108例成人斯蒂尔病患者中医证型研究

Study on TCM Syndrome Types of 108 Adult Onset Still's Disease

目的:探讨成人斯蒂尔病(AOSD)的中医证型分布与患者一般情况、服用糖皮质激素时间及C-反应蛋白(CRP)、血清铁蛋白(SF)的相关性。方法:回顾性纳入2011年1月至2015年12月住院确诊的AOSD患者108例,频数表描述证型分布,SPSS19.0统计分析各影响因素与证型相关性。结果:108例AOSD患者67.59%在春夏发病,出现频率大于50%的症状有发热、皮疹、咽痛、关节痛、肌痛、瘰疬肿痛、乏力,证型分布为气阴两虚兼湿热痹阻证(25.93%)、湿热痹阻证(21.30%)、阴虚内热证(17.59%)、气营两燔证(15.74%)、气阴两虚证(10.19%)、卫气同病证(9.26%);病程及服用激素时间长短、CRP、SF均影响证型分布。结论:AOSD多见中青年女性,典型症状为发热、皮疹、咽痛、关节痛,中医证型以虚实夹杂的复合证型气阴两虚兼湿热痹阻证最常见,卫气同病证最少见,病程、服用激素时间、CRP、SF与证型有明显相关性,即病程及服用激素时间越长表现为虚证越明显,CRP、SF越高病程越短则实证越明显。

Objective： Take a discussion about the correlation between TCM syndromes of AOSD and basic situation of patients,taking glucocorticoid time and CRP,SF. Methods： Retrospective inclusion is used on 108 AOSD in our hospital from January 2011 to December 2015,frequency table describe syndrome distribution,use SPSS19. 0 statistical software to analyze the correlation between various factors and syndrome. Results： In 108 AOSD patients,67. 59% in the spring and summer onset,symptoms appear more than 50% are fever,rash,sore throat,joint pain,myosalgia,scrofulous sore,weak; Distribution of syndrome： Qi-yin deficiency and Dampness-heat blockage（ 25. 93%）,Dampness-heat blockage type（ 21. 30%）,Yin deficiency inner Heat（ 17. 59%）,Qi Ying two burnt is（ 15. 74%）,Qi-Yin deficiency is（ 10. 19%）,Wind-heat invading（ 9. 26%）; Gender and age have no effects on the distribution of syndrome,course of disease,duration of hormone use、CRP、SF all the AOSD syndrome distribution. Conclusion： AOSD usually was found in young females,the course of disease is always long. The typical symptoms are fever,rash,sore throat,joint pain; the composite syndrome of deficiency and excess of Qi-yin deficiency and Dampness-heat blockage is the most common syndrome,Wind-heat invading is the least common; course of disease,taking glucocorticoid time,CRP,SF and syndrome are significantly correlated： the longer the course of disease,and the longer time of glucocorticoid used,deficiency symdrome is more obvious; If CRP,SF are more higher and course of disease is more shorter,then exterior syndrome is more obvious.