【摘要】 目的分析类风湿关节炎中医证候分布特点。方法采集全国18家研究中心1602例类风湿关节炎患者的病史及中西医诊断信息,设计类风湿关节炎病证规律调查表,将所有信息录入类风湿关节炎中医临床数据库。将患者辨证分为风湿痹阻证、寒湿痹阻证、湿热痹阻证、痰瘀痹阻证、气血两虚证、肝肾不足证。分析患者中医证候分布及组合特点。结果共收集符合标准的调查表1602份。因部分调查表证候诊断缺如,1418例证候填写完整的RA患者中,单一证候1232例占86.88%,其中湿热痹阻证比例最高共计622例,占43.86%,其他依次为寒湿痹阻证、肝肾不足证、痰瘀痹阻证、风湿痹阻证、气血不足证。RA患者不同证候分布差异具有统计学意义(P<0.05)。除西南地区外,其他各地区RA患者均以湿热痹阻证为主要证候,湿热痹阻证在华北地区的证候分布中所占比例最高为57.08%(137例/240例),西南地区最低为25.48%(66例/259例),西南地区以寒湿痹阻证为主要证候占32.82%(85例/259例)。各地区证候分布差异具有统计学意义(P<0.05)。痰瘀痹阻证、肝肾不足证病程与风湿痹阻证、寒湿痹阻证、湿热痹阻证、气血两虚证相比,差异具有统计学意义(P<0.05)。结论湿热痹阻证是类风湿关节炎患者的主要证候类型,其地域分布广,病程较痰瘀痹阻证、肝肾不足证患者短。更多还原

【Abstract】 Objective To analyze the characteristics of the distribution of Chinese Medicine syndromes in rheumatoid arthritis. Methods A total of 1602 rheumatoid arthritis patients from 18 research centers across the country were recruited for the diagnosis of rheumatoid arthritis and the diagnostic information of traditional Chinese and western medicine. The questionnaire for rheumatoid arthritis syndrome was designed and all information was recorded in the Chinese Medicine clinical database of rheumatoid arthritis. The patients were divided into wind dampness obstruction syndrome,cold dampness obstruction syndrome,dampness heat obstruction syndrome,phlegm stasis obstruction syndrome,qi and blood deficiency syndrome,liver and kidney deficiency syndrome. Patients’ TCM syndrome distribution and combination characteristics were analyzed. Results A total of 1602 questionnaires that met the criteria were collected. Due to lack of diagnosis in some of the questionnaires,in 1418 patients who completed the questionnaire,1236 cases with single syndrome accounted for 86. 88%,of which the highest proportion of dampness heat obstruction syndrome totaled 622 cases,accounting for 43. 86%,followed by cold dampness obstruction syndrome,liver and kidney deficiency syndrome,phlegm stasis obstruction syndrome,wind dampness obstruction syndrome,qi and blood deficiency syndrome,The difference in distribution of different syndromes in RA patients was statistically significant( P < 0. 05). Except for the southwest region,all patients in other regions had major symptoms of dampness heat obstruction syndrome. The highest proportion of damp heat obstruction syndrome in the distribution of syndromes in North China was 57. 08%( 137/240 cases). The lowest was 25. 48%( 66/259 cases) in the southwest region. The major syndrome was cold dampness obstruction syndrome of 32. 82%( 85/259 cases) in the southwest region. There was a statistically significant difference in the distribution of syndromes in each region( P < 0. 05). Significant differences were found between the phlegm stasis obstruction syndrome,liver and kidney deficiency syndrome duration and wind dampness obstruction syndrome,wind dampness obstruction syndrome,dampness heat obstruction syndrome,and qi and blood deficiency syndrome( P < 0. 05). Conclusion Dampness heat obstruction syndrome is the main syndrome type of patients with rheumatoid arthritis. Its geographical distribution is wide,and the course of disease is shorter than that of patients with phlegm stasis obstruction syndrome and liver and kidney deficiency syndrome.更多还原