类风湿关节炎中医证候分型与自身抗体的相关研究

Study of Correlation between Syndrome Types of Traditional Chinese Medicine and Autoantibody in Rheumatoid Arthritis

目的 ：探讨类风湿关节炎（RA）中医辨证分型与类风湿因子等多种自身抗体的相关性,为RA中医辨证分型提供实验室参考依据。方法：收集RA住院病例资料及自身抗体检测结果,参照《中药新药临床研究指导原则》进行中医辨证分型。共分为5型：寒湿痹阻证、湿热痹阻证、瘀血痹阻证、肾气虚寒证和肝肾阴虚证,比较其自身抗体与中医辨证分型之间的关系。结果 ：共收集RA确诊病例218例,其中寒湿痹阻证55例,湿热痹阻证62例,瘀血痹阻证38例,肾气虚寒证31例,肝肾阴虚证32例。类风湿因子和抗环瓜氨酸肽抗体在不同证型中的分布差异有统计学意义（P〈0.05）,类风湿因子阳率高低依次为：湿热痹阻证〉寒湿痹阻证〉肾气虚寒证〉瘀血痹阻证〉肝肾阴虚证;抗环瓜氨酸肽抗体阳率高低依次为：瘀血痹阻证〉湿热痹阻证〉寒湿痹阻证〉肝肾阴虚证〉肾气虚寒证。结论：不同中医证型RA自身抗体分布存在差异,类风湿因子和抗环瓜氨酸肽抗体可为RA的分型提供实验室参考依据。

Objective：To study the correlation between the differential syndrome types of traditional Chinese medicine（ TCM） and autoantibody such as rheumatoid factor in patients with rheumatoid arthritis（ RA）.Methods：Hospitalized patients with RA were enrolled,and their data and experimental results of autoantibody were collected and analyzed. The patients were divided into five syndrome types according to Guidelines for Clinical Research of TCM New Medicine：bi-obstruction of cold dampness,bi-obstruction of damp heat,bi-obstruction of blood stasis,deficient cold of kidney qi,yin deficiency of liver and kidneys. The correlation between autoantibody distributions and TCM syndrome types was analyzed. Results：There were 218 patients included in this study,in which there were 55 cases of bi-obstruction of cold dampness,62 cases of bi-obstruction of damp heat,38 cases of bi-obstruction of blood stasis,31 cases of deficient cold of kidney qi,and 32 cases and yin deficiency of liver and kidneys. The distribution of rheumatoid factor and anti-cyclic citrullinated peptide antibody was significantly different in the five groups with statistical significance（P〈0.05）. The positive rates of rheumatoid factors from the high to the low were as follows ：bi-obstruction of damp heat,bi-obstruction of cold dampness,deficient cold of kidney qi,bi-obstruction of blood stasis,yin deficiency of liver and kidneys,and the positive rates of anti-cyclic citrullinated peptide antibody from the high to the low were as follows：bi-obstruction of blood stasis,bi-obstruction of damp heat,bi-obstruction of cold dampness,kidney yin deficiency of liver and kidneys,and deficient cold of kidney qi. Conclusion：In different TCM syndromes,distributions of autoantibody in RA patients show variations. Rheumatoid factor and anti-cyclic citrullinated peptide antibody could be the laboratory reference for the determination of TCM syndrome types of RA.