[1]巩勋 姜泉△ 韩曼 周新尧 唐晓颇.类风湿关节炎患者临床诊断相关特征研究[J].中国中医骨伤科杂志,2020,28(05):10-13.
　GONG Xun JIANG Quan HAN Man ZHOU Xinyao TANG Xiaopo.Study of Clinical Diagnosis Characteristics in Rheumatoid Arthritis Patients[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(05):10-13.
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类风湿关节炎患者临床诊断相关特征研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年05期
页码:
10-13
栏目:
临床研究
出版日期:
2020-05-10

文章信息/Info

Title:
Study of Clinical Diagnosis Characteristics in Rheumatoid Arthritis Patients
文章编号:
1005-0205(2020)05-0010-04
作者:
巩勋1 姜泉1△ 韩曼1 周新尧1 唐晓颇1
1中国中医科学院广安门医院(北京,100053)
Author(s):
GONG Xun1 JIANG Quan1△ HAN Man1 ZHOU Xinyao1 TANG Xiaopo1
1Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053,China.
关键词:
类风湿关节炎;  临床特征;  证候;  类风湿因子;  环瓜氨酸多肽抗体
Keywords:
rheumatoid arthritis;  clinical characteristics;  syndrome;  rheumatoid factor;  cyclic citrulline polypeptide antibody
分类号:
R684.3
文献标志码:
A
摘要:
目的:探讨我国中医医院就诊的类风湿关节炎患者的发病年龄、确诊用时、病程分布、类风湿因子(RF)及抗环瓜氨酸多肽抗体(CCP)的阳性率等,分析中医证候与临床诊断特征的关系。方法:设计类风湿关节炎病证规律调查表,采集1 602例类风湿关节炎患者临床数据,将所有入选病例数据录入类风湿关节炎中医数据中心,进行数据管理分析。结果:类风湿关节炎患者发病年龄的中位数为47岁,围绝经期女性发病最为常见。发病1年内明确诊断的患者占61.75%,而诊断用时在5年以上者占11.17%。类风湿关节炎患者RF阳性率高于CCP阳性率(P<0.05),7.02%的患者诊断缺乏血清学证据。不同证型患者的RF与CCP阳性率差异无统计学意义(P>0.05),不同证型患者病程差异有统计学意义(P<0.05),痰瘀痹阻证和肝肾不足证多见于长病程患者。结论:围绝经期女性是类风湿关节炎发病的主要人群,部分患者诊断无血清学证据,值得临床关注。
Abstract:
Objective:To explore the age of onset, time of diagnosis, course distribution, positive rate of rheumatoid factor(RF)and cyclic citrullinated polypeptide antibody(CCP)of rheumatoid arthritis patients, and the relationship between Traditional Chinese Medicine syndromes and clinical diagnosis characteristics was analyzed. Methods:A questionnaire for the RA syndrome was designed. A cross-sectional survey was conducted on the information of 1 602 RA patients collected from the national multi-center RA clinical data. All clinical data were entered into Chinese Rheumatoid Arthritis Data Center-Traditional Chinese Medicine.Results: The median age of onset of rheumatoid arthritis was 47 years old, and it was most common in perimenopausal women. 61.75% of the patients were diagnosed within 1 year of symptoms, and 11.17% were diagnosed within 5 years. The positive rate of RF in patients with rheumatoid arthritis was higher than that of CCP antibodies(P<0.05), and 7.02% of patients were diagnosed without positive serological indicators. The course of rheumatoid arthritis patients with different syndromes was different(P<0.05), Tanyubizu syndrome and Ganshenbuzu syndrome were mostly found in patients with a long course of disease.Conclusion:Perimenopausal women are the main group of rheumatoid arthritis. It requires a focus on rheumatoid arthritis patients without serological evidence.

