through clinical cases and the use of statistical methods.Methods Epidemiological cross-sectional survey was completed in 1 024 RA outpatients using clinical information collection table including analysis of rheumatoid arthritis generally symptoms and syndrome factor distribution regularity and features.Rheumatoid arthritis symptoms,syndrome type,tongue syndrome elements of pulse condition were statistically analyzed.Results 1 024 cases of rheumatoid arthritis case syndrome in traditional Chinese medicine distribution frequency statistics,through the analysis of the data collected information table,combining the expert opinion,the top five from high to low with symptoms of sequence for： joint swelling,joint tenderness,feel chill,flexion and adverse,lumbar debility.The first three tongue demonstration： dark,pale and red tongue.The first three common coated tongue is： moss white,moss white greasy,moss yellow.Top three for pulse is： pulse slippery,pulse tiny,pulse string,etc.RA common syndromes： spleen and kidney deficiency syndrome,phlegmy wet resistance winding certificate,the wind cold dampness bi-complex certificate,wet stasis bi-complex resistance certificate and etc.Conclusion The research of rheumatoid arthritis distribution of common syndrome type,symptoms and elements of the syndrome was good for determination of etiologic factors based on differentiation and treatment aiming at its pathogenesis in clinic.So as to further improve the accuracy of the syndrome differentiation and clinical treatment effect.