早期类风湿关节炎生化、X线检测与中医证型相关性系统综述  

Laboratory Examination and X-ray Examination of 43 Cases of Early Diagnosis of Rheumatoid Arthritis in Chinese and Western Medicine

作　　者：陆佳[1] 陶弘武[2] 李奕星[3] 

机构地区：[1]辽宁中医药大学第二临床学院,沈阳110034 [2]辽宁中医药大学附属第二医院影像科,沈阳110034 [3]辽宁中医药大学第一临床学院中西医结合医学心血管科,沈阳110034

出　　处：《实用中医内科杂志》2016年第1期5-8,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[主要目的]分析生化、X线检测早期类风湿关节炎(RA)与中医证型关系。[资料来源]选取辽宁中医药大学附属第二医院风湿科2013年1月至2014年12月早期类风湿关节炎患者病历。[选择文献量及依据]1研究类型:临床观察。2研究对象:符合RA诊断标准;西医、中医四诊资料齐全;新入院患者明确诊断纳入。使用X线检查;实验室检测。3辨证分型:风寒湿阻、风湿热阻、肝肾亏虚、痰邪痹阻。4评价指标:类风湿因子-RF-Ig M、C反应蛋白、血沉、免疫抗体(Ig M、Ig G、Ig A)、抗CCP,X线检查。排除1合并有其他风湿性疾病。2合并有重大心脑血管疾病。3有传染性病变、血液病患者及过敏体质。4妊娠、哺乳期、经期妇女。纳入样本43例。[数据提炼规则及应用方法]STATIF 400VAC 3ph 115A50Hz 50KW及Ysio 60083≤105KWA 380V/50Hz X线机。均摄X线平片,双侧关节部位对比。使用Microsoft Excel2013建数据库,分析X线影像学特点与中医分型相关性。[数据综合得出结果与结论]13例仅关节间隙变窄,16例关节滑膜肿胀、关节梭形变,9例骨质侵蚀囊变,2例关节半脱位。类风湿因子升高32例;C反应蛋白升高30例。血沉升高37例,Ig M、Ig G阳性4例,Ig A(+)6例,抗CCP抗体(+)4例。X线检查能诊断出早期类风湿性关节炎,生化检测能帮助提高诊断率。中医证型与X线分期有相关性。[未来展望]进一步研究指向性对应分期分型用药,以达更好的疗效。[Main purpose]Analysis of laboratory test,X-ray examination of early rheumatoid arthritis and syndrome type relationship.[Data sources]The second hospital affiliated to Liaoning University of Traditional Chinese Medicine from December 2014 to January 2013 in the early stage of rheumatoid arthritis patients.[Selection of Literature Quantity and Basis]①Research type：Clinical observation.②Research object：RA diagnostic criteria;Western medicine,TCM four diagnostic information is complete;Newly admitted patients with definite diagnosis.Using X-ray examination;Laboratory test.③Syndromedifferentiation：Cold wind resistance、Rheumatic fever resistance,Liver and kidney deficiency、Phlegm obstruction.④Evaluation index：Laboratory test,X-ray examination.Exclusion criteria（Meet one of the following criteria）①Other rheumatic diseases.②Combined with major cardiovascular and cerebrovascular diseases.③Infectious diseases,blood diseases and allergic constitution.④Pregnancy,lactation,menstruation women.43 cases were included in the sample.[Data Extraction Rules and Application Method]STATIF 400 VAC 3ph 115 A 50Hz 50 KW and Ysio 60083 is no more than 380V/50 Hz 105KWA X-ray machine.43 cases of RA patients were taken X-ray plain film,Joint on both sides of the contrast.Use Microsoft Excel2013 establish database,and SPSS17.0 statistical analysis.Analysis of X-ray imaging characteristics and the correlation between TCM Typing and TCM.[Results and Conclusions of the Data Synthesis]13 cases of joint space narrowing,16 cases of synovial membrane swelling,joint spindle deformation,9 cases of bone erosion capsule,2 cases of subluxation.Rheumatoid factor increases 32 cases;Elevated c-reactive protein in 30 cases.Elevated blood sedimentation 37 cases,4 cases were positive IgM and IgG,IgA（＋） 6 cases,Anti CCP antibody（＋） in 4 cases.X-rays can be diagnosed early rheumatoid arthritis,and laboratory tests can help improve the diagnostic rate.TCM syndrome type with a certain correlation between X-ray stage.[

关 键 词：类风湿性关节炎 历节 痹证 尪痹 类风湿因子-RF-IgM C反应蛋白 血沉 IGM IgG IgA 抗CCP X线 风寒湿阻 风湿热阻 肝肾亏虚 痰邪痹阻 相关性 回顾性研究 系统综述 

分 类 号：R259.932.2[医药卫生—中西医结合]