参考文献/References:

[1] SMOLEN J S,ALETAHA D,MEINNES I B.Rheumatoid arthritis[J].Lancet,2016,388(10055):2023-2038.
[2] 姜泉,王海隆,巩勋,等.类风湿关节炎病证结合诊疗指南[J].中医杂志,2018,20:1794-1800.
[3] 中华医学会风湿病分会.2018中国类风湿关节炎诊疗指南[J].中华内科杂志,2018,57(4):242-251.
[4] ARNETT F C,EDWORTHY S M,BLOCH D A,et al.The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J].Arthritis Rheum,1988,31(3):315-324.
[5] ALETAHA D,NEOGI T,SILMAN A J,et al.2010 rheumatoid arthritis classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J].Ann Rheum Dis,2010,69(9):1580-1588.
[6] 国家中医药管理局.尪痹(类风湿关节炎)中医临床路径[M].北京:中国中医药出版社,2010:247-252.
[7] 王建,巩勋,唐晓颇,等.1602例类风湿关节炎患者中医证候分布特点的多中心横断面调查[J].中医杂志,2018,59(11):963-967.
[8] MCLNNES I B,SCHETT G.Pathogenetic insishts from the treatment of rheumatoid arthritis[J].Lancet,2017,389(10086):2328-2337.
[9] SYMMONS D P M, BARRETT E M, BANKHEAD C R,et al.The incidence of rheumatoid arthritis in the United Kingdom:results from the Norfolk Arthritis Register[J].British Journal of Rheumatology,1994, 33(8):735-739.
[10] 陈娟,孙华榆,李少华.类风湿关节炎患者血浆睾酮雌二醇及糖皮质激素水平的改变及其意义[J].中华风湿病学杂志,2001(4):261-263.
[11] 刘栩,贾园,安媛,等.类风湿关节炎患者就医及治疗现状分析[J].中华风湿病学杂志,2008,12(9):637-639.
[12] MCQUEEN F M, BENTON N, CRABBE J,et al.What is the fate of erosions in early rheumatoid arthritis Tracking individual lesions using X rays and magnetic resonance imaging over the first two years of disease[J].Annals of the Rheumatic Diseases,2001,60(9):859.
[13] 马明坤,温学红,肖继,等.类风湿关节炎患者中医证型与实验室指标的相关性研究[J].医学综述,2013,19(16):3063-3065.
[14] 曾小峰,艾永兴,甘晓丹,等.抗环瓜氨酸肽抗体检测在类风湿关节炎中的意义[J].中华风湿病杂志,2001(5):281-284.
[15] 乐惠荣,梁昀,袁惠,等.类风湿关节炎中医证型与抗环瓜氨酸肽抗体的相关研究[J].湖北中医杂志,2008(10):18-19.
[16] 邢丽丽,高明利.辽宁地区类风湿关节炎患者中医证候规律的回顾性研究[J].风湿病与关节炎,2013(7):35-38.
[17] 成之巍.类风湿性关节炎中医证型与不同型RF相关性研究[J].中国社区医师:医学专业,2012,14(4):270-271.
[18] 姜泉,蒋红,曹炜,等.475例类风湿关节炎患者中医临床证候分析[J].中医杂志,2007(3):253-255.
[19] 谢丽萍,肖敬,史伟,等.广西地区类风湿关节炎中医证候分布的研究[J].时珍国医国药,2008,19(2):380-381.
[20] 宋玉洁.类风湿性关节炎中医辨证的客观化研究[J].中国中医药科技,2007(5):308-309.
[21] 于秀明,刘学明,侯云峰,等.类风湿性关节炎中医辨证分型与实验室指标的研究[J].中华中医药学刊,2007(7):1462-1464.
[22] 查青林,何羿婷,吕爱平.类风湿关节炎寒热属性分类及其对中西药疗效的影响[J].江西中医学院学报,2007(6):21-23.
[23] 李宁,王拥军,施杞.从中医“治未病”思想谈类风湿性关节炎的防治[J].中国中医骨伤科杂志,2012,20(11):64-65.

备注/Memo

备注/Memo:
基金项目:国家重点研发计划项目(2018YFC1705200)国家自然科学基金项目(81704063)△通信作者 E-mail:doctorjq@126.com(收稿日期:2020-02-11)
更新日期/Last Update: 2020-05-10