740例类风湿关节炎患者中医证型及临床指标特点分析

Analysis of TCM syndromes and clinical indicators of 740 patients with rheumatoid arthritis

目的观察740例类风湿关节炎(RA)患者中医证型及临床指标特点。方法收集740例RA患者,对其中医证型及临床指标进行统计分析。结果各中医证型RA患者的红细胞沉降率(ESR)、C反应蛋白(CRP)水平均高于正常值范围;CRP水平比较,湿热痹阻证>痰瘀痹阻证>肝肾亏虚证>寒湿痹阻证,比较差异有统计学意义(χ~2=13.788,P=0.003)。纤维蛋白原(FIB)水平比较,湿热痹阻证>痰瘀痹阻证>肝肾亏虚证>寒湿痹阻证,比较差异有统计学意义(χ~2=15.911,P=0.001)。血小板计数(PLT)水平比较,湿热痹阻证>寒湿痹阻证>痰瘀痹阻证>肝肾亏虚证,比较差异有统计学意义(χ~2=10.709,P=0.013)。免疫球蛋白(Ig)G水平比较,寒湿痹阻证>湿热痹阻证>痰瘀痹阻证>肝肾亏虚证,比较差异有统计学意义(χ~2=10.564,P=0.014)。结论 RA患者以痰瘀痹阻证多见,湿热痹阻证疾病活动度最高,湿热和痰瘀是RA发病的主要因素。

Objective To observe the characteristics of TCM syndromes and clinical indicators of 740 patients with rheumatoid arthritis (RA). Methods 740 RA patients were collected and their TCM syndromes and clinical indicators were analyzed statistically. Results The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels of RA patients with different TCM syndromes were higher than the normal range. Comparison of CRP levels, the damp-heat obstruction syndrome > blockage of phlegm and blood stasis syndrome > liver and kidney deficiency syndrome > cold-dampness blockage syndrome, the difference was statistically significant (χ^ 2= 13.788 , P =0.003). Comparison of fibrinogen (FIB) levels, the damp-heat obstruction syndrome > blockage of phlegm and blood stasis syndrome > liver and kidney deficiency syndrome > cold-dampness blockage syndrome, the difference was statistically significant (χ^2=15.911, P =0.001). Comparison of platelet (PLT) levels, the damp-heat obstruction syndrome > cold-dampness blockage syndrome > blockage of phlegm and blood stasis syndrome > liver and kidney deficiency syndrome, the difference was statistically significant (χ^ 2=10.709, P =0.013). Comparison of immunoglobulin (Ig) G levels, the cold-dampness blockage syndrome > damp-heat obstruction syndrome >blockage of phlegm and blood stasis syndrome > liver and kidney deficiency syndrome, the difference was statistically significant (χ^ 2=10.564, P =0.014). Conclusion Patients with RA have more common blockage of phlegm and blood stasis syndrome, and damp-heat obstruction syndrome has the highest activity. Damp-heat and phlegm- blood stasis are the main factors in the pathogenesis of RA.