青岛地区类风湿关节炎的辨证分型调查

Investigation on TCM syndrome differentiation of rheumatoid arthritis in Qingdao area

目的结合类风湿关节炎患者的症状、体征进行辨证分型，分析青岛地区类风湿关节炎患者的中医证型分布情况。方法选取2010年10月1日至2012年1月1日于山东青岛中西医结合医院就诊的类风湿关节炎患者共656例，结合症状、体征进行中医辨证分型。结果青岛地区类风湿关节炎患者证型多以寒湿痹阻证、肝肾亏虚证为主，其次为风寒痹阻证、气血亏虚证、湿热痹阻证。血沉（ESR）、C反应蛋白（CRP）的积分水平以湿热痹阻证[分别为（56．23±13．87）mm／h、（69．49±21．56）mg/L]最高，与寒湿痹阻证、风寒痹阻证、肝肾亏虚证、气血亏虚证[ESR分别为（35．02±21．63）mm／h、（32．13±19．54）mm／h、（38．14±18．63）mm／h、（33．63±17．23）mm／h；CRP分别为（46．49±21．56）mg／L、（41．67±19．66）mg／L、（44．63±19．78）mg／L、（41．23±18．24）mg／L]比较，差异有显著性意义（P〈0．05）。类风湿因子、免疫球蛋白IgG、IgA、IgM各证型间无明显统计学差异（P〉0．05）。肝肾亏虚证的年龄、病程[年龄为（59．3±12．15）岁，病程为（7．98±3．76）年]、气血亏虚证[年龄为（52．5±11．5）岁，病程为（6．56±3．12）年]大于寒湿痹阻证、湿热痹阻证、风寒痹阻证[年龄分别为（46．2±11．12）岁、（45．8±11．60）岁、（43．5±12．50）岁：病程分别为（5．56±2．76）年、（5．78±2．98）年、（5．12±2．32）年]（P〈0．05）。结论青岛地区类风湿关节炎患者以寒湿痹阻证、肝肾亏虚证为主，其次为风寒痹阻证、气血亏虚证、湿热痹阻证。类风湿关节炎患者中，肝肾亏虚证、气血亏虚证患者的年龄偏高、病程较长。

Objective Combined with the patients arthritis symptoms and signs, TCM syndrome differentiation of rheumatoid arthritis was undertaken to investigate TCM syndrome distribution. Methods A total of 656 patients of rheumatoid arthritis from October 1 st 2010 to January 1 st 2012 hospitalized in Shandong Qingdao Combine Traditional Chinese and Western Medicine hospital were untaken TCM syndrome differentiation according to their symptoms and signs. Results The main syndromes of rheumatoid arthritis patients were cold-dampness blockage syndrome and liver and kidney deficiency syndrome, followed by cold-wind blockage syndrome, deficiency of Qi and blood syndrome, and dampness-heat blockage syndrome. The highest scores of ESR and C reactive protein appeared in dampness-heat blockage syndrome group, with ESR being （56.23±13.87） ram/h, CRP being （69.49±21.56） mg/L. These values showed significant difference than other syndrome group （P 〈 0.05）. There was no significant difference of rheumatoid factor, immunoglobulin IgG, IgA, IgM values among these syndrome groups （P〉0.05）. Comparison of age, course of disease showed the liver and kidney deficiency syndrome group （age was 59.3±12.15, duration was 7.98±3.76） and Qi and blood deficiency syndrome group （age was 52.5±11.5, duration was 6.56±3.12） were significant higher than cold-dampness blockage syndrome, damp-heat blockage syndrome group and cold-wind blockage syndrome group with the age of （46.2±11.12） and （45.8±11.60）, （43.5±12.50） respectively and course of （5.56±2.76）, （5.78±2.98）, （5.12±2.32） respectively （P〈0.05） . Conclusion The mainTCM syndromes of rheumatoid arthritis patients in Qingdao area were cold-dampness syndrome, liver and kidney deficiency syndrome,followed by cold-wind blockage sydrome, Qi and blood deficiency syndrome, damp-heat blockage syndrome. Among all syndromes, relatively high age and disease course of patients appeared in liver and kidney deficiency syndrome and Qi and blood deficiency syndrome.