皮肌炎中医辨证分型与临床指标关系研究

Study on the Relationship between Dermatomyositis TCM Syndrome and Clinical Indicator

目的:检测皮肌炎(Dermatomyositis,DM)不同中医证型与临床指标的关系。方法:将68例确诊DM患者按照中医辨证分型标准分为热毒炽盛证、湿热蕴结证、寒湿痹阻证、脾肾两虚证、肝肾阴虚证,检测临床指标变化,并设64例健康志愿者作为健康对照组。结果:热毒炽盛证、湿热蕴结证患者血清磷酸肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)、免疫球蛋白G(Ig G)、红细胞沉降率(ESR)高于其他组,有显著性差异(P<0.01);寒湿痹阻证患者血清CK、CKMB、LDH、HBDH高于脾肾两虚证、肝肾阴虚证、健康对照组,有显著性差异(P<0.01)。热毒炽盛证与湿热蕴结证两证型中病情活动期发生率高于稳定期,差异有显著性(P<0.01);寒湿痹阻证病情活动期与稳定期发生率无明显差异(P>0.05);脾肾两虚证、肝肾阴虚证两证型中处于病情活动期发生率低于稳定期,差异有显著性(P<0.01)。结论:DM患者的中医证型与病情活动度存在相关性。

Objective：To investigate the relationship between different TCM syndrome types and clinical indicator in dermatomyositis（DM）. Methods：68 cases of DM patients were divided into heat-toxin flourishing syndrome,damp-heat accumulation syndrome,cold-dampness obstruction syndrome,spleenkidney deficiency syndrome,liver-kidney Yin deficiency syndrome. Clinical indicator was inspected in the 68 patients and the 64 healthy controls. To observe the relationship between these indicators and syndromes. Results：Levels of serum CK,CKMB,LDH,HBDH,Ig G and ESR in patients with heat toxin flourishing syndrome,damp heat syndrome patients were higher than the range of others（P〈0.01）;Levels of serum CK,CKMB,LDH,HBDH in patients with cold-dampness obstruction syndrome were higher than of spleenkidney deficiency syndrome,liver-kidney Yin deficiency syndrome and healthy control group（P〈0.01）.Incidence rate of disease activity period was significantly higher than that of disease stable period in heattoxin flourishing syndrome and damp-heat accumulation syndrome（P〈0.01）;There was no significant difference on incidence rate of disease activity period and that of disease stable period in cold-dampness obstruction syndrome（P〈0.05）;Incidence rate of disease activity period was significantly lower than that of stable period in spleen-kidney deficiency syndrome,liver-kidney Yin deficiency syndrome（P〈0.01）. Conclusion：There was association between TCM syndrome types and disease active level in DM patient.