来源：风湿病与关节炎,2021,10（8）:6-9.

早期类风湿关节炎患者的临床特点与中医证候分布规律研究（临床研究）

王秀芳¹，赵衍振¹，樊　冰²，张　迪²

　　【摘　要】目的：通过统计分析早期类风湿关节炎患者的临床特点，探讨证候分布规律。方法：收集2019年1月至2020年9月在山东中医药大学附属医院就诊的早期类风湿关节炎患者66例，记录其一般资料、实验室指标、病情活动评分，辨别中医证型，采用统计软件进行数据分析。结果：早期类风湿关节炎患者以女性为主；高发年龄段为51～60岁；病程以6个月为主；证型分布中湿热痹阻证19例（28.79%），痰瘀痹阻证9例（13.64%），风湿痹阻证8例（12.12%），寒湿痹阻证7例（10.61%），瘀血阻络证、气血两虚证、肝肾不足证各6例（9.09%），气阴两虚证5例（7.58%）。各证型在性别、红细胞沉降率（ESR）、C反应蛋白（CRP）、血小板（PLT）方面比较，差异有统计学意义（P < 0.05）；各证型在发病年龄、病程、抗环瓜氨酸肽抗体、类风湿因子、DAS28-CRP评分及分级方面比较，差异无统计学意义（P > 0.05）。结论：早期类风湿关节炎患者的性别、ESR、CRP、PLT与中医证候分布存在相关性。湿热痹阻证患者女性较多，炎症指标较高，与类风湿关节炎疾病的活动性相关。

　　【关键词】　类风湿关节炎；早期；临床特点；中医证候；相关性分析

Clinical Characteristics and TCM Syndrome Distribution of Patients with Early Stage Rheumatoid Arthritis

WANG Xiu-fang,ZHAO Yan-zhen,FAN Bing,ZHANG Di

　　【ABSTRACT】Objective:To explore the syndrome distribution by statistically analyzing the clinical characteristics of patients with early stage rheumatoid arthritis（RA）.Methods:Sixty-six patients with early stage RA treated in the Affiliated Hospital of Shandong University of Chinese Medicine from January 2019 to September 2020 were collected.Their general data,laboratory indexes and disease activity scores were recorded,and the TCM syndrome types were distinguished.The data were analyzed by statistical software.Results:The patients with early stage RA were mainly women.The high incidence age was 51~60 years old.The course of disease was mainly six months.In the distribution of syndrome types,there were 19 cases of dampness-heat-obstruction syndrome（28.79%）,9 cases of phlegm-blood-stasis-obstruction syndrome（13.64%）,8 cases of rheumatism-obstruction syndrome（12.12%）,7 cases of cold-dampness-obstruction syndrome（10.61%）,6 cases of blood-stasis-obstruction syndrome（9.09%）,6 cases of qi and blood deficiency syndrome（9.09%）,6 cases of liver and kidney deficiency syndrome（9.09%）and 5 cases of qi and yin deficiency syndrome（7.58%）.There were significant differences in gender,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）and platelet（PLT）among syndrome types（P < 0.05）.There was no significant difference among syndrome types in age of onset,course of disease,anti cyclic citrullinated peptide antibody,rheumatoid factor,DAS28-CRP score and grade（P > 0.05）.Conclusion:The gender,ESR,CRP,PLT of patients with early stage RA are correlated with the distribution of TCM syndromes.There are more women with dampness heat obstruction syndrome,with higher inflammatory indexes,which is related to the activity of RA disease.

　　【Keywords】 rheumatoid arthritis;early stage;clinical features;TCM syndrome;correlation analysis