The Clinical Characteristics Of Rheumatoid Arthritis With Hypercoagulable State And Its Correlation With TCM Syndrome Types

Objective: To study the clinical characteristics of rheumatoid arthritis(RA)combined with hypercoagulable state,to evaluate the value of coagulation/fibrinolysis index detection in the diagnosis and treatment of rheumatoid arthritis;to study the distribution characteristics of TCM syndromes in RA hypercoagulable state,and the correlation of TCM syndromes with hypercoagulable state and coagulation/fibrinolysis indexes;and explore the effect of RA hypercoagulable state on venous thromboembolism and cardiovascular disease.It is expected to provide clinical evidence for TCM syndrome differentiation and treatment,and provide a reference for the prevention and treatment of RA complicated with coronary heart disease by integrated TCM and Western medicine.Methods: Based on the diagnosis,inclusion and exclusion criteria,209 RA patients who were treated in the Department of Rheumatology,Shandong University of Traditional Chinese Medicine Hospital from June 1,2020 to December 31,2020 were selected to fill in the medical history collection form and follow the diagnostic criteria for hypercoagulable state Carry out grouping,syndrome differentiation,and use SPSS22.0 software for statistical analysis of relevant laboratory indicators and TCM syndrome types.Result:1.This study included 209 patients in the RA hypercoagulable state group,137 cases,23 males and 114 females;72 cases in the RA non-hypercoagulable state group,6 males and 66 females,the average age of the patients was 58.15±13.15 Years old,the average course of disease was10.84±9.13 years,mostly middle-aged women.2.RA patients with a history of smoking and RA patients with coronary heart disease are more likely to show blood hypercoagulability.3.The scores of PLT,TG,LDL,CRP,ESR,TJC,SJC,PGA and DAS28-ESR in the hypercoagulable state group were higher than those in the non-hypercoagulable state group.RA hypercoagulable state group has higher disease activity than non-hypercoagulable state group.4.LDL,RF,CRP are risk factors for RA hypercoagulability;patients with high disease activity are at higher risk of hypercoagulability than patients in remission;MPV is a protective factor for hypercoagulability.The hypercoagulable state of RA patients is a risk factor for coronary heart disease.5.Among the 209 patients,106 cases were of damp-heat blockage type,47 cases were phlegm-stasis blockage type,27 cases were liver and kidney deficiency type,18 cases were cold-damp blockage type,and 11 cases were Qi-blood deficiency type.The distribution of RA hypercoagulability status according to TCM classification is as follows: damp-heat arthralgia syndrome>phlegm-stasis arthralgia syndrome>liver and kidney deficiency syndrome>cold dampness syndrome = qi and blood deficiency syndrome.There is a positive correlation between damp-heat arthralgia syndrome and RA hypercoagulability status,and cold-dampness arthralgia syndrome has a negative correlation with RA hypercoagulability status;the level of DD in damp-heat arthralgia syndrome is higher than other syndrome types.Conclusion:1.RA hypercoagulable state has higher disease activity,and the inflammatory index and immune index are higher than the non-hypercoagulable state group,and it is easy to merge with abnormal lipid metabolism.2.RA hypercoagulable state has a higher risk of complicated coronary heart disease than non-hypercoagulable state.3.RA patients with damp-heat arthralgia syndrome are more likely to be hypercoagulable than patients with other syndromes;DD has a reference role in the TCM syndrome differentiation of RA hypercoagulable state.