类风湿关节炎肺间质病变患者的中医证候特征  

TCM Syndrome Features in Patients with Rheumatoid Arthritis Interstitial Lung Diseases

作　　者：李松伟[1] 王济华[1] 杨科朋 郭洪涛[1] 李桓[3] 李增变 李纪高[1] 

机构地区：[1]河南中医学院第一附属医院,河南省郑州市人民路19号450000 [2]郑州市中医院 [3]河南中医学院

出　　处：《中医杂志》2015年第19期1655-1658,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(U1204828);河南省科技厅科技攻关项目(112102310277)

摘　　要：目的探讨类风湿关节炎肺间质病变(RA-ILD)中医证型分布及其证候特征。方法收集320例RA-ILD患者的临床资料,根据中医辨证分为肺肾气阴两虚证、肺肾气虚证、肺脾气虚证和肾阳虚证4个证型,研究各个证型患者血常规、肝肾功能、血沉(ESR)、C反应蛋白(CRP)、免疫球蛋白、自身抗体等分布情况。结果 320例患者中肺肾气阴两虚证有156例(占48.8%),明显多于其余证型(P<0.05)。肺脾气虚证在女性患者所占比例明显高于男性,肾阳虚证患者关节变形数明显低于其余证型(P<0.05)。肺脾气虚证的血小板(PLT)、ESR、CRP、免疫球蛋白M(Ig M)检测结果均明显高于其余证型(P<0.05)。肾阳虚证在类风湿因子Ig M(RF-Ig M)、类风湿因子Ig A(RF-Ig A)及类风湿因子Ig G(RF-Ig G)的滴度方面明显低于其余证型(P<0.05)。结论肺肾气阴两虚证是RA-ILD的主要证候类型,肺脾气虚证的炎症活动程度最高,肾阳虚证预后最好。Objective To explore TCM syndrome distribution and its syndrome features of rheumatoid arthritis interstitial lung diseases （RA-ILD）. Methods Collected clinical data of 320 patients with RA-ILD. Divided them into 4 syndromes as lung-kidney Qi-yin deficiency syndrome, lung and kidney Qi deficiency syndrome, lung and spleen Qi deficiency syndrome and kidney yang deficiency syndrome, according to Chinese Medicine syndrome differ- entiation. Observe the condition of blood routine examination, hepatorenal function, erythrocyte sedimentation rate （ESR）, C reactive protein （CRP）, immune globulin, autoantibody of patients of each syndrome type. Results There were 156 cases of lung-kidney Qi-yin deficiency syndrome in 320 patients, to account for 48.8% , remarkably superior to other syndromes （ P 〈 0. 05 ）. The proportion of lung and spleen Qi deficiency syndrome in female patients was remarkably higher than that in male patients. The number of joint deformation in patients of kidney yang deficien- cy was remarkably less than that of other syndromes （P 〈0.05）. The level of platelet （PLT）, ESR, CRP, immune globulin M （IgM） were all remarkably higher than that of other syndromes （P 〈 0. 05 ）. The titer of rheumatoid factor IgM （RF-IgM）, rheumatoid factor IgA （RF-IgA）, and rheumatoid factor IgG （RF-IgG） in kidney yang deficiency syndrome was remarkably lower than in other syndrome types （P 〈 0. 05）. Conclusion Lung-kidney Qi-yin defi- ciency syndrome is the main syndrome type of RA-ILD. Inflammation grades of lung and spleen Qi deficiency syn- drome is the highest. The prognosis of kidney yang deficiency syndrome is the best.

关 键 词：类风湿关节炎 肺间质病变 中医证型 类风湿因子 

分 类 号：R259[医药卫生—中西医结合]