| Objective:To provide some feasible advises to the improvement of the quality of life and seasonable treatment and diagnose of patients with RA around Chengdu by studying the quality of life,the distribution of TCM type of syndrome, the demographic characteristics of RA patients and the related influencing factors of RA.Methods:According to diagnostic criteria for RA which is published by the American College of Rheumatology and the European League Against Rheumatism at 2009,the research collected the clinical data of 146 RA patients, which including the basic information, the general conditionjoint performance, extra-articular manifestations, the rank of the function of joint, laboratory examination, combined with other diseases and medication. Some related Health Questionnaires and SAS, SDS, the TCM symptoms scale was used in the research. All the datas was used to analyse the basic state of the illness and the quality of life of RA. The research focused on the distribution of TCM type of syndrome at the same time.Results:1. Basic information:53 cases in Sichuan Provincial People’s Hospital,53 cases in Sichuan Provincial Hospital of TCM,40 cases in West China Hospital. Of which 50 cases of male, female 96 cases, male to female ratio was 1:1.92, the average age was 52.27±14.50 years old, male’s was 53.06±16.28 years; female’s was 51.85±13.55 years old. the maximum age is 80 years old, the youngest is 22 years old. The average course of disease was 2 (0.5,5) years, the shortest duration is 0.17 years, the longest duration is 50 years.2.Articular manifestations:morning stiffness in 108 cases (73.97%), pain in 142 cases (97.26%), swelling in 129 cases (88.36%), abnormal in 24 cases (16.44%). 3.blood system damage in 84 cases(57.53%):anemia in 49 cases (33.56%), Thrombocytosis in 35 cases (23.97%).4.respiratory system damage:interstitial lung disease in 24 cases(16.44%), pleural effusion in 12 cases (8.22%), pulmonary nodular in 3 cases(2.05%).5.digestive system damage:abnormal liver function in 51 cases(34.93%), fatty liver in 14 cases(9.59%), chronic gastritis in 9 cases (6.16%), hepatitis B in 6 cases(4.11%), liver cirrhosis in 2 cases(1.37%).6.Rheumatism indexes:erythrocyte sedimentation rate (ESR) increased in 119 cases (81.51%), C reactive protein (CRP) increased in 115 cases (78.77%), RF was positive in 127 patients (86.99%), anti cyclic citrullinated peptide antibody (A-CCP) positive in 132 cases (90.41%).7.Treatment:standardized Western medicine treatment in 99 cases (67.81%), no standardized treament in 41 cases (28.08%), serious irregularities in 6 cases(4.11%); a Chinese medicine treatment in 97 cases(66.44%),acupuncture therapy in 21 cases(14.4%).8.The scores of each dimension of the quality of life in RA patients were lower than the norm group.The quality of life was greatly influence by the economic situation, course of disease and disease activity.9.Anxiety and depression:mild anxiety patients in 68 cases (46.58%); moderate anxiety in 24 cases. Mild depression in 73 cases (50%), moderate depression in 20 cases (13.7%). There was statistical significance in the difference between men and women(P<0.05).lO.Analysis of the relativity between SAS,SDS scale and:The relativity between the emotion and the related indexes of rheumatism was not statistically significant (P>0.05).11.The distribution of TCM syndrome type:The syndrome of cold-dampness blocking in 37 cases(25.34%), the syndrome of heat-dampness blocking in 41 cases(28.08%), the syndrome of phlegm accumulating with stagnant blood in 27 cases(18.49%), the syndrome of deficiency of kidney and cold coagulation in 19 cases(13.01%), the syndrome of deficiency of liver and kidney in 14 cases(9.59%), the syndrome of deficiency of qi and blood in 8 cases(5.48%).Conclusion:1.In the research female to male ratio was 1.92:1, the average age was 52.27±14.50 years, the average course of disease was 2 (0.5,5) years;2.The damaged joints of RA patients were metacarpophalangeal joints, proximal interphalangeal joint, wrist joint, distal interphalangeal joint, knee joint, ankle joint;3.The positive rate of ACCP was 90.41%; 4.the common extra-articular system damage was in blood system, respiratory system and digestive system;5.The quality of life in patients with RA is lower than the normal population; 6.The outcome of emotion scales shows that the feeling of anxiety and depression may be affected by the disease itself, but the emotion has little effect on the activity of disease;7.The distribution of TCM type of syndrome:in RA patients the syndrome of heat-dampness blocking is the most,followed by the syndrome of cold-dampness blocking;8.The application rate of TCM acupuncture and moxibustion is low, more should be done to get the RA patients being aware of the important of standardized treatment.And we should take advantages of TCM to improve the quality of life of patients. |
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