强直性脊柱炎中医证型与HLA-B27及相关指标的关系

Relationship between HLA-B27 and Related Indexes and Traditional Chinese Medicine Syndrome Types in Ankylosing Spondylitis

目的分析强直性脊柱炎患者中医证型与人体白细胞抗原B27(HLA-B27)及相关指标之间的关系。方法选取在九江市第一人民医院治疗的强直性脊柱炎患者82例,根据患者中医证型进行分组,研究不同证型患者在病情、病程、性别与HLA-B27及其他相关指标之间的关系。结果4种证型强直性脊柱炎患者性别比例,瘀血阻络组与肝肾亏虚组比较,差异无统计学意义(P>0.05);湿热阻络组与寒湿痹阻组比较,差异无统计学意义(P>0.05)。4种证型强直性脊柱炎之间病程、HLAB27差异无统计学意义(P>0.05);4种证型Bath强直性脊柱炎疾病活动指数(BASDAI)与Bath强直性脊柱炎疾病功能指数(BASFI)HLA-B27阴性与阳性之间差异有统计学意义(P<0.05);BASDAI与BASFI,4种证型之间差异无统计学意义(P>0.05)。结论HLA-B27与不同中医证型之间并不存在明显的相关性,不同HLA-B27强直性脊柱炎患者可以表现出各种中医证候,HLA-B27可能影响强直性脊柱炎患者的病情发展及病情活动。寒湿痹阻证病例数较少,与寒湿痹阻证出现在急性期较少,寒痹日久化热或者是虚痹多夹寒痹易外感有关。

Objective To analyze the relationship between traditional Chinese medicine(TCM)syndrome types and HLA-B27 and related indicators in patients with ankylosing spondylitis.Methods 82 patients with ankylosing spondylitis treated in Jiujiang First People’s Hospital were divided into groups according to the TCM syndrome types,and the relationship between the condition,course of disease,gender and HLA-B27 and other related indicators was studied.Results There was no significant difference in the sex ratio of patients with 4 types of syndromic ankylosing spondylitis between the blood stasis blocking group and the liver and kidney deficiency group(P>0.05).There was no significant difference between the dampness-heat blocking group and the cold-dampness-bi blocking group(P>0.05).There were no significant differences in the course of disease and HLA-B27 among the four types of ankylosing spondylitis(P>0.05).Bath ankylosing spondylitis disease activity index(BASDAI)and Bath ankylosing spondylitis Disease Function Index(BASFI)had statistical significance between negative and positive HLA-B27(P<0.05).There was no significant difference between BASDAI and BASFI(P>0.05).Conclusion There is no significant correlation between HLA-B27 and different TCM syndrome types.Patients with different HLA-B27 ankylosing spondylitis can show various TCM syndrome,and HLA-B27 may affect the disease development and activity of patients with ankylosing spondylitis.The small number of cases of cold and dampness impediment syndrome is related to the less occurrence of cold and dampness impediment syndrome in the acute stage,the prolonged heat of cold and dampness impediment or the external symptoms of cold and dampness impediment.