强直性脊柱炎中医辨证分型与风湿活动指标的相关性研究

Correlation between Differentiation and Classification of Syndrome with Rheumatism Activity Indexes of Ankylosing Spondylitis

目的:研究强直性脊柱炎中医辨证分型与风湿活动指标两者之间的相关性。方法:将强直性脊柱炎120例辨证分型为寒湿痹阻型、湿热壅滞型、瘀血阻络型、肾虚失养型,观察风湿活动指标血沉(ESR)、C反应蛋白(CRP)的变化,同时进行脊柱功能指标ASDAI和BASFI、Schober试验、枕壁距、扩胸度、指地距指标等观察;分析ESR、CRP水平及脊柱功能指标与辨证分型之间的关系。结果:湿热壅滞型、寒湿痹阻型ESR、CRP水平明显高于肾虚失养型、瘀血阻络型(P<0.01);而湿热壅滞型ESR、CRP水平又高于寒湿痹阻型(P<0.05);肾虚失养型、瘀血阻络型血清ESR、CRP水平无显著性差异(P>0.05)。湿热壅滞型、寒湿痹阻型功能指标如BASDAI和BASFI、Schober试验、枕壁距、扩胸度、指地距指标等显著高于肾虚失养型、瘀血阻络型(P<0.01),而湿热壅滞型又高于寒湿痹阻型(P<0.05)。结论:强直性脊柱炎活动期多见于湿热壅滞型、寒湿痹阻型,而静止期多以瘀血阻络型、肾虚失养型为主。

Objective：To study the correlation between differentiation of symptoms and signs for classification of syndrome with rheumatism activity index of ankylosing spondylitis.Methods：120 patients were randomly divided into four types：cold-dampness obstruction type,blood stasis blocked collaterals type,dampness-heat obstruction type,kidney deficiency type.The erythrocyte sedimentation rate （ESR）,C reaction protein （CRP） were detected,spinal function such as ASDAI,BASFI,etc were observed and analyze the correlation between them.Results：ESR and CRP levels of cold-dampness obstruction type and dampness-heat obstruction type were high than those of blood stasis blocked collaterals type and kidney deficiency type,ESR and CRP levels of dampness-heat obstruction type were higher than those of cold-dampness obstruction type （P 〈 0.05）.Spinal function indexes BASFI,pillow away from the wall,BASDAI,chest degrees,Schober test,refers to the distance in cold-dampness obstruction type,dampness-heat obstruction type were worse than those in blood stasis blocked collaterals type and kidney deficiency type,those in dampness-heat obstruction type were the worst （P 〈 0.05）.Conclusion：The active stage of ankylosing spondylitis mainly showed dampness-heat obstruction type and cold-dampness obstruction type;blood stasis blocked collaterals type and kidney deficiency type were the common-seen in stationary phase.