中医体质与强直性脊柱炎患者发病因素的相关性研究  

Investigation on the Correlation Between Traditional Chinese Medicine Constitution and Pathogenic Factors in Patients with Ankylosing Spondylitis

作　　者：吕水英 殷继超 徐鹏刚 刘德玉[3] 任宝娣 王颖 丁明辉 张俊莉 LYU Shui-Ying;YIN Ji-Chao;XU Peng-Gang;LIU De-Yu;REN Bao-Di;WANG Ying;DING Ming-Hui;ZHANG Jun-Li(The Fifth Hospital of Xi’an,Shaanxi Hospital of Integrated Traditional Chinese and Western Medicine,Xi’an 710082 Shaanxi,China;Xi’an Health School,Xi’an 710054 Shaanxi,China;The First Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000 Shaanxi,China)

机构地区：[1]西安市第五医院,陕西省中西医结合医院,陕西西安710082 [2]西安市卫生学校,陕西西安710054 [3]陕西中医药大学第一附属医院,陕西咸阳712000

出　　处：《广州中医药大学学报》2024年第3期545-549,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：陕西省中医药管理局中西医结合临床协作创新项目(编号:2020-ZXY-006);西安市第五医院院内科研项目(编号:20201c01)。

摘　　要：【目的】研究中医体质与强直性脊柱炎(ankylosing spondylitis,AS)患者发病因素的相关性。【方法】选取2019年8月至2020年9月就诊于西安市第五医院(即陕西省中西医结合医院)的100例强直性脊柱炎患者及其家系成员作为研究对象。采用中华中医药学会颁布的《中医体质分类与判定》中的准则对研究对象进行体质判定,通过问卷调查和临床调查的方式收集强直性脊柱炎患者及其家系成员的社会人口学、生活习惯、临床症状、中医体质等情况,调查强直性脊柱炎患者的疾病诱发因素;采用二进制逻辑回归模型,分析强直性脊柱炎患者中医体质类型与发病因素的相关性。【结果】(1)100例强直性脊柱炎患者中,以偏颇体质居多,其分布频率由高到低依次为阳虚质、气虚质、湿热质,分别占33.00%、14.00%、18.00%。(2)强直性脊柱炎患者的Ⅰ、Ⅱ、Ⅲ级亲属的患病率分别为56.25%、40.00%、25.00%;在人类白细胞抗原B27(HLA-B27)阳性率方面,强直性脊柱炎患者的HLA-B27均为阳性,而其Ⅰ、Ⅱ、Ⅲ级亲属的HLA-B27阳性率分别为44.31%、30.67%、15.63%。(3)回归分析结果显示,强直性脊柱炎患者的病程与气虚质、骶髂关节炎级别与气郁质、年龄与血瘀质呈显著相关性(P<0.05或P<0.01)。表明强直性脊柱炎患者的病程和年龄是影响体质的重要因素,其中病程与气虚关系密切,年龄与血瘀关系密切。【结论】强直性脊柱炎为高度遗传的自身免疫性疾病,其发病与HLA-B27相关;阳气亏欠是强直性脊柱炎最基本的体质特点,而湿热质是强直性脊柱炎疾病进展过程(尤其是疾病活动期)的主要体质类型,且随病程的延长会加剧病情和气虚表现。Objective To study the correlation between traditional Chinese medicine(TCM)constitution and pathogenic factors in patients with ankylosing spondylitis(AS).Methods One hundred patients of AS and their family members who had medical consultation in the Fifth Hospital of Xi’an(i.e.,Shaanxi Hospital of Integrated Traditional Chinese and Western Medicine)in August 2019 and September 2020 were selected as the study subjects.The guidelines of Classification and Determination of Traditional Chinese Medicine Constitution issued by the China Association of Chinese Medicine were adopted to determine the traditional Chinese medicine(TCM)constitution types of the study subjects.The sociodemographic information,living habits,clinical symptoms,and TCM constitution types of the AS patients and their family members were collected by means of questionnaires and clinical investigations,and then the pathogenic factors of the patients with AS were investigated.The binomial Logistic regression model was used to analyze the correlation between TCM constitution types and pathogenic factors in patients with AS.Results(1)Among the 100 AS patients,the majority of them had the biased constitutions,and the biased constitutions with the occurrence frequency in descending order were yang deficiency constitution,qi deficiency constitution,and damp-heat constitution,which accounted for 33.00%,14.00%,and 18.00%,respectively.(2)The prevalence rates of AS in the first-,second-,and third-degree relatives of AS patients were 56.25%,40.00%and 25.00%,respectively.For the positive rates of human leukocyte antigen B27(HLA-B27)in AS patients and their family members,HLA-B27 in AS patients was all positive,while the positive rates of HLA-B27 in the first-,second-,and third-degree relatives of AS patients were 44.31%,30.67%and 15.63%,respectively.(3)The results of regression analysis showed that the disease duration of AS patients was significantly correlated with qi deficiency constitution,the grading of sacroiliac arthritis was correlated with qi stagn

关 键 词：强直性脊柱炎 中医体质 阳虚质 气虚质 湿热质 人类白细胞抗原B27(HLA-B27) 

分 类 号：R259.323[医药卫生—中西医结合]