Study On The TCM Syndrome And Treatment Rules Of Rheumatoid Arthritis With Thrombocytosi

Objective: To study the syndrome and treatment rule of RA with thrombocytopenia,summarize its syndrome type distribution and medication rule,and provide evidence-based basis for TCM clinical treatment of rheumatoid arthritis with thrombocytopenia based on syndrome differentiation.Data and methods: Based on the data of outpatients and inpatients in the Department of Rheumatology and Immunology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine(October 2019 to September 2021),case screening was carried out in strict accordance with the admission criteria,and the database was established with WPS Office tables for statistical and analysis.SPSS Statistics 26.0 and SPSS Modeler18.0 software were used for data analysis and mining to analyze the distribution of syndrome types and medication rules of rheumatoid arthritis with thrombocytopenia.Results:1.A total of 240 cases meeting the criteria were collected in this study,including 44 male cases and 196 female cases,with a male to female ratio of 1:4.45.The patients ranged in age from 18 to 87 years,with a mean age of 60.70±11.96 years.2.Syndrome distribution(in order of constituent proportion): Phlegm-stasis syndrome(46.67%)> damp-heat syndrome(27.50%)> cold-dampness syndrome(17.08%)>cold-dampness syndrome combined with blood stasis syndrome(3.33%)> damp-heat syndrome combined with blood stasis syndrome(1.67%)= deficiency of qi and Yin(1.67%)> deficiency of liver and kidney(0.83%)> deficiency of qi and Yin Combined blood stasis syndrome(0.42%)= deficiency of qi and blood(0.42%)= deficiency of liver and kidney combined blood stasis syndrome(0.42%).3.A total of 240 prescriptions were included in this study,involving 143 traditional Chinese medicines,with a total frequency of 3162 times,with the highest frequency of 162 times and the lowest frequency of 1 time.The top 12 traditional Chinese medicines in the frequency of use were red peony root,coix seed,Atractylodes atractylodes,Radix anthellae,cassia twig,Angelica sinensis,chingiwo,Poria cocos,talcum powder,radix cholangata,Phellodendron phellodendron and Honeysuckle.4.The most frequently used drugs are those that benefit water and permeate moisture,while relieving surface drugs,tonifying qi drugs,promoting blood circulation and removing stasis drugs,dispelling wind and dampness drugs,clearing heat and cooling blood drugs and resolving phlegm,relieving cough and antiasthmatic drugs are also commonly used.5.Cluster analysis was performed on 41 high-frequency drugs(frequency ≥ 25 times),and a total of 7 groups of drugs were obtained:(1)of myrrh,frankincense,salvia miltiorrhiza,angelica,bravery south star,mustard,rhizoma ligustici wallichii(2)In cultured(3)main licorice,aconite,radix paeoniae alba,herba ephedrae,bran Fried atractylodes(4)pinellia,big jujube,radix scutellariae,ginger,oysters,acid-insoluble ash(5)gypsum,bitter almond,peach kernel,cortex moutan,poria cocos,radix puerariae,cassia twig(6)astragalus,atractylodes,radix glycyrrhizae,radix aconiti(7)Phellodendron Japonicum,Honeysuckle,Forsythia suspensa,Dioscorea Xieba,Dioscorea Xieba,Dioscorea Xieba,Dioscorea Xieba,Coix seed,Atractylodes atractylodes and Red peony root.6.Complex network analysis was performed on 41 high-frequency drugs(frequency ≧25 times),and association analysis was performed on high-frequency drugs with 2,3 and 4 as the maximum number of preceding items,respectively,and it was concluded that the compatibility combinations of Radix paeoniae,Coix seed,Atractylodes atractylodes,Radix tetrandrrhizae and talcum powder were more commonly used.The syndrome type was regarded as a drug,and association rule analysis was carried out for all drugs.The core drugs of damp-heat bi syndrome were Phellodendri chinensis,Honeysuckle and Coix seed.The core drugs of cold-dampness bi syndrome are licorice root and Astragalus membranaceus.Conclusion:1.RA accompanied by thrombocytopenia is a symptom of deficiency,and phlegm dampness,blood stasis and heat may be the main pathological factors of RA.The treatment is mainly to remove pathogenic factors,supplemented by invigorating qi,and at the same time,combined with anti-surface drugs to treat pathogenic factors.2.Cluster analysis suggested the following prescription rules: addition and reduction of Huoluoxiao Lingdan and addition and reduction of Guizhi Poria bolus may be used in the pain of phlegm,dampness,stagnation and blood stasis;Ephedra aconiti Decoction may be used for the deficiency of spleen Yang,edema of limbs and other diseases;The addition and reduction of Huangqin Plus Xia Jiang decoction may be used in the patients with phlegm and heat intermingled and drink overflow of limbs.Aconitum decoction may be used to block meridians and collaterals with wind cold and dampness,and the syndrome of adverse joints around the body.Simiao pill hemu Fangji decoction may be applied to those with joint swelling,heat,pain and thirst.3.The core drug combination of RA with thrombocytopenia is red peony root,Coix seed,Atractylodes atractylodes,Radix Tetrandrrhizae,Qiang activating and talcum powder.