来源：风湿病与关节炎,2017,6（9）:20-24.

腰膝酸软是否为类风湿关节炎肝肾不足证关键指标的

临床研究（临床研究）

李院魏^1,2，娄玉钤¹

　　【摘　要】目的：探讨腰膝酸软是否为类风湿关节炎肝肾不足证关键指标，并探讨其临床应用意义。方法：将河南风湿病医院类风湿关节炎数据库（HFRA数据库）中收录的409例患者按有无腰膝酸软分为腰膝酸软组和无腰膝酸软组。并采用SPSS 19.0软件分析2组在关节表现及关节外表现方面的区别与联系。结果：腰膝酸软患者占总数的30%（122/409）。劳累加重、活动减轻、生气加重、胀痛、遇冷痛增遇热痛减、沉痛、酸痛、全身乏力、神倦懒动、心烦、听力下降、畏寒肢冷、多梦、休息后乏力减轻、失眠、口苦、五心烦热、低热、月经色暗、大便稀溏、心神不宁、肢体麻木、少气懒言、头晕、耳鸣、盗汗、心慌、视力减退、口黏腻、咽干、口淡不渴、活动后乏力加重、易感冒、眼干、头重如裹、食后腹胀、发热时间不定、声低、肢体水肿、动则气喘、鼻干、渴不欲饮、遇冷痛增遇热痛减等表现腰膝酸软组多于无腰膝酸软组，在这些表现中，虚证方面较多，同时湿邪、瘀血、气滞也较为突出；而无腰膝酸软组仅固定痛较多。结论：腰膝酸软应该是类风湿关节炎肝肾不足证的关键表现；腰膝酸软组比无腰膝酸软组病情相对深重。

　　【关键词】　关节炎，类风湿；腰膝酸软；无腰膝酸软；肝肾不足证；HFRA数据库

Clinical Research on Whether Soreness and Weakness of Waist and Knees Being the Key Indicator to Insufficiency of the Liver and Kidney in Rheumatoid Arthritis

LI Yuan-wei,LOU Yu-qian

　　【ABSTRACT】Objective:To investigate whether soreness and weakness of waist and knees is the key indicator to insufficiency of the liver and kidney in rheumatoid arthritis and to explore its clinical significance.Methods:Four hundred and nine cases recorded in the HFRA database（database of Henan Rheumatism Hospital）were divided into a group with soreness and weakness of waist and knees（the SWWK group）and a group without soreness and weakness of waist and knees（the Non-SWWK group）.The software SPSS 19.0 was used to analyze the differences and relations of joint manifestation and extra-articular manifestation of the two groups.Results:Patients with soreness and weakness of waist and knees accounted for 30%（122/409）.The following manifestations appeared more frequently in the SWWK group than in the Non-SWWK group:pain aggravated due to overwork but relieved after activity,anger-caused aggravation,distending pain,pain aggravated while it’s cold and relieved while it’s hot,heavy pain,aching pain,lack of strength of the whole body,lassitude,lazy,vexation,hearing loss,aversion to cold,dreaminess,recovery from fatigue after a rest,insomnia,bitter mouth,vexing heat in the five centers（chest,palms and soles）,low-grade fever,dark menstrual color,loose stool,restlessness,limb numbness,weak breathing with no desire to speak,dizziness,tinnitus,palpitation,sweating,restlessness,blurred vision,sticky and greasy mouth,dry throat,bland taste in the mouth without thirst,fatigue increased after activity,tending to catch cold,dry eyes,head heavy as if swathed,abdominal distension after meal,uncertain fever,low voice,edema,asthma while moving,dry nose,and thirst without desire to drink.Most manifestations mentioned above were deficient syndromes and at the same time,dampness,blood stasis and qi stagnation were also more prominent.Patients in the Non-SWWK group mostly had fixed pain.Conclusion:Soreness and weakness of waist and knees may be the key feature of liver and kidney deficiency in patients with rheumatoid arthritis.Patients' condition in the SWWK group was more serious than those in the Non-SWWK group.

　　【Keywords】 arthritis,rheumatoid;soreness and weakness of waist and knees;without soreness and weakness of waist and knees;deficiency of liver and kidney;HFRA database