来源：风湿病与关节炎,2018,7（12）:5-8.

类风湿关节炎中医证型与病情活动指标的相关性分析

（临床研究）

侯　雷¹，元晓龙²，曾　苹¹，姚血明¹，马武开¹

　　【摘　要】目的：探讨类风湿关节炎患者病情活动指标与不同中医证型的相关性。方法：选取符合中医诊断标准的湿热痹阻型、寒湿痹阻型、痰瘀痹阻型、肝肾亏虚型类风湿关节炎患者各30例作为研究对象，观察类风湿关节炎患者临床常用判断病情的活动指标，包括关节肿胀度、关节压痛度、疼痛视觉模拟评分法（VAS）评分、晨僵时间、C-反应蛋白（CRP）、红细胞沉降率（ESR）、类风湿因子（RF）及28个关节疾病活动度（DAS28）评分，分析其与不同中医证型的相关性。结果：关节肿胀度、VAS评分、晨僵时间、ESR、CRP在各中医证型间比较，差异有统计学意义（P < 0.05）；而关节压痛度、RF在各中医证型间比较，差异无统计学意义（P > 0.05）。病情活动指标由高到低依次为：湿热痹阻型 > 寒湿痹阻型 > 痰瘀互结型 > 肝肾亏虚型。且湿热痹阻型与其他3种证型比较，DAS28评分差异有统计学意义（P < 0.05）。结论：类风湿关节炎中医证型与病情活动指标存在一定关系，但与关节压痛度、RF无关；类风湿关节炎病情活动期中医证型主要为湿热痹阻型，病情活动指标最高。

　　【关键词】　关节炎，类风湿；中医证型；病情活动指标；相关性

Correlation Analysis Between TCM Syndrome Types and Disease Activity Indexes of Rheumatoid Arthritis

HOU Lei,YUAN Xiao-long,ZENG Ping,YAO Xue-ming,MA Wu-kai

【ABSTRACT】Objective:To explore the correlation between TCM syndrome types and disease activity indexes in patients with rheumatoid arthritis.Methods:Thirty patients with rheumatoid arthritis of damp-heat obstruction,cold-dampness obstruction,phlegm-blood stasis obstruction and liver-kidney deficiency were selected as subjects.The commonly used clinical activity indicators of patients with rheumatoid arthritis were observed,including joint swelling,joint tenderness,VAS,morning stiffness time,CRP,ESR,RF and DAS28,which were used to analyze their correlation with different TCM syndromes.Results:There were significant differences in the degree of joint swelling,VAS,morning stiffness time,ESR and CRP among all the TCM syndromes（P < 0.05）,but there was no significant differences in the degree of joint tenderness and RF among all the TCM syndromes（P > 0.05）.The indexes of disease activity from high to low were:damp-heat obstruction,cold-dampness obstruction,phlegm-blood stasis obstruction,and liver-kidney deficiency,and the difference of DAS28 between damp-heat obstruction type and other three syndromes was significant（P < 0.05）.Conclusion:TCM syndrome has a certain relationship with disease activity index in rheumatoid arthritis,but has nothing to do with joint tenderness and RF.The damp-heat obstruction type is the main TCM syndrome with the highest disease activity index.

　　【Keywords】 arthritis,rheumatoid;TCM syndrome type;disease activity index;correlation