类风湿关节炎合并抗ENA抗体异常患者的中西医临床特征  

Clinical Features of Traditional Chinese Medicine and Western Medicine in Patients with Rheumatoid Arthritis Complicated with Abnormal Antibodies to Extractable Nuclear Antigen

作　　者：陈淑琳 林昌松[2] CHEN Shu-Lin;LIN Chang-Song(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2022年第4期735-740,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81774262);广州中医药大学“双一流”与高水平大学学科协同创新团队项目(编号:A1-2601-21-415-012)。

摘　　要：【目的】探讨类风湿关节炎(RA)合并抗可提取核抗原(ENA)抗体异常患者的中西医临床特征。【方法】收集2019年1月至2021年3月在广州中医药大学第一附属医院风湿科住院的RA合并抗ENA抗体异常患者的病历资料,应用SPSS 22.0统计软件进行数据的统计分析,探讨抗ENA抗体与RA相关实验室指标的相关性,并观察RA合并抗ENA抗体异常患者的中医证型分布及证型间血清学表现的差异。【结果】(1)共收集RA合并抗ENA抗体异常患者100例,干燥综合征(SS)为患者合并最多的免疫疾病。(2)中医证型方面,100例患者中,肝肾不足证36例(36.0%),风寒湿痹证31例(占31.0%),湿热痹阻证15例(占15.0%),痰瘀痹阻证10例(占10.0%),气血两虚证8例(占8.0%),其中以肝肾不足证为患者最常见的中医证型。(3)抗ENA抗体异常计数与补体3(C3)、补体4(C4)、血红蛋白量、红细胞总数、淋巴细胞总数呈负相关,与类风湿因子(RF)、抗环瓜氨酸肽抗体(anti-CCP)、C反应蛋白(CRP)、血沉(ESR)、中性粒细胞总数、白细胞总数、血小板总数、尿酸、病程、年龄等无关。(4)5种证型间的血小板总数比较,差异有统计学意义(P<0.05),其中,风寒湿痹证与湿热痹阻证及痰瘀痹阻证比较,差异有统计学意义(P<0.05或P<0.01)。【结论】RA患者中多种抗ENA抗体异常与补体、淋巴细胞总数的下降及贫血严重程度相关,RA疾病活动以及炎症、病程、年龄并非导致抗ENA抗体异常的主要原因;患者以肝肾不足证为主要证型,且5种证型的血小板总数差异反映了中医与西医在病理机制上存在共通性。Objective To investigate the clinical features of traditional Chinese medicine(TCM)and western medicine in the patients with rheumatoid arthritis(RA)complicated with abnormal antibodies to extractable nuclear antigen(anti-ENA antibodies).Methods Medical records of RA patients with abnormal anti-ENA antibodies hospitalized in the Rheumatology Department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2019 to March 2021 were collected.SPSS 22.0 statistical software was used for statistical analysis of the data,and the correlation between anti-ENA antibodies and RA-related laboratory indicators was discussed.The distribution of TCM syndromes and the differences of serological manifestations in RA patients complicated with abnormal anti-ENA antibodies were investigated.Results(1)A total of 100 RA patients combined with abnormal anti-ENA antibodies were collected,and Sjogren’s syndrome(SS)predominated in the complicated immune disease.(2)In terms of TCM syndromes of the 100 patients,36 cases(36.0%)were differentiated as liver and kidney insufficiency syndrome,31 cases(31.0%)as wind-cold-damp obstruction syndrome,15 cases(15.0%)as damp-heat obstruction syndrome,10 cases(10.0%)as phlegm and blood stasis obstruction syndrome,8 cases(8.0%)as qi and blood deficiency sydrome.The syndrome of liver and kidney insufficiency was the most common TCM syndrome type.(3)The count of abnormal anti-ENA antibodies was negatively correlated with complement 3(C3),complement 4(C4),hemoglobin amount,total erythrocyte count and total lymphocyte count.However,the count of abnormal anti-ENA antibodies has no correlation with rheumatoid factor(RF),anti-cyclic citrullinated peptide(anti-CCP),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),total neutrophil count,total white blood cell count,total platelet count,uric acid,course of disease,age,etc.(4)There were statistically significant differences in total platelet count among the five syndrome types(P<0.05).There were statistically signifi

关 键 词：类风湿关节炎 抗可提取核抗原抗体 中医证候 肝肾不足证 血小板总数 

分 类 号：R593.22[医药卫生—内科学]