类风湿关节炎患者中医体质分布特点及其与血清TNF-α、25(OH)D水平的关系  

Distribution characteristics of TCM constitutions and their relationship with serum TNF-αand 25(OH)D levels in patients with rheumatoid arthritis

作　　者：李云[1] 张强 吕婧 温淑云 王云汉 杨娜[1] LI Yun;ZHANG Qiang;LV Jing(Department of Traditional Chinese Medicine,Dezhou Hospital,Qilu Hospital,Shandong University,Dezhou Shandong 253000,China;Dezhou College of Vocational Education,Dezhou Shandong 2530000,China)

机构地区：[1]山东大学齐鲁医院德州医院中医科,山东德州253000 [2]德州学院职业教育学院,山东德州253000

出　　处：《四川中医》2024年第4期95-100,共6页Journal of Sichuan of Traditional Chinese Medicine

基　　金：山东省中医药科技项目(编号:2020M176)。

摘　　要：目的:探究类风湿关节炎(RA)患者中医体质分布特点及其与血清肿瘤坏死因子-α(TNF-α)、25-羟基维生素D(25(OH)D)水平的关系。方法:于2021年6月~2023年5月我院收治的RA患者中选取86例作为研究对象,据《中医体质分类与判定表》判定患者的中医体质并收集一般资料,比较不同性别、年龄、病程、RA表现(活动期/非活动期、有/无关节外表现)患者的体质分布;同时应用ELISA法测定不同体质患者血清TNF-α、25(OH)D水平,分析二者之间的关系。结果:86例RA患者均表现偏颇质,无平和质,其表现依次排序为阳虚质、气虚质、阴虚质、血瘀质、气郁质、痰湿质、湿热质、特禀质;不同性别、年龄、病程、RA表现患者的体质分布均存在差异(P<0.05);不同体质在TNF-α、25(OH)D水平方面存在差异(P<0.05),且阳虚质的TNF-α水平均高于其他体质,25(OH)D水平均低于其他体质,差异有统计学意义(P<0.05)。结论:RA患者主要表现为偏颇质,且不同性别、年龄、病程、RA表现患者的体质分布均存在显著差异,这种差异可能与TNF-α、25(OH)D的表达存在关联。Objective To explore the distribution characteristics of TCM constitutions and their relationship with levels of serum tumor necrosis factor-α(TNF-α)and 25-hydroxyvitamin D[25(OH)D]in patients with rheumatoid arthritis(RA).Methods A total of 86patients with RA in outpatient or inpatient department of the hospital were enrolled as the research objects between June 2021and May 2023.According to Classification and Evaluation Scale of TCM Constitutions,TCM constitutions of enrolled patients were determined.The general data of patients were collected.The distribution of TCM constitutions in patients with different genders,age,course of disease and RA manifestations(active/inactive stage,with/without extra-articular manifestations)was compared.The levels of serum TNF-αand 25(OH)D in patients with different TCM constitutions were detected by ELISA.The relationship between TCM constitutions and TNF-α,25(OH)D was analyzed.Results There was biased constitution and no peaceful constitution in all the 86RA patients.The proportion of yang-deficiency constitution was the highest,followed by qi-deficiency constitution,yin-deficiency constitution,blood-stasis constitution,qi-stagnation constitution,phlegmdampness constitution,damp-heat constitution and specific-endowment constitution.There were significant differences in the distribution of TCM constitutions among patients with different genders,age,course of disease and RA manifestations(P<0.05).There were differences in levels of TNF-αand 25(OH)D among patients with different constitutions(P<0.05).The level of serum TNF-αin patients with yang-deficiency constitution was higher than that with the other constitutions,while 25(OH)D level was lower than that with the other constitutions(P<0.05).Conclusion One of the main manifestations is biased constitution in RA patients.There are significant differences in the distribution of TCM constitutions among patients with different genders,age,course of disease and RA manifestations,which may be related to TNF-αand 25(OH)D levels

关 键 词：类风湿关节炎 中医体质 分布规律 肿瘤坏死因子-Α 25-羟基维生素D 

分 类 号：R593.22[医药卫生—内科学]