类风湿关节炎湿热与寒湿证候病情指标差异探讨

Discussion on the difference of disease index between rheumatoid arthritis syndrome of damp-heat and cold-dampness

目的:探讨类风湿关节炎(RA)湿热痹阻证、寒湿痹阻证两组证候之间在血小板(PLT)、健康评估问卷(HAQ)评分、双手X线的差异。方法:选取类风湿关节炎中医数据中心(CRDC-TCM)确诊为RA湿热痹阻证与寒湿痹阻证患者,比较两组证候的人口学特征(性别、年龄、病程)与PLT指标、HAQ评分以及影像学(双手X线分期)特征。结果:共纳入625例RA确诊患者,其中湿热痹阻证RA患者420例,寒湿痹阻证RA患者205例。两组RA患者在性别分布、年龄与病程长短上比较,差异均无统计学意义。湿热痹阻证RA患者PLT、HAQ评分总体水平显著高于寒湿痹阻证RA患者(P<0.05)。两组RA患者在总体双手X线分期比较,差异无统计学意义,均以Ⅰ、Ⅱ期多见;两证之间比较,寒湿痹阻证Ⅲ、Ⅳ期RA患者占比较多。结论:两组证候在人口学特征上无明显差异;湿热痹阻证RA患者在PLT、HAQ评分总体上较寒湿痹阻证高;两组证候在双手X线分期差异无统计学意义,两证之间寒湿痹阻证Ⅲ、Ⅳ期RA患者占比较多。

Objective:To investigate the differences of platelet(PLT),Health Assessment Questionnaire(HAQ)score and X-ray of both hands between two groups of rheumatoid arthritis(RA)syndrome of damp-heat blockade syndrome,and colddampness blockade syndrome.Methods:Rheumatoid arthritis data center(CRDC-TCM)was selected to identify patients with RA of damp-heat blockade syndrome and cold-dampness blockade syndrome,compare two groups syndrome of demographic characteristics(including gender,age,course of the disease)and imaging X-ray stage(hands),PLT index and describe patients subjective feeling of HAQ.Results:A total of 625 patients with RA were included,including 420 patients with damp-heat blockade syndrome and 205 patients with cold-dampness blockade syndrome.There were no statistically significant differences in the gender distribution,age and length of disease course between the two groups of RA patients.The overall level of PLT and HAQ scores in RA patients with damp-heat blockade syndrome was significantly higher than that in RA patients with colddampness blockade syndrome(P<0.05).There was no statistical difference between the two groups of RA patients in the overall bimanual X-ray stage,which was more common in phaseⅠandⅡ.However,two-hand X-ray manifestations of cold-dampness blockade syndrome account for more RA patients in stageⅢandⅣ.Conclusion:There is no significant difference in demography between the two groups.The PLT and HAQ scores of RA patients with dampness and heat arthralgia are higher than those with cold and dampness arthralgia.There is no statistical difference between the two groups of syndromes in the two hands X-ray stage,and RA patients in the phaseⅢandⅣof cold and damp arthralgia syndrome accounted for a large proportion.