【摘要】 目的 基于“肺热叶焦”理论探讨皮肌炎/多发性皮肌炎（PM/DM）合并间质性肺疾病（ILD）临床特征。方法 回顾性分析2020年1月—2024年12月于山东省中医院及千佛山医院符合标准的561例PM/DM患者，分为ILD组（423例）和非ILD组（138例），比较2组患者临床特征及中医证型。结果 与非ILD组相比，ILD组患者发热、肌痛/肌无力、关节痛、皮疹、技工手、“完整三联征”、红细胞沉降率（ESR）、铁蛋白（FER）、ANA抗体、抗Ro52、MDA5、ARS抗体阳性率升高，TIF-1γ、Mi-2、NXP2、SAE抗体阳性率及CK、CK-MB、LDH、αHBDH、TLC、VC、FVC、FEV₁、DLCO、DLCO%下降，差异均有统计学意义（P<0.05）。结论 ILD组患者以发热、肌痛/肌无力、关节痛、皮疹、“完整三联征”、技工手及ESR、FER、ANA抗体、抗Ro52、MDA5、ARS抗体阳性率升高等全身高炎症状态为突出表现，符合“肺热叶焦”理论中热毒炽盛、津液耗伤，肌肤、五脏失养的核心病机。更多还原

【Abstract】 Objective To explore clinical characteristics of dermatomyositis/polymyositis(PM/DM) complicated with interstitial lung disease(ILD) based on the theory of “lung heat with leaf scorching”. Methods A retrospective analysis was conducted on 561 eligible patients with PM/DM who were treated at Shandong Provincial Hospital of Traditional Chinese Medicine and Qianfoshan Hospital from January 2020 to December 2024. These patients were divided into the ILD group(423 cases) and the non-ILD group(138 cases). The clinical characteristics and traditional Chinese medicine syndrome types of the two groups were compared. Results Compared with the non-ILD group, the ILD group had a higher positive rate of fever, myalgia/muscle weakness, arthralgia, rash, mechanic′s hands, “complete triad”, erythrocyte sedimentation rate(ESR), ferritin(FER), antinuclear antibody(ANA), antiRo52 antibody, anti-MDA5 antibody, and anti-ARS antibody. In contrast, the ILD group showed a lower positive rate of anti-TIF-1γ antibody, anti-Mi-2 antibody, anti-NXP2 antibody, and anti-SAE antibody, as well as decreased levels of creatine kinase(CK), creatine kinase-MB(CK-MB), lactate dehydrogenase(LDH), α-hydroxybutyrate dehydrogenase(αHBDH), total lung capacity(TLC), vital capacity(VC), forced vital capacity(FEV1), diffusing capacity of the lung for carbon monoxide(DLCO), and percentage of predicted diffusing capacity of the lung for carbon monoxide(DLCO%). All these differences were statistically significant(P<0.05). Conclusion Patients in the ILD group were characterized by prominent systemic hyperinflammatory manifestations, including fever, myalgia/muscle weakness, arthralgia, rash, “complete triad”, mechanic′s hands, as well as elevated positive rates of ESR, FER, ANA, anti-Ro52 antibody, anti-MDA5 antibody, and anti-ARS antibody. This is consistent with the core pathogenesis of the theory of “lung heat with leaf scorching”, which features blazing heat-toxin, consumption of body fluids, and inadequate nourishment of the skin, muscles, and the five zang-organs.更多还原