类风湿关节炎中医证型与病情活动指标的相关性分析  

Correlation Analysis Between TCM Syndrome Types and Disease Activity Indexes of Rheumatoid Arthritis

作　　者：侯雷[1] 元晓龙 曾苹[1] 姚血明[1] 马武开[1] HOU Lei;YUAN Xiao-long;ZENG Ping;YAO Xue-ming;MA Wu-kai

机构地区：[1]贵阳中医学院第二附属医院,贵州贵阳550003 [2]贵阳中医学院,贵州贵阳550025

出　　处：《风湿病与关节炎》2018年第12期5-8,共4页Rheumatism and Arthritis

基　　金：贵州省社会发展攻关项目(黔科合SY字[2015]3048);贵州省高层次创新型人才培养计划--"百"层次人才项目(黔科合平台人才[2016]5650);贵州省中医药(民族医药)治疗风湿病医学平台建设(黔科合平台人才[2018]5707);贵州省中医药管理局课题(QZYY-2015-049);贵阳中医学院院内课题(贵中医科院内[2016]05号)

摘　　要：目的:探讨类风湿关节炎患者病情活动指标与不同中医证型的相关性。方法:选取符合中医诊断标准的湿热痹阻型、寒湿痹阻型、痰瘀痹阻型、肝肾亏虚型类风湿关节炎患者各30例作为研究对象,观察类风湿关节炎患者临床常用判断病情的活动指标,包括关节肿胀度、关节压痛度、疼痛视觉模拟评分法(VAS)评分、晨僵时间、C-反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)及28个关节疾病活动度(DAS28)评分,分析其与不同中医证型的相关性。结果:关节肿胀度、VAS评分、晨僵时间、ESR、CRP在各中医证型间比较,差异有统计学意义(P <0.05);而关节压痛度、RF在各中医证型间比较,差异无统计学意义(P> 0.05)。病情活动指标由高到低依次为:湿热痹阻型>寒湿痹阻型>痰瘀互结型>肝肾亏虚型。且湿热痹阻型与其他3种证型比较,DAS28评分差异有统计学意义(P <0.05)。结论:类风湿关节炎中医证型与病情活动指标存在一定关系,但与关节压痛度、RF无关;类风湿关节炎病情活动期中医证型主要为湿热痹阻型,病情活动指标最高。Objective:To explore the correlation between TCM syndrome types and disease activity indexes in patients with rheumatoid arthritis.Methods:Thirty patients with rheumatoid arthritis of dampheat obstruction,cold-dampness obstruction,phlegm-blood stasis obstruction and liver-kidney deficiency were selected as subjects.The commonly used clinical activity indicators of patients with rheumatoid arthritis were observed,including joint swelling,joint tenderness,VAS,morning stiffness time,CRP,ESR,RF and DAS28,which were used to analyze their correlation with different TCM syndromes.Results:There were significant differences in the degree of joint swelling,VAS,morning stiffness time,ESR and CRP among all the TCM syndromes(P<0.05),but there was no significant differences in the degree of joint tenderness and RF among all the TCM syndromes(P>0.05).The indexes of disease activity from high to low were:damp-heat obstruction,cold-dampness obstruction,phlegm-blood stasis obstruction,and liver-kidney deficiency,and the difference of DAS28between damp-heat obstruction type and other three syndromes was significant(P<0.05).Conclusion:TCM syndrome has a certain relationship with disease activity index in rheumatoid arthritis,but has nothing to do with joint tenderness and RF.The damp-heat obstruction type is the main TCM syndrome with the highest disease activity index.

关 键 词：关节炎 类风湿 中医证型 病情活动指标 相关性 

分 类 号：R259[医药卫生—中西医结合]