类风湿关节炎湿热与寒湿证候的病情特点分析

目的:探讨类风湿关节炎(RA)湿热痹阻证与寒湿痹阻证两组证候之间的差异。方法:选取类风湿关节炎中医数据中心(CRDC-TCM)确诊为RA湿热痹阻证与寒湿痹阻证患者,比较两组证候的人口学特征与病情特点。结果:共纳入659例RA确诊患者,其中湿热痹阻证463例、寒湿痹阻证196例。两组RA患者性别、年龄、病程比较,差异均无统计学意义。湿热痹阻证RA患者血沉(ESR)、C-反应蛋白(CRP)总体水平显著高于寒湿痹阻证RA患者(P<0.01),但在RF方面比较差异无统计学意义。湿热痹阻证RA患者关节肿胀数总体水平较寒湿痹阻证多(P<0.05),但在关节压痛数方面比较差异无统计学意义;湿热痹阻证与寒湿痹阻证RA患者在DAS-28(CRP)等级分布上差异有统计学意义(P<0.05),湿热痹阻证RA患者以高度活动较多、寒湿痹阻证RA患者以中度活动较多。结论:湿热痹阻证与寒湿痹阻证RA患者在人口学特征上差异不明显;病情特点方面,在RF、关节压痛数上差异不明显,在ESR、CRP、关节肿胀数与疾病活动度上有显著差异。

Analysis of the disease characteristics of rheumatoid arthritis syndrome of dampness-heat and cold-dampness

Objective:To explore the differences between damp-heat arthralgia syndrome and cold-dampness arthralgia syndrome in rheumatoid arthritis(RA).Methods:Patients with RA syndrome of damp-heat obstruction and cold-dampness obstruction diagnosed by CRDC-TCM were selected,and the demographic and disease characteristics of the two groups were compared.Results:A total of 659 patients with RA were included,including 463 cases of damp-heat obstruction and 196 cases of cold-dampness obstruction.There was no significant difference in sex,age and course of disease between the two groups.ESR and C-reactive protein(CRP)of RA patients with damp-heat obstruction syndrome were significantly higher than those of RA patients with cold-dampness obstruction syndrome(P<0.01),but there was no significant difference in RF.The overall level of joint swelling in RA patients with damp-heat obstruction syndrome is more than that of cold-dampness obstruction syndrome(P<0.05),but there is no significant difference in joint tenderness.There is a significant difference in DAS-28(CRP)grade distribution between RA patients with damp-heat obstruction syndrome and RA patients with cold-dampness obstruction syndrome(P<0.05).RA patients with damp-heat obstruction syndrome have high activity and RA patients with cold-dampness obstruction syndrome have moderate activity.Conclusion:There is no obvious difference in demographic characteristics between RA patients with damp-heat obstruction syndrome and those with cold-dampness obstruction syndrome.There is no obvious difference in RF and joint tenderness,but significant difference in ESR,CRP,joint swelling and disease activity.