类风湿性关节炎患者舌象特征的临床研究

Clinical Study on Tongue Features Characteristics of Patients with Rheumatoid Arthritis

[目的]探讨类风湿性关节炎(rheumatoid arthritis,RA)患者的舌象特征。[方法]选取200例符合RA诊断标准的患者作为研究对象,对其性别、年龄、病程、实验室指标、使用28个关节的疾病活动评分(disease activity score uses 28 joint counts,DAS28)等基本信息进行详细记录,观察其舌象变化,以多项Logistic回归分析法探究现有中医证型与患者舌象的相关性。[结果]本次研究中200例RA患者的舌质以淡白舌、胖大舌和齿痕舌为主,舌苔以白苔、厚苔和腻苔为主;不同舌象的患者病情活动指标差异无统计学意义(P>0.05);多项Logistic回归分析法结果显示,现有证型与此次舌象研究结果无明显相关性(P>0.05)。结合本课题组前期相关研究,提出了一种新的RA证型——脾虚湿阻证,并明确了其舌质以淡白舌、胖大舌和齿痕舌为主,舌苔以白苔、厚苔和腻苔为主。[结论]RA患者舌象丰富多变,且不同证型中的表现不同,脾虚湿阻证是RA新的中医分型,该结果对临床诊疗和研究具有借鉴意义。

[Objective]To explore the tongue features characteristics of patients with rheumatoid arthritis(RA). [Methods]Two hundred patients who met the diagnostic criteria of RA were selected as the subjects of this study. The basic information such as sex, age, course of disease, laboratory index and disease activity score uses 28 joint counts(DAS28) were recorded in detail, the changes of tongue features were observed, multiple Logistic regression analysis was used to explore the correlation between the existing traditional Chinese medicine(TCM) syndrome types and the tongue features of patients in this study.[Results]In this study, the tongue features of 200 patients with RA were mainly pale tongue, fat tongue, toothed tongue;and the coating on the tongue was mainly white fur, thick fur, greasy fur. There was no significant difference in disease activity index among patients with different tongue pictures( P>0.05).The results of multiple Logistic regression analysis showed that there was no significant correlation between the existing syndrome types and the tongue features(P>0.05). Combined with the previous research, this study put forward a new type of RA syndrome: Spleen deficiency and dampness obstruction syndrome, it is clear that the tongue is mainly of pale tongue, fat tongue and toothed tongue, and the tongue coating is mainly of white fur, thick fur and greasy fur.[Conclusion]The tongue features of patients with RA are rich and changeable, and the manifestations are different in different syndrome types.Spleen deficiency and dampness obstruction syndrome is a new TCM classification of RA. The results can be used for reference for clinical diagnosis,treatment and research.