类风湿关节炎症状公因子与中西药疗效的关系  

Principal factor analysis of symptoms of rheumatoid arthritis and their correlations with efficacy of traditional Chinese medicine and Western medicine

作　　者：何羿婷 查青林[2] 喻建平[2] 谭勇[3] 吕诚[4] 吕爱平[4] 

机构地区：[1]广州中医药大学第二附属医院,广东广州510120 [2]江西中医学院国家药物工程研究中心,江西南昌330006 [3]首都医科大学中医药学院,北京100069 [4]中国中医科学院中医临床基础医学研究所,北京100700

出　　处：《中西医结合学报》2008年第1期32-36,共5页Journal of Chinese Integrative Medicine

基　　金：国家自然科学基金重大计划重点项目(No90209002);国家自然科学基金项目(No3042121);上海高校中医内科E-研究院项目(NoE03008)

摘　　要：目的:在对类风湿关节炎(rheumatoid arthritis,RA)症状进行因子分析的基础上,探讨公因子与中西药疗效的关系。方法:将413例确诊为活动期RA的病例随机分成中药治疗组209例和西药治疗组204例。西药治疗方案包括口服扶他林缓释片、甲氨喋呤和柳氮磺胺吡啶,中药治疗包括雷公藤多苷片、益肾益蜀痹丸和辨证用药。利用美国风湿病学会20(ACR20))标准进行疗效评价。数据分析在SAS8.2软件上进行,对18项症状进行因子分析,并对因子分析结果与疗效进行χ2检验。结果:18项症状因子分析得到4个公因子,能较好地反映关节局部病情以及中医寒证、虚证、热证的症状。西药的总体疗效优于中药。治疗第12周,中药对非虚证的疗效优于对虚证的疗效;治疗第24周,西药对寒证的疗效优于对非寒证的疗效。结论:RA症状的因子分析结果与中医辨证相关,同时症状组合与疗效有相关性。因此要加强症状对疗效影响的研究。To explore the correlations between symptom-based principal factors of rheumatoid arthritis （RA） and the effect of traditional Chinese medicine or Western medicine on RA after factor analysis of RA symptoms. Methods： Four hundred and thirteen RA patients from 9 clinical centers were included in the clinical trial. They were randomly divided into Western medicine （WM） treated group with 204 cases and traditional Chinese medicine （CM） treated group with 209 cases. A complete physical examination and 18 common clinical manifestations were recorded before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included glucosidorum Tripterygll totorum tablet and Yishen Juanbi Tablet. The American College of Rheumatology 20 （ACR20） was used for efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. Eighteen symptoms in the RA patients were analyzed by factor analysis and the relationships between the factors and effects were analyzed with Chi-Square test. Results： Four principal factors were obtained from the analysis results of the 18 symptoms. The factors could represent the symptoms related to joints, cold-syndrome, deficiency syndrome and heat-syndrome in traditional Chinese medicine （TCM）, respectively. The effect of WM therapy was better than CM therapy. After 12 weeks of treatment, the effect of CM on patients without deficiency-syndrome was better than the patients with deficiency-syndrome. After 24 weeks of treatment, WM therapy showed better effect on patients with cold syndrome than patients without cold syndrome. Conclusion： The results based on the factor analysis of RA symptoms are similar to the results of syndrome differentiation of TCM, and the factor-related different categories of symptoms are associated with the curative effect, thus further research on the symptoms is necessary.

关 键 词：类风湿性关节炎 因子分析 统计学 治疗效果 

分 类 号：R593.22[医药卫生—内科学]