Rheumatoid Arthritis Complicated With Sarcopenia Study On The Correlation Between TCM Syndrome Types And Constitutions

Objective:The purpose of this study is to investigate the correlation between different TCM evidence types and physical constitution,and to provide an objective basis for the improvement of the evidence-based treatment system of RA and to provide evidence-based ideas for the treatment of RA patients with sarcopenia.Methods: Patients with RA who visited the outpatient clinic and ward of the Department of Rheumatology and Immunology of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine between September 2020 and January 2023 were selected for the study,and after the patients signed the informed consent form to fill in the case questionnaire,general information was obtained,and the patients were instructed to fill in the Chinese Medicine Physical Classification and Determination Form and the Health Assessment Questionnaire for RA patients,and two chief physicians of the Department of Rheumatology and Immunology jointly performed TCM evidence type determination.The information was collated and entered into the database,and data analysis was performed using SPSS25.0.Results:1.256 patients with RA who met the inclusion criteria of this study were clinically collected,including 177 cases of RA non-sarcopenia and 79 cases of RA sarcopenia.The prevalence of RA sarcopenia in this study was 30.9%.2.Of the 79 patients with RA sarcopenia,6(7.6%)were male and 73(92.4%)were female,with a mean age of 54.62 ± 10.40 years.Age segmentation of patients with RA sarcopenia revealed the largest number of people in the age group of 45-59 years.statistical differences existed between RA sarcopenia and RA non-sarcopenia in terms of gender,age,disease duration,erythrocyte sedimentation rate(ESR),disease activity score28(DAS28),health assessment questionnaire records(HAQ)(P < 0.05),and there was no statistical difference in C-reactive protein(CRP)(P > 0.05).Logistic regression analysis was used to find that gender,age,disease duration,DAS28 and HAQ were risk factors for the development of sarcopenia in RA patients(P < 0.05),and ESR was not correlated with the development of sarcopenia in RA patients(P > 0.05).3.The distribution of TCM evidence types in patients with RA sarcopenia in order of frequency was: damp-heat paralysis(26.6%),liver-kidney deficiency(24.1%),qi-blood deficiency(21.5%),phlegm-stasis paralysis(12.7%),wind-damp paralysis(8.9%),and cold-damp paralysis(6.3%).There was no statistical difference in gender,age,disease duration,ESR,CRP,and DAS28 among the different TCM types(P > 0.05),and HAQ was statistically significant(P < 0.05),with the highest HAQ in the damp-heat paralysis obstruction evidence.4.The TCM constitution types of RA sarcopenia patients in order of frequency were: yang deficiency(35.4%),qi yu(26.6%),qi deficiency(21.5%),damp-heat(7.6%),phlegm-damp(3.8%),yin deficiency(2.5%),blood stasis(1.3%),pinghe(1.3%),and special endowment(0.0%).the distribution of TCM constitution in RA sarcopenia was There was no statistical difference in gender,age,disease duration,ESR,CRP,DAS28,and HAQ among different TCM constitutions in RA sarcopenia(P > 0.05).5.There was a statistical difference in the distribution of TCM evidence and constitution in patients with RA sarcopenia(P < 0.05).The most common TCM constitution for Damp-Heat paralysis is Damp-Heat,the most common TCM constitution for Liver-Kidney deficiency is Yang deficiency,the most common TCM constitution for Qi-Blood deficiency is Qi deficiency,the most common TCM constitution for Damp-Heat paralysis is Damp-Heat paralysis,and the most common TCM constitution for Qi-Yu is Damp-Heat paralysis,Phlegm-Damp paralysis and Qi-Blood deficiency.Conclusion:1.Differences in sex,age,disease duration,ESR,DAS28,and HAQ existed between RA sarcopenia and RA non-sarcopenia.2.Female,advanced age,high DAS28,long disease duration and high HAQ are risk factors for the development of sarcopenia in patients with RA.3.The more common TCM evidence types in patients with RA sarcopenia are damp-heat paralysis and obstruction,liver and kidney deficiency,and qi and blood deficiency.4.Compared with other TCM evidence,patients with Damp-Heat paralysis obstruction had the highest HAQ,suggesting that patients with Damp-Heat paralysis obstruction evidence of RA sarcopenia had the lowest quality of life.5.The more common TCM constitutions in patients with RA sarcopenia are Yang deficiency,Qi yu and Qi deficiency.6.Patients with RA sarcopenia have damp-heat paralysis obstruction evidence mostly as damp-heat quality,liver and kidney deficiency evidence mostly as yang deficiency quality,and qi and blood deficiency evidence mostly as qi deficiency quality.Damp-Heat quality is mostly Damp-Heat paralysis obstruction evidence,Qi-Yu quality is mostly Damp-Heat paralysis obstruction evidence,Phlegm-Damp paralysis obstruction evidence and Qi-Blood two deficiency evidence.