Study On Relationship Between Associated Factors Of Rheumatoid Arthritis With Interstitial Pulmonary Fibrosis And TCM Syndrome Types

Objective: TO explore the factors associated with Rheumatoid Arthritis and Interstitial Pulmonary Fibrosis and the relationship between TCM Syndrome Types,in order to detect the lung lesions in patients with RA for early.Methods: Collected 200 RA patients in the Department of Rheumatology in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2015 to October 2016.According to the western medicine diagnostic criteria of RA-IPF,all the patients were divided into two groups:simple RA 100 cases and RA-IPF 100 cases.According to the diagnostic criteria of TCM syndrome,the patients were sorted to 5 types: the stagnancy of heat-dampness type,and the stagnancy of cold-dampness,and the deficiency of kidney Qi type,and the insufficiency of both the liver and the kidney type,and the stagnancy of blood stasis.To analyse the different situation of RA-IPF between the syndromes of RA;and to compare the differences between different groups and different syndrome types in general situation,clinical manifestations,laboratory indexes,joint functional classification,two hand X-ray staging and anti rheumatic drugs;and to observe the pulmonary symptoms,signs and chest HRCT in RA-IPF patients.Results: The five TCM Syndrome Types have statistical significance(P<0.01).The proportion of RA-IPF in different syndromes: 30.53% of the persons in the stagnancy of heat-dampness type,40% of the persons in the stagnancy of cold-dampness,57.14% of the persons in the deficiency of kidney Qi type,52%of the persons in the insufficiency of both the liver and the kidney type,82.14% of the persons in the stagnancy of blood stasis.Doing the deep analysis,there was statistical significance between the stagnancy of heat-dampness type,and the deficiency of kidney Qi type,and the insufficiency of both the liver and the kidney type,and the stagnancy of blood stasis(P<0.05);the stagnancy of blood stasis,and the stagnancy of cold-dampness,and the deficiency of kidney Qi type,and the insufficiency of both the liver and the kidney type(P<0.05).There were no statistical significances in other groups(P>0.05).The group of RA-IPF and RA have statistical significances in age of onset,smoking,morning stiffness,CRP,anti rheumatic drugs(LEF)(P<0.05 or P<0.01).There were no statistical significances in other aspects(P>0.05).RA-IPF patients had some symptoms,including cough 81(81%),sputum 58(58%),chest tightness 59(59%),shortness of breath 38(38%),wheezing 22(22%),acropachy 8(8%),Velcro rales 17(17%).All RA-IPF patients had abnormal changes in chest HRCT.Conclusion: This investigation results show that RA patients who had the greater age of onset,smoking history,more morning stiffness time,high CRP,long time use of leflunomide were more easily with pulmonary fibrosis.The pathogenesis of RA-IPF may be mainly related to the stagnancy of blood stasis.Chest HRCT is specific for the diagnosis of RA-IPF,and it can be used as an important means to diagnose the disease.