Study On The Relationship Between Related Factors Of Rheumatoid Arthritis Secondary Osteoporosis And TCM Syndrome Types

Objective:To study the related influencing factors of RA secondary osteoporosis and its relationship with TCM syndrome types,early detection of osteoporosis lesions in RA patients,with a view to early intervention,improve prognosis,and provide reference for clinical treatment.Methods:A total of 214 patients with RA who underwent bone mineral density examination in the Department of Rheumatology and Immunology of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were collected.Based on the inclusion and exclusion criteria,195 patients were included.According to the bone density results,they were divided into rheumatoid arthritis group(RA group)and rheumatoid arthritis secondary osteoporosis group(RA-OP group),including 102 patients in RA group and 93 patients in RA-OP group.According to the "Guidelines for the Diagnosis and Treatment of Rheumatoid Arthritis Combined with Diseases and Syndromes" of the Chinese Academy of Traditional Chinese Medicine and the clinical reality,formulate the classification criteria for each syndrome type,divided into rheumatism obstruction syndrome,cold and dampness obstruction syndrome,damp heat obstruction syndrome,sputum There are 8 types of syndromes including stasis-blocking syndrome,stasis-blocking-collateral syndrome,qi-blood deficiency syndrome,liver-kidney deficiency syndrome,qi-yin deficiency syndrome.Design the case collection table,collect the medical record data retrospectively,and establish a database,and use SPSS22.0 data analysis software to analyze the RA group and RA-OP group between the two groups and different syndrome types in general information,clinical manifestations,laboratory indicators,Bone density and other differences.Results:1.General information:1.1 According to the TCM syndrome classification of 195 RA patients,there were 9 cases of rheumatism obstruction syndrome,cold dampness obstruction syndrome,and qi-yin deficiency syndrome,accounting for 4.62%.Less is not representative,so we will not discuss analysis.1.2 The differences between the RA group and the RA-OP group in height,OSTA,duration,and DAS28 were statistically significant(P <0.01);the differences in smoking and VAS were statistically significant(P <0.05).1.3 Compared with different syndrome types in RA group and RA-OP group,the damp-heat obstruction syndrome: the difference in DAS28 is statistically significant(P <0.01),and the difference in gender,OSTA,and VAS is statistically significant(P < 0.05);Phlegm and Stasis Obstruction Syndrome,Stasis and Blood Obstruction Syndrome: The difference in DAS28 is statistically significant(P <0.01);Qi and Blood Deficiency Syndrome: the differences in height,duration of morning stiffness,and DAS28 have Significantly statistically significant(P <0.01),the difference in the course of disease is statistically significant(P <0.05);liver and kidney deficiency syndrome: the difference in height,duration,and DAS28 is statistically significant(P <0.01);The difference in OSTA was statistically significant(P <0.05).2.Laboratory indicators2.1 The differences between the RA group and the RA-OP group in ESR,RF,anti-CCP,ALP,N-MID,and β-crossla were statistically significant(P<0.01);the differences in CRP were statistically significant(P <0.05).2.2 Compared with different syndrome types in RA group and RA-OP group,the damp-heat-blocking syndrome: the differences in ESR,CRP,and RF were statistically significant(P <0.05);the phlegm-stasis-blocking syndrome:the difference in CRP was statistically significant(P <0.05);Stasis and blood clotting syndrome: the differences in ALP are statistically significant(P <0.01);Qi and blood deficiency syndrome: the differences in N-MID are statistically significant(P <0.01),the differences in RF and β-crossla were statistically significant(P <0.05);liver and kidney deficiency syndrome: the differences in N-MID were statistically significant(P <0.01),The differences in RF and anti-CCP were statistically significant(P <0.05).3.T-value and BMD in RA-OP group3.1 The differences between the RA group and the RA-OP group in BMD of lumbar spine and hip were statistically significant(P <0.01).3.2 In the RA-OP group,T-values of the lumbar vertebrae and hips of patients with deficiency of both Qi and blood were statistically significant(P <0.05);the differences of stagnation and stasis syndrome in BMD of the lumbar spine were statistically significant(P <0.05);The difference between the obstruction-blocking syndrome in the hip is statistically significant(P<0.01),and the differences in Qi and blood deficiency syndromes in the lumbar spine and hip BMD are statistically significant(P <0.01).Conclusion:1.Liver and kidney deficiency syndrome,Qi deficiency and blood deficiency syndrome,and phlegm and blood stasis obstruction syndrome are common syndromes of secondary OP in RA patients.2.RA patients with OSTA index,a long course of disease,a history of smoking,high VAS and DAS28 scores,and high levels of ESR,CRP,RF,anti-CCP,ALP,N-MID,and β-crossla are more likely to be secondary OP.3.Comparison of different syndrome types: Among patients with RA secondary to OP,there are more men with damp heat syndrome and higher levels of ESR and CRP.There are more women with deficiency of qi and blood,and deficiency of liver and kidney.There must be a certain degree of emphasis on treatment.Qi and blood nourishment,regulate liver and kidney;anti-CCP combined with RF antibody detection can effectively predict the possibility of RA secondary OP;ALP,N-MID and β-crossla can be used as indicators to evaluate whether RA may secondary OP;sputum stasis Patients with obstruction syndrome and deficiency of qi and blood should prevent the occurrence and development of OP in time when BMD is low.