类风湿关节炎患者血清同型半胱氨酸、C反应蛋白与中医证型的相关性  

Correlation of Serum Homocysteine and C-Reactive Protein Levels with Traditional Chinese Medicine Syndrome Types in Rheumatoid Arthritis Patients

作　　者：王旭光 温淑云 李云[1] WANG Xuguang;WEN Shuyun;LI Yun(Dezhou Hospital of Qilu Hospital of Shandong University,Dezhou 253014 Shandong,China)

机构地区：[1]山东大学齐鲁医院德州医院,山东德州253014

出　　处：《广州中医药大学学报》2025年第2期266-271,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:81601368);山东省中医药科技计划项目(编号:2020M176)。

摘　　要：【目的】分析类风湿关节炎患者的中医证型分布及其与血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)的相关性。【方法】选取2021年12月至2023年12月山东大学齐鲁医院德州医院收治的186例类风湿关节炎患者作为研究组,根据中医辨证分型标准将患者分为寒湿痹阻证、气血两虚证、痰瘀痹阻证、肝肾不足证4种中医证型;另外,纳入同期在山东大学齐鲁医院德州医院体检的100例健康志愿者作为健康对照组。分析类风湿关节炎患者的中医证型分布,比较研究组与对照组及不同中医证型患者血清Hcy、CRP水平,并采用Pearson分析类风湿关节炎患者血清Hcy、CRP水平与不同中医证型病情严重程度的相关性。【结果】(1)中医证型分布方面,研究组的186例类风湿关节炎患者中,寒湿痹阻证41例(22.04%),痰瘀痹阻证40例(21.51%),气血两虚证50例(26.88%),肝肾不足证55例(29.57%)。(2)血清Hcy、CRP水平方面,研究组的血清Hcy和CRP水平分别为(7.61±2.07)μmol/L和(27.93±5.92)mg/L,均高于健康对照组的(5.33±0.91)μmol/L和(1.85±0.67)mg/L,差异均有统计学意义(P<0.01);不同中医证型患者血清Hcy、CRP水平比较,差异均有统计学意义(F=7.637,P<0.01;F=5.639,P<0.01)。其中,以寒湿痹阻证患者的血清Hcy、CRP水平最高,其他依次为痰瘀痹阻证、气血两虚证和肝肾不足证患者,组间两两比较,差异均有统计学意义(P<0.05)。(3)相关性方面,经Pearson相关性分析,28个关节疾病活动度(DAS28)评分与血清Hcy、CRP水平均呈正相关关系(r=0.396,P<0.01;r=0.407,P<0.01);血清Hcy、CRP水平与类风湿关节炎不同中医证型病情严重程度均呈正相关关系(P<0.05或P<0.01)。【结论】类风湿关节炎患者血清Hcy、CRP表达异常升高;血清Hcy、CRP表达水平与不同中医证型密切相关,其中以寒湿痹阻证的表达水平最高。Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types in patients with rheumatoid arthritis(RA)and to explore their correlation with serum homocysteine(Hcy)and C-reactive protein(CRP)levels.Methods From December 2021 to December 2023,a total of 186 RA patients admitted to Dezhou Hospital of Qilu Hospital of Shandong University were selected as the study group,and the patients were classified into four TCM syndrome types according to the criteria of TCM syndrome differentiation,namely colddamp blockage syndrome,qi and blood deficiency syndrome,phlegm-stasis blockage syndrome,deficiency of liver and kidney syndrome.Moreover,100 healthy volunteers who had physical examination at the same hospital during the same period were included as the healthy control group.The distribution of TCM syndrome types in RA patients was investigated,the serum Hcy and CRP levels in the two groups and in RA patients with various TCM syndrome types were observed,and then Pearson's correlation was used for explorating the correlation of serum Hcy and CRP levels with severity of illness of RA patients with different TCM syndrome types.Results(1)Among the 186 RA patients in the study group,there were 41 cases(22.04%)of cold-damp blockage syndrome,40 cases(21.51%)ofphlegm-stasisblockagesyndrome,50cases(26.88%)ofqi andblooddeficiencysyndrome,and 55 cases(29.57%)of deficiency of liver and kidney syndrome.(2)The serum Hcy and CRP levels in the study group were(7.61±2.07)μmol/L and(27.93±5.92)mg/L,respectively,which were higher than those of the healthy control group([5.33±0.91)μmol/L and(1.85±0.67)mg/L,respectively],and the differences were statistically significant(P<0.01).Statistically significant differences of serum Hcy and CRP levels were shown among the patients with various TCM syndrome types(F=7.637,P<0.01;F=5.639,P<0.01).The serum levels of Hcy and CRP in patients with cold-damp blockage syndrome were the highest,and the levels in patients with phlegm-stasis blockage syndrome,qi and blood de

关 键 词：类风湿关节炎 同型半胱氨酸 C反应蛋白 中医证型 寒湿痹阻证 相关性 

分 类 号：R259.322[医药卫生—中西医结合]