| Objective:Ankylosing spondylitis is a chronic inflammatory disease that mainly affects the sacroiliac joint,spine,soft tissue adjacent to the spine