1602例类风湿关节炎患者中医证候特点与血小板、血红蛋白计数关系的研究

目的探讨类风湿关节炎(Rheumatoid arthritis,RA)血小板(PLT)计数、血红蛋白(HGB)含量及白细胞(WBC)计数与中医证型间的关联关系。方法采用多中心、横断面调查问卷研究的形式,记录来自全国6个地区18家研究中心1602例RA患者的血常规值,录入类风湿关节炎中医临床数据库。将患者分为不同的中医证候。统计分析各证型与PLT、HGB及WBC之间的联系。结果因部分调查表数据缺如,1418例RA患者证候诊断及血常规指标填写完整,1319例患者的数据对血沉应答有效。通过方差分析发现,PLT、HGB在不同证型的RA患者中差异有统计学意义(P<0.05)。PLT以湿热痹阻证候最高,其他依次为寒湿痹阻证,痰瘀痹阻证。HGB以气血两虚证最低,湿热痹阻证与肝肾不足证次之。RA疾病活动度DAS28-ESR与PLT呈显著正相关(r=-0.206,P<0.01);与HGB呈现显著负相关(r=-0.204,P<0.01),WBC在不同证候类型中差异无统计学意义(P>0.05)。结论RA不同证型的PLT计数以湿热痹阻证患者最高;HGB含量以气血两虚证最低,湿热痹阻证与肝肾不足证次之;白细胞计数在各证型间比较无统计学意义;RA患者疾病活动度越高,出现贫血的概率越大。疾病活动度DAS28-ESR与PLT呈显著正相关。

Correlation between TCM syndrome characteristics of rheumatoid arthritis and the count of platelet and hemoglobin in 1602 cases

Objective To investigate the correlation between PLT,HGB,WBC and TCM syndromes in patients with rheumatoid arthritis(RA).Methods A multicenter,cross-sectional questionnaire study was applied.1602 patients with RA from18 research centers of 6 regions were included and the data was recorded in the TCM clinical database of RA.The patients were divided into different syndrome patterns.The correlation between each syndrome pattern and the indexes of PLT,HGB,and WBC was analyzed.Results Some data in the questionnaire missed.1418 patients with RA completed the questionnaire of syndrome differentiation and blood routine,and 1319 patients were effective in response to ESR.The analysis of variance showed that there was significance of PLT and HGB in RA patients with different syndromes(P<0.05).Patients with dampness heat obstruction had highest level of PLT,then with cold dampness obstruction and phlegm stasis obstruction respectively.Patients with qi and blood deficiency had the lowest level of HGB,followed by dampness heat obstruction and liver-kidney insufficiency.RA disease activity score DAS28-ESR had positive correlation with PLT(r=-0.206,P<0.01)and negative correlation with HGB(r=-0.204,P<0.01)with significance.However,there was no significant difference of WBC in different syndrome patterns(P>0.05).Conclusion RA patients with dampness heat obstruction have highest level of PLT and patients with qi and blood deficiency have the lowest level of HGB,followed by dampness heat obstruction and liver-kidney insufficiency.There is no significance of WBC in different syndrome patterns.The higher disease activity of RA patients has,the larger the incidence of anemia is.There is a positive correlation between DAS28-ESR and PLT.