类风湿关节炎蒙医证型与关节症状体征的相关性研究

摘要

目的：研究类风湿关节炎( rheumatioid arthritis, RA)蒙医证型与关节疼痛、压痛、肿胀、关节活动度、晨僵时间、关节功能分级等指标的相关性。方法采用临床流行病学调查方法,对53例RA患者进行辨证分析,分为齐素协日、巴达干赫依、协日乌素3种证型。设计统一调查量表,对RA患者关节疼痛、压痛、肿胀、关节活动度、晨僵时间、关节功能分级等指标进行评分,详细记录相关数据,进行统计学分析。结果3种证型间关节疼痛、肿胀和压痛积分差异有统计学意义(P<0．05),积分高到低依次为：齐素协日型>协日乌素型>巴达干赫依型；关节活动度积分差异无统计学意义(P>0．05)；关节功能分级上差异有统计学意义(P<0．05),巴达干赫依型以关节功能Ⅰ级,协日乌素型以Ⅱ级,齐素协日型以Ⅲ级为多见；晨僵时间上差异有统计学意义(P<0．05),长到短依次为：齐素协日型>协日乌素型>巴达干赫依型。结论蒙医证型中齐素协日证型者关节疼痛、肿胀、压痛、晨僵时间等症状体征较重,关节功能较差,而巴达干赫依型及协日乌素型者关节症状体征较轻,关节功能较好。%Objective To investigate the relationship between various syndromes of rheumatioid arthritis ( RA) according to mongolian medicine and joints pain, tenderness, swelling, joint mobility, time of morning stiffness, joint function grading index of correlation. Methods 53 patients with RA were in-cluded in the standard dialectical analysis, which divided into three types:QiSuXieRi day type, BaDaGan-HeYi type and XieRi WuSu type. Unified survey scale were Designed, related data of RA patients such as Joint pain in , tenderness, swelling, joint mobility, time of morning stiffness, joint function classification indexes were recorded and analyzed. the correlation study were done between the three syndromes and relat-ed symtoms and signs. Results The differences of joint pain, swelling and tenderness points among the three syndrome types the difference were all statistically significant ( P<0. 05 ) , particularly, QiSuXieRi day type>XieRi WuSu type>BaDaGanHeYi type;There was no statistically significant difference of motion (P>0. 05);The joint function was statistically significant difference (P<0. 05), particularly, BaDaGan-HeYi type is Joint function Ⅰ level , XieRi WuSu type is Joint function Ⅱ level, QiSuXieRi day type is Joint function Ⅲ level commonly; Morning stiffness time difference was statistically significant ( P <0. 05), short to long in the order: QiSuXieRi day type >XieRi WuSu type >BaDaGanHeYi type type. Conclusion Among the three Mongolian medicine card types, the symptoms and signs such as morning stiffness time, joint pain, swellingand tenderness as well as the joint function were seriously, while the symptoms and signs of BaDaGanHeYi type and XieRi WuSu type were much better.