湖南地区类风湿关节炎中医证型与临床检测指标关系研究

目的 探索湖南地区类风湿关节炎（Rheumatoid arthritis,RA）中医证型与临床检测指标的关系,为RA临床辨证论治提供参考依据。方法 采集2015年1月-2016年5月于湖南中医药大学第一附属医院风湿科就诊且确诊为RA病历资料299例。采用Epidata 3.1建立数据库,并采用SPSS 22.0软件进行数据处理,分析RA中医证型与类风湿因子、血沉、C反应蛋白、肝功能等临床检测指标关系。结果 血沉：湿热痹阻证血沉表达水平与肝肾阴虚证比较,差异有统计学意义（P=0.021）。类风湿因子：各证型间的类风湿因子表达水平比较,差异无统计学意义（P>0.05）。C反应蛋白：湿热痹阻证表达水平与寒湿痹阻证比较,差异具有统计学意义（P=0.022）。肝功能：RA各证型球蛋白平均表达量均高于正常值,白球比均低于正常值,但各证型间比较,差异无统计学意义（P>0.05）。结论 RA中医证型与临床检测指标存在一定关系,血沉是潜在的湿热痹阻证与肝肾阴虚证辨证指标,C反应蛋白是潜在的湿热痹阻证与寒湿痹阻证辨证指标,但其临床检验效能尚有待于进一步研究。

Study on the Relationship Between TCM Syndromes and Clinical Examination Indexes of Rheumatoid Arthritis in Hunan

Objective To explore the relationship between TCM Syndromes and clinical detection indexes of rheumatoid arthritis (RA) in Hunan region, and provide a reference for clinical practice. Methods A total of 299 patients with definitive diagnosis of RA who admitted in the First Affiliated Hospital of Hunan University of Chinese Medicine from January 2015 to May 2016. Medical database was built by using Epidata3.1. The relationship of TCM Syndromes between rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and liver function indexes were analysed by using SPSS 22.0 software. Results ESR levels between the damp-heat stagnation syndrome and Yin deficiency of liver-kidney were significantly different (P=0.021). RF between the syndromes were not significant (P>0.05). CRP between the damp-heat stagnation syndrome and Yin deficiency of liver-kidney were significantly different (P=0.022). Globin expression levels of all syndromes were higher than the normal value, while globulin ratio was lower than the normal value(P>0.05). Conclusion There are certain relationships between TCM Syndromes and clinical detection indexes of RA. ESR is the potential syndrome differentiation index of damp-heat stagnation and Yin deficiency of liver-kidney syndromes. CRP is the potential syndrome differentiation index of damp-heat stagnation and cold-damp stagnation syndromes. The clinical effectiveness of ESR and CRP need to be further studied.