类风湿关节炎中医证候客观化研究  

Objectification of Traditional Chinese Medicine Syndromes of Rheumatoid Arthritis

作　　者：姬森国[1] 吴頔[1] 张徐明 刘芳[1] 刘炬[1] JI Senguo;WU Di;ZHANG Xuming;LIU Fang;LIU Ju(Department of Rheumatology and Immunology,Jiujiang First People's Hospital,Jiangxi Province,Jiujiang 332000,China)

机构地区：[1]九江市第一人民医院风湿免疫科,江西九江332000

出　　处：《光明中医》2024年第11期2109-2112,共4页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：江西省中医药管理局科技计划(No.2021B410);中国中医药研究促进会科研立项(No.2022032)。

摘　　要：目的探究类风湿关节炎(RA)相关指标与中医证型之间的关系。方法选取RA患者300例,根据中医辨证分型的不同将其分为湿热痹阻证、寒湿痹阻证、肾气虚寒证、肝肾阴虚证和瘀血痹阻证5个证型,每个证型60例。分析各个证型患者的临床表现、免疫学指标、检验学指标与各个证型之间的联系。结果中医证候在关节肿胀、关节疼痛、关节畸形3种临床表现方面,差异有统计学意义(P<0.05);各证型RA患者的类风湿因子(RF)、抗环瓜氨酸多肽(CCP)抗体、红细胞沉降率(ESR)、C反应蛋白(CRP)、血小板计数(PLT)、D-二聚体(DD)等指标之间比较,差异无统计学意义(P>0.05)。结论类风湿关节炎严重程度与各指标无明显相关性;各指标与中医证候无明显相关性。中医治疗各个证型的RA患者主要原则是活血化瘀,并贯穿于整个治疗过程。Objective To explore the relationship between related indicators of rheumatoid arthritis(RA)and TCM syndrome types,and to find the objective law of TCM syndrome types of RA,providing clinical data for the establishment of modern TCM syndrome differentiation and treatment system.Methods A total of 300 patients with RA enrolled in Jiujiang First People's Hospital from June 2021 to May 2023 were selected.According to the different types of TCM syndrome differentiation,they were divided into 5 syndrome types:dampness-heat obstruction syndrome,cold-dampness-obstruction syndrome,kidney qi deficiency cold syndrome,liver and kidney yin deficiency syndrome and blood stasis obstruction syndrome,with 60 cases in each group.The relationship between clinical manifestations,immunological indicators,and laboratory indicators of patients with each syndrome type was analyzed.Results The main clinical characteristics of patients with rheumatoid arthritis were joint swelling,joint pain and joint deformity,and there were significant differences in the above three clinical manifestations of TCM syndromes(P<0.05).There were no significant differences in immunological and laboratory indexes of rheumatoid factor(RF),anti-cyclic guanidine polypeptide(CCP)antibody,erythrocyte deposition(ESR),C-reactive protein(CRP),platelet(PLT),D-dimer(DD)among patients with different TCM syndromes(P>0.05).There was no significant correlation between the severity of rheumatoid arthritis and immunological and laboratory indicators.There was no significant correlation between immunological and laboratory indexes of patients with rheumatoid arthritis and TCM syndromes.Conclusion The levels of DD,ESR,CRP and PLT were all increased in patients with RA,but there was no significant difference in the above 4 indexes among the 5 TCM syndrome types.The main principle of TCM treatment for RA patients with different syndromes is to promote blood circulation and remove blood stasis,which runs through the whole treatment process.

关 键 词：痹证 类风湿关节炎 中医证候 免疫学指标 检验学指标 

分 类 号：R259[医药卫生—中西医结合]