游走痛是否类风湿关节炎中医风邪关键指标的临床研究

Clinical Research on Whether Wandering Pain Being the Key Indicator to Rheumatoid Arthritis Caused by Wind Evil

目的:探讨游走痛是否类风湿关节炎中医风邪关键指标,并探讨相关证候。方法:将河南风湿病医院类风湿关节炎数据库(HFRA数据库)中收录的409例患者按有无游走痛分为游走痛组和无游走痛组,并采用SPSS 19.0软件分析2组在关节表现及关节外表现方面的区别与联系。结果:游走痛组的原始变量之间相关性弱,不适合因子分析的统计学方法,无法进行聚类分析。从无游走痛组聚类分析结果中出现的肢体麻木、全身怕风怕冷均为风邪与他邪相合而致,不能单独作为风邪的判断指标。同时对2组间差异有统计学意义(P<0.05)的临床表现对比可知,有统计学意义的16个变量:热痛、胀痛、脱发、唇甲暗红、疼痛活动后减轻、痰多、活动乏力、动则气喘、肌肤局部发暗、口淡不渴、休息后乏力减轻、凉痛、头晕、阴雨天加重、盗汗、鼻干,均为游走痛组<无游走痛组。剩余66个变量之间差异无统计学意义,且其与风邪所致临床表现无关。在409例患者中,有游走痛者102例(25%)。这102例同时满足类风湿关节炎诊断标准,即都存在至少3个关节区持续6周以上的肿胀。肿胀属中医湿邪。结论:游走痛可以作为类风湿关节炎中医风邪的关键指标;类风湿关节炎存在"风湿痹阻"证候,这一证候的患者不超过患者总数的25%。

Objective：To investigate whether wandering pain is the key indicator to rheumatoid arthritis caused by wind evil,and to explore the related syndrome.Methods：Four hundred and nine cases with rheumatoid arthritis recorded in the HFRA database （ database of Henan Rheumatism Hospital ） were divided into the wandering pain group and non-wandering pain group.Software SPSS 19.0 was used to analyze the difference and relationship of articular manifestation and extra-articular manifestation of the two groups.Results：Because there were weak correlations between the original variables in the wandering pain group,it was not suitable for cluster analysis.The clustering results of the non-wandering pain group showed that body numbness and the whole body＇s aversion to cold and wind were caused by wind evil or other evils,which couldn＇t be the only judging index for wind evil.At the same time,the difference between the two groups was statistically significant （ P 〈 0.05 ） . The 16 variables with statistical significance were as follows：heat pain,gas pain,hair loss,dark red lip and nails,relief of pain after activity, excessive phlegm, fatigue,asthma,local dark skin,tastelessness in mouth without thirst,recovering from fatigue after rest,cold pain, dizziness,aggravation during rainy days,night sweat and dry nose These manifestations in the wandering pain group were less serious than those in the non-wandering group.There was no significant difference between the other 66 variables,and the symptoms were not related to the clinical manifestations caused by wind evil.Among 409 patients,there were 102 cases （ 25% ） with wandering pain.The 102 patients met the criteria for the diagnosis of rheumatoid arthritis,that is,there were at least 3 joints in the area that lasted for more than 6 weeks.Swelling belongs to TCM dampness.Conclusion：Wandering pain can be used as the key index to judge the wind evil causing rheumatoid arthritis.Rheumatoid arthritis has the syndrome of rheumatic arthralgia,the number of patients caused by which is less than 25% of the total number.