来源：风湿病与关节炎,2017,6（11）:24-27.

春季发病与秋季发病的类风湿关节炎临床表现异同的研究（临床研究）

丁琳琳^1,2，李院魏^1,2，张子扬^1,2，娄玉钤¹

　　【摘　要】目的：探讨春季发病与秋季发病的类风湿关节炎临床表现的异同，明确不同发病季节对中医辨证的意义。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例患者按发病季节分为春季组和秋季组，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：409例患者中，春季组85例，秋季组59例。通过对2组161个关节表现及关节外表现进行χ²检验，2组间差异有统计学意义（P < 0.05）的临床表现共9项，其中凉痛，肿胀部位（左踝、右踝），关节柔韧感（左踝、右踝），口干，渴喜冷饮，闭经，春季组 > 秋季组；月经量少，春季组 < 秋季组。结论：春季发病的类风湿病关节炎患者在湿的临床表现上较秋季明显，且多集中于踝关节，故春季发病者更应重视除湿。“春季多风，秋季多燥”不适合春季发病与秋季发病的类风湿关节炎患者的辨证。

　　【关键词】　关节炎，类风湿；春季发病；秋季发病；临床表现；HFRA数据库；中医辨证；临床研究

Comparison of Clinical Manifestations of Rheumatoid Arthritis Between Onset in Spring and Autumn

DING Lin-lin,LI Yuan-Wei,ZHANG Zi-yang,LOU Yu-qian

　　【ABSTRACT】Objective:To investigate the differences and similarities of clinical manifestations of rheumatoid arthritis between onset in spring and autumn,to clarify their significance to TCM syndrome differentiation.Methods:Four hundred and nine cases recorded in the database of Henan Rheumatism Hospital（HFRA Database）were divided into a spring group and an autumn group according to the onset season.The SPSS 19.0 software was used to analyze the differences and correlations between joint manifestations and extra articular manifestations in the two groups.Results:Among all the patients,there were 85 cases in the spring group and 59 cases in the autumn group.By χ² testing to 161 joint manifestations and extra articular manifestations of the two groups,there were 9 clinical manifestations with statistically significant differences in the two groups:as for cold pain,swelling part（left and right ankle）,joint flexibility（left and right ankle）,dry mouth,thirst for cold drinking,and amenorrhea,the spring group suffered more than the autumn group;as for hypomenorrhea,the spring group suffered less than the autumn group.Conclusion:Dampness in clinical manifestations of rheumatoid arthritis is more obvious in spring than in autumn,mostly in ankle joint.Therefore,more attention should be paid to dehumidification in spring.The saying "windy in spring and dry in autumn" is not suitable for the differentiation of rheumatoid arthritis patients with onset in spring and autumn.

　　【Keywords】 arthritis,rheumatoid;onset in spring;onset in autumn;clinical manifestation;HFRA Database;TCM syndrome differentiation;clinical study