| Purpose: By reviewing the distribution characteristics and laboratory data of elderly patients with Elderly Onset Rheumatoid Arthritis(EORA),we analyzed the clinical characteristics of Chinese and Western medicine in EORA patients,and provided evidence for diagnosis and treatment of EORA.Material and method:Selecting 128 cases of EORA patients(age over 60 years old)clinical data from 2015.11 ~ 2016.10 in the Department of Rheumatology of Liaoning University of Traditional Chinese Medicine Hospital.SPSS19.0 and Excel2010 were used to build database.The data were analyzed by routine frequency and descriptive statistics analysis,cluster analysis and correlation analysis.Results:1.Among the 128 cases of EORA,female was 74.2%,male was 25.8%,and the proportion of men and women was about 1:2.88.The age of onset was 69.2±5.9,the average age was73.5±6.7,and the course of disease was 4.2±4.2.The age of onset between 60~69 was58.6%,70~79 was 34.4%,and 7% over 80 years old.The small joints are easily involved in the metacarpophalangeal and proximal interphalangeal joints,and the middle and large joints are prone to shoulder,elbow,wrist,knee and ankle joint.32.8% of the patients were secondary to pulmonary fibrosis,and 6.3% secondary Sjogren syndrome.Oral administration of leflunomide and hormone each accounted for about 40%,Tripterygium wilfordii,Wangbi Pian,accounting for about 20% of total glucosides of paeony,biological agents 3.1%.2.TCM Syndromes of phlegm and blood stasis of damp heat blockage accounted for 30.5%,accounting for 28.9%,accounting for 18% of liver and kidney deficiency,cold dampness accounted for 22.6%.60~69 years old damp heat arthralgia most,70~79 years old phlegm stasis obstruction most,80~89 years old phlegm stasis obstruction most.The cluster analysis of the four diagnostic information,finally can be divided into 4 categories: blockage of phlegm and blood stasis,cold dampness,dampness heat blockage,deficiency of liver and kidney.3.Laboratory examination: CRP:42.6±53,ESR:49.1±24.2,RF:231.3±322.5,anti CCPantibody: 745.8±628,Hb:115.7±15.8,PLT:277.9±103.7.DAS28-ESR(3)was 6.7±1.2,and DAS28-CRP(3)was 6.1±1.2.The highest DAS28 cold dampness.DAS28 is negatively correlated with Hb,and is positively related to PLT,weakly related to TCM syndrome type,and has no correlation with RF and anti CCP antibody.Conclusion:1.The proportion of men and women in 128 cases of EORA was 1:2.88,and more in women than in men.At the age of 60~69,the number of first onset patients is the most,and the incidence of the disease decreases with age.Small joint finger joint,proximal interphalangeal joint involvement in large joints in the palm,easy to knee joint,wrist,ankle,elbow,shoulder joint.The average level of CRP,RF and anti CCP antibody in EORA patients was higher than that of the RA patients,and the mean value of Hb and PLT was low,and the level of ESR was equal.EORA mainly uses the treatment of hormone combined with DMARDs to control the disease,and fewer patients choose to use biological agents.2.EORA patients with phlegm and blood stasis syndrome type most,remaining in decreasing order of damp heat blockage,cold dampness,deficiency of liver and kidney,different age syndrome distribution difference.According to the information of four diagnostic methods of cluster analysis,were divided into four groups: phlegm and blood stasis,cold dampness,dampness heat blockage,deficiency of liver and kidney,consistent with clinical syndromes.3.of four kinds of traditional Chinese medicine syndrome of cold dampness syndrome in patients with disease activity is relatively high.DAS28 was negatively correlated with hemoglobin,positively correlated with platelets,and had no correlation with RF and anti CCP antibody,and was weakly related to TCM syndrome type. |
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