Study On The TCM Syndrome And Treatment Rules Of Ankylosing Spondyliti

Purpose: To collect the medical records of 281 patients with ankylosing spondylitis in the Affiliated Hospital of Liaoning University of traditional Chinese medicine in the past 5 years.Through retrospective analysis of the collected medical records,we summarized the distribution of the evidence of ankylosing spondylitis and the pattern of medication,in order to provide certain ideas of medication and clinical experience for the clinical treatment of ankylosing spondylitis and further improve the clinical efficacy.Material and Methods: In this study,we collected clinical data of patients hospitalized with ankylosing spondylitis from July 1,2016 to June 30,2021 in the Department of Rheumatology and Rheumatology Rehabilitation of the Affiliated Hospital of Liaoning University of Chinese Medicine,and used EXCEL 2016,SPSS Statistics 26.0 software and IBM SPSS Modeler 18.0 software to analyze the distribution of evidence patterns of cases meeting the criteria of nadir,drug frequency,and association rules were statistically analyzed to summarize their evidence patterns.Results:1.A total of 281 patients with ankylosing spondylitis were included in this study,including a total of 196 male patients and 85 female patients,with a male to female ratio of 2.31:1.The age of onset was mostly concentrated between 21-40 years old,accounting for 59.07% of the total number of patients.2.The frequency of TCM syndrome types are,in descending order,kidney deficiency cold coagulation syndrome(37.37%),cold dampness obstruction syndrome(30.96%),kidney deficiency blood stasis syndrome(19.22%),kidney deficiency damp heat syndrome(9.61%),liver and kidney deficiency syndrome(2.84%).3.Among the 281 patients in this study,there were 169 cases with extra-articular manifestations,accounting for 60.14% of the total study population,including 87 cases with systemic symptoms,22 cases with hematologic involvement,29 cases with uveitis,11 cases with pulmonary lesions,and 85 cases with osteoporosis.4.In this study,a total of 281 prescriptions were counted,involving 190 Chinese herbal medicines,and the total frequency of medication was 4231 times,with Achyranthes bidentata,Radix Paeoniae Alba,Eucommia ulmoides,angelica root,Fangfeng,Gouji,Dipsacus,Guizhi,notopterygium and Rehmannia glutinosa being the high-frequency drugs for the treatment of this disease.The drug categories were unified and standardized,and a total of 19 drug categories were involved in this study,and the commonly used drug categories were tonic for deficiency,dispelling wind and dampness,relieving superficiality,and activating blood circulation and resolving blood stasis.In terms of medicinal properties,warm drugs are used most.They were ranked from high to low as warm,cold,flat,cool,and hot.The taste of drugs was mostly sweet,bitter and pungent.From the analysis of drug meridians,most of the drugs belong to liver meridian,spleen meridian,lung meridian and kidney meridian.5.Cluster analysis of the top 25 drugs in terms of frequency of use can be divided into three groups: Category 1: Clematis,Rhizoma Drynariae,Rehmannia glutinosa,antler cream,Anemarrhena,aconite,Cinnamon Twig,notopterygium notopterygium,dog ridge,Eucommia ulmoides,angelica,Dipsacus,Fangfeng,Achyranthes bidentata,white peony;Class2: licorice and astragalus;Category 3: Gentiana macrophylla,asarum,Codonopsis pilosula,cinnamon,Poria cocos,Angelica sinensis and Ligusticum chuanxiong and Mulberry parasitism.6.Setting the support level greater than 40% and confidence level greater than 80%,the association analysis of drugs showed that the highest support level was for Eucommia ulmoides + Achyranthes bidentata,Duhuo + Achyranthes bidentata with 76.15658% and the highest confidence level was for Achyranthes bidentata + Duhuo + Eucommia ulmoides with99.40476%.Conclusion:1.Most AS patients are prone to extra-articular manifestations.2.Clinically,patients with kidney deficiency and cold condensation evidence are most common,followed by cold-damp paralysis evidence,kidney deficiency and stasis evidence and kidney deficiency and damp-heat evidence,and less often liver and kidney deficiency evidence.3.The disease is mostly based on kidney deficiency,with cold,dampness,stasis and heat as the symptoms,and the deficiency as the symptoms.Treatment should be based on nourishing the deficiency,with dispelling wind and dampness,relieving the symptoms,and activating blood circulation and eliminating blood stasis to help eliminate evil,paying more attention to the use of warm,sweet,bitter and pungent flavors,and paying attention to regulating the liver,spleen,lung and kidney meridians.4.The core drug combination for this disease is Angelicae Pubescentis Radix,Niubizi,Radix et Rhizoma,Eucommia,Fructus,and Paeonia.