类风湿关节炎寒热症候患者临床特征分析

Analysis of clinical characteristics of rheumatoid arthritis patients with different cold and heat syndromes in traditional Chinese medicine

目的:依据'寒热为纲',探究类风湿关节炎患者寒证与热证的之间临床指标的差异。方法:纳入类风湿关节炎患者120例,依据问诊症状将其分为寒证组(53例)和热证组(67例),比较患者临床资料、体格检查、炎性指标、关节及肌肉骨骼超声的表现间的差异。结果:热证组较之于寒证组,患者的28关节压痛数、28关节肿胀数、28关节超声下滑膜炎数、28关节超声下PD数、患者自我评估、血沉、C反应蛋白、Ln(RF+1)、DAS28升高存在显著性差异(P<0.01或P<0.05);年龄、骨侵蚀、病程和Ln(CCP+1)不具有显著性差异(均P>0.05)。结论:热证组较之于寒证组,体格检查指标、肌肉骨骼超声指标及RA相关抗体部分升高,炎性指标及DAS28指标升高,提示热证RA患者处于一个较高的疾病活动状态。

Objective:To explore the differences in clinical indicators between cold syndrome and heat syndrome in patients with rheumatoid arthritis based on'Differentiation of Cold and Heat Syndromes'.Methods:We enrolled 120 patients with rheumatoid arthritis.According to the symptoms of consultation,they were divided into cold syndrome group(53 cases)and heat syndrome group(67 cases).The basic clinical data,physical examination,inflammatory index and musculoskeletal ultrasounography were observed,in order to explore the differences between the two groups.Results:Compared with the cold syndrome group,the data in the heat syndrome group,such as its 28-tender joint count,28-swollen joint count,28-synovitis joint under ultrasound,28-PD joint under ultrasound,General health,erythrocyte sedimentation rate,C-reactive protein,Ln(RF+1)and DAS28 were all increased statistically significantly(P<0.05 or P<0.01).The differences of age,bone erosion,course of disease and Ln(CCP+1)were not statistically significant(P>0.05).Conclusion:Compared with the cold syndrome group,the physical examination index,musculoskeletal ultrasound index and RA-related antibody were elevated,and the inflammatory index and DAS28 index were partly elevated,suggesting that patients with heat syndrome were at a higher disease activity status.