1075例类风湿关节炎患者的发病与二十四节气的关系探析

Exploration of the correlation between the onset of rheumatoid arthritis and the twenty-four solar terms in 1075 cases

目的 了解类风湿关节炎(RA)发病与二十四节气的关系,为临床中医防治RA提供参考。方法 选取2016~2018年苏州市中医医院风湿免疫科住院的1075例RA患者,采用频数分析及绘制雷达图分析所有患者一般特征以及RA发病与节气的关系。结果 2016年入院RA患者共357例,其中雨水前后RA发病例数最多(27例,7.56%),清明、芒种次之,均为22例,占比6.16%,大寒发病例数最少,仅1例(0.28%)。2017年共入院RA患者345例,其中芒种最多23例,占比6.67%,立春、立秋次之,分别为22例(6.38%)、21例(6.09%),秋分发病例数最少,仅8例,占比2.32%。发病例数较多时间段集中分布在立春至春分前后。2018年入院RA患者共373例,RA发病时间段集中分布在惊蛰至谷雨前后,其中惊蛰发病最高,24例,占比6.43%,清明次之,23例,占比6.17%,春分、谷雨发病入院例数均为22例(5.90%);谷雨后发病例数逐渐减少呈递减趋势,至小暑(22例,5.90%)、处暑(21例,5.63%),两个节气入院人数再次升高。大寒发病例数最少,仅5例(1.34%)。综合上述三年的总体数据,RA发病节气集中分布在雨水至立夏前后,即春季为主。其中雨水RA发病最多共59例,占比5.49%;清明次之,RA发病57例,占比5.30%;其次为春分55例,占比5.12%;谷雨53例,占比4.93%;立夏51例,占比4.74%;惊蛰50例,占比4.65%。芒种过后至白露期间,RA入院人数又逐渐增加,出现第二个高峰,即夏季为主。芒种58例,占比5.40%,夏至51例、占比4.74%,小暑45例、占比4.19%,大暑及立秋入院均47例、占比4.37%,处暑45例、占比4.19%,白露51例、占比4.74%。2016~2019年三年期间RA发病最高为雨水(5.49%),其次为芒种(5.40%)、清明(5.30%),大寒最少(1.58%)。结论 春季RA入院患者较多、病情活动,至深秋、冬季后RA入院人数明显减少。不同节气由于气候特点不同,发病人数亦不相同,临床可据此防治本病。

Objective To understand the correlation between the development of rheumatoid arthritis(RA and the twenty-four solar terms,so as to provide reference for clinical Chinese medicine to prevent and treat RA.Methods 1075 patients with RA hospitalized in the Department of Rheumatology and Immunology of Suzhou Hospital of Traditional Chinese Medicine in 2016-2018 were selected for study.The general characteristics of all patients and the correlation between onset of RA and solar term were analyzed by frequency analysis and radar mapping.Results In 2016,357 patients with RA were admitted to the hospital,of which the highest number of RA cases(27 cases,7.56%) occurred before and after the Rain Water,followed by Qingming and Grain in Ear,both with 22 cases,6.16%;the lowest number of cases occurred in the Great Cold,with only 1 case(0.28%).In 2017,345 patients with RA were admitted to the hospital,of which the highest number of RA cases(23 cases,6.67%) in Grain in Ear,followed by 22 cases(6.38%) and 21 cases(6.09%) in Beginning of Spring and Beginning of Autumn,respectively,and the least frequent in Autumnal Equinox,with only 8 cases(2.32%);the number of cases was concentrated in the period from Beginning of Spring to Spring Equinox.In 2018,a total of 373 RA patients were admitted to the hospital,and the time period of RA onset was concentrated around the period from Awakening of Insects to Grain Rain,with the highest incidence of Awakening of Insects,24 cases,accounting for 6.43%,followed by Qingming,23 cases,accounting for 6.17%,and 22 cases(5.90%) were admitted to the hospital for both the Spring Equinox and Grain Rain.The number of cases decreased gradually in a decreasing trend after the Grain Rain,and the number of admissions rose again in the Slight Heat(22 cases,5.90%) and the Limit of Heat(21 cases,5.63%).The lowest number of cases was seen in the Great Cold,with only 5 cases(1.34%).Based on the overall data of the above three years,the RA onset was concentrated in the period from Rain Water to around the Beginning of Summer,that was,mainly in spring.Among them,Rain Water had the most RA cases with a total of 59 cases,accounting for 5.49%;Qingming was second,with 57 RA cases,accounting for 5.30%;followed by Spring Equinox with 55 cases,accounting for 5.12%;Grain Rain with 53 cases,accounting for 4.93%;Beginning of Summer with 51 cases,accounting for 4.74%;and Awakening of Insects with 50 cases,accounting for 4.65%.The number of RA admissions gradually increased again after the Grain in Ear to the White Dew period,and a second peak occurred,which was mainly in summer.There were 58 cases in Grain in Ear,accounting for 5.40%,51 cases in Summer Solstice,accounting for 4.74%,45 cases in Slight Heat,accounting for 4.19%,47 cases in both Great Heat and Beginning of Autumn,accounting for 4.37%,45 cases in Limit of Heat,accounting for 4.19%,and 51 cases in White Dew,accounting for 4.74%.The highest RA onset from 2016 to 2019 was Rain Water(5.49%),followed by Grain in Ear(5.40%) and Qingming(5.30%),and the least 17 cases(1.58%) were in the Great Cold.Conclusion The number of RA is higher and more active in spring,and decreases significantly in late autumn and winter.The number of patients with rheumatoid arthritis varies from season to season due to different climatic characteristics,which can be used to prevent and treat the disease.