强直性脊柱炎MRI表现与中医证型相关性研究

Study of the Correlation between MRI Manifestations and TCM Syndrome Types in Patients with Ankylosing Spondylitis

目的:观察强直性脊柱炎(AS)不同中医证型的MRI表现及实验室指标,探讨其与中医辨证分型的相关性。方法:将强直性脊柱炎患者77例按中医辨证分为3组,其中湿热证35例,督寒证20例,肝肾不足证22例。分别观察其MRI表现并进行SPARCC评分,同时分析患者外周血CRP及ESR水平。结果:MRI主要表现为骶髂关节面骨质囊变、侵蚀、硬化,关节间隙变窄,关节旁骨髓炎性水肿。3组患者的年龄、性别、病程比较差异无统计学意义(P>0.05),SPARCC评分湿热证>督寒证>肝肾不足证,差异有统计学意义(P<0.05)。湿热证组与督寒证组患者ESR、CRP水平均高于肝肾不足证组,差异有统计学意义(P<0.05),但湿热证组与督寒证组患者ESR、CRP水平比较差异无统计学意义(P>0.05)。结论:AS不同中医证型与其MRI表现及实验室指标有一定的相关性,提示MRI表现及实验室指标可为AS的中医辨证分型提供客观依据。

Objective：To observe the MRI manifestations and laboratorYindexes in different TCM syndrome types of ankylosing spondylitis （AS）, and to explore the correlation between them and TCM syndrome types. Meth-ods：The 77 patients with ankylosing spondylitis were divided into three groups according to TCM syndrome differ-entiation, including 35 cases of damp-heat syndrome, 20 cases of Du-cold syndrome, 22 cases of deficiency of liver and kidney. The MRI manifestations and SPARCC scores were observed. At the same time, the levels of CRP and ESR in peripheral blood were analyzed. Results：The main manifestations of MRI were cystic changes of sacroiliac joint surface bone, erosion, hardening, joint space narrowing and para-articular marrow inflammatory edema. There was no significant difference in the comparisions among the three groups in age, gender and disease duration （P〉0.05）. Besides, SPARCC score of damp-heat syndrome〉Du-cold syndrome〉liver and kidney deficiency syndrome, the difference was statistically significant （P〈0.05）. The levels of ESR and CRP in patients with damp-heat syn-drome and Du-cold syndrome groups were higher than those in liver and kidney deficiency syndrome group, the dif-ference was statistically significant （P〈0.05）. However, there was no significant difference in the comparisions of the levels of ESR and CRP between damp-heat syndrome and Du-cold syndrome group （P〉0.05）. Conclusion：There is certain correlation between different TCM syndromes in AS and its MRI performance and laboratorYindi-cators, which suggest that MRI performance and laboratorYindicators can provide an objective basis for TCM syn-drome differentiation of AS.