类风湿关节炎寒热证型与肌肉骨骼超声表现的相关性研究

Study on correlation between cold-heat syndrome of rheumatoid arthritis and ultrasonic appearance of musculoskeletal

目的:研究类风湿关节炎(RA)寒热证型与肌肉骨骼超声(MSUS)表现的相关性。方法:2017年3月-2018年3月收治RA患者54例,按辨证分型分为寒湿痹阻证组和湿热痹阻证组。两组患者均行MSUS。比较两组28个关节疾病活动指数(DAS28)评分、MSUS子评分及总评分。结果:湿热痹阻证组DAS28评分、滑膜厚度评分及超声总评分均显著高于寒湿痹阻证组,差异有统计学意义(P<0.05)。湿热痹阻证组DAS28评分与滑膜厚度评分、积液评分、骨侵蚀评分、滑膜血流评分、超声总评分均呈正相关。结论:RA湿热痹阻证时疾病活动度高,DAS28与MSUS子指标评分和超声总评分有一定相关性,MSUS为RA辨证分型提供一定客观依据。

Objective:To study the correlation between the cold-heat syndrome of rheumatoid arthritis(RA)and the ultrasonic appearance of musculoskeletal(MSUS).Methods:From March 2017 to March 2018,54 patients with rheumatoid arthritis were enrolled,according to dialectical classification,they were divided into cold and heat blocking syndrome group and damp heat blocking syndrome group.Both groups of patients received MSUS.The disease activity index(DAS28)scores of 28 joints,the sub-scores and total scores of MSUS were compared between the two groups.Results:The scores of DAS28,the scores of synovial thickness and total scores of ultrasound in damp heat blocking syndrome group were significantly higher than cold and heat blocking syndrome group,the differences were statistically significant(P<0.05).In the damp heat blocking syndrome group,DAS28 score was positively correlated with synovial thickness scores,effusion scores,bone erosion scores,synovial blood flow scores and total scores of ultrasound.Conclusion:The disease activity is high in cold-heat syndrome of rheumatoid arthritis disease,there is some correlation between DAS28 sub-scores and MSUS sub-scores and total scores of ultrasound,so MSUS provides some objective basis for cold-heat syndrome of rheumatoid arthritis.