五运六气与强直性脊柱炎肾虚督寒证及肾虚湿热证关联性的回顾性临床研究  

A Retrospective Clinical Study on the Correlation between the Theory of Five Movements and Six Climates,and Kidney Deficiency with Governor Vessel Cold Syndrome and Kidney Deficiency Damp-Heat Syndrome in Ankylosing Spondylitis

作　　者：吴娟 李月 阎小萍[2] 孔维萍[2] WU Juan;LI Yue;YAN Xiaoping;KONG Weiping(Graduate School of Beijing University of Chinese Medicine,Beijing,100029;China-Japan Friendship Hospital)

机构地区：[1]北京中医药大学研究生院,北京市100029 [2]中日友好医院

出　　处：《中医杂志》2023年第21期2208-2215,共8页Journal of Traditional Chinese Medicine

基　　金：中日友好医院高水平医院临床科研业务费专项(2022-NHLHCRF-LX-02-0104);国家自然科学基金(81403378);北京市自然科学基金(7182148);北京市中医药科技发展资金项目(JJ-2020-87)。

摘　　要：目的 基于五运六气理论,探讨强直性脊柱炎(AS)患者肾虚督寒证及肾虚湿热证与其出生及发病年份运气的关系。方法 收集2010年9月5日至2020年9月9日于中日友好医院住院治疗且符合诊断及纳入标准的1791例AS患者临床资料,将患者根据中医证候标准分为肾虚督寒证和肾虚湿热证。出生日期、发病年份根据《万年历》运气符号转换为出生日期的地支、岁运、主运、客运、主气、客气、司天之气、客主加临、运气相合、节气、季节及发病年份的地支、岁运、司天之气。采用两独立样本t检验或曼惠特尼U检验、皮尔森(Pearson)χ~2检验或单因素Logistic回归分析进行单因素分析,将单因素分析存在统计学意义的变量纳入多因素Logistic回归分析。比较AS肾虚督寒证组及肾虚湿热证组患者在一般情况、临床表现、体征、实验室指标[包括C反应蛋白(CRP)、红细胞沉降率(ESR)及人类白细胞抗原B27 (HLA-B27)]、测量学指标(包括枕墙距、颌柄距、指地距、胸廓活动度及Schober试验)、出生及发病运气的分布差异,探索五运六气与AS肾虚督寒证及肾虚湿热证的关联性。结果 两组患者ESR水平、CRP水平、胸廓活动度、跟腱附着点炎及外周关节炎发生率差异有统计学意义(P<0.05)。单因素分析发现,以肾虚督寒证为参照组,相对出生岁运太水、出生主运太木、出生客运太木及发病岁运太木,出生岁运少金(OR=2.000,P=0.004)、出生主运太金(OR=1.745,P=0.024)或太土(OR=1.781,P=0.023)、出生客运少火(OR=1.689,P=0.049)、少木(OR=1.901,P=0.018)及太金(OR=2.163,P=0.004)、发病岁运太水(OR=1.880,P=0.013)或少木(OR=1.707,P=0.022)均增加罹患肾虚湿热证的风险。多因素Logistic回归分析发现,以肾虚督寒证组为参照组,出生岁运少金(相对出生岁运太水)、出生主运太金(相对出生主运太木)、ESR水平越高、胸廓活动度越大、合并跟腱附着点炎�Objective To explore the relationship between the kidney deficiency and governor vessel cold syndrome and the kidney deficiency damp-heat syndrome in ankylosing spondylitis(AS) patients and the five evolutive phases and six climatic factors of their birth and onset year based on the theory of five movements and six climates(FMSC).Methods Totally 1791 patients with AS who were admitted to China-Japan Friendship Hospital from September 2010 to September 2020 and met the diagnostic and inclusion criteria were selected in this study.The clinical data were classified into two types of syndromes,kidney deficiency and governor vessel cold syndrome and the kidney deficiency damp-heat syndrome based on the diagnostic criteria of traditional Chinese medicine syndromes.The date of birth and the year of disease onset were converted into FMSC symbols according to the perpetual almanac (《万年历》),and the two could be converted into the terrestrial branch,year evolutive phase,host evolutive phase,guest evolutive phase,host climatic qi,guest climatic qi,celestial manager qi,guest climatic qi adding to fixed host qi,combined analysis of five evolutive phases and six climatic factors,solar terms,and season of the date of birth,as well as the terrestrial branch,year evolutive phase,and celestial manager qi of the year of disease onset.Univariate analyses were performed using the two independent samples t-test or the Mann Whitney U-test,the Pearson(Pearson) χ^(2) test,or one-way logistic regression analyses,and variables for which statistical significance existed in the oneway analyses were included in the multivariate logistic regression analyses.General conditions,clinical manifestations,physical signs,laboratory indicators [including C reactive protein(CRP),erythrocyte sedimentation rate(ESR),and humans leukocyte antigen B27(HLA-B27)],measurement(including occipital wall distance,jaw peduncle distance,finger-to-ground distance,thoracic range of motion,and Schober experiment),and distribution of FMSC of birth and disease o

关 键 词：强直性脊柱炎 五运六气 发病年份 肾虚督寒证 肾虚湿热证 

分 类 号：R259[医药卫生—中西医结合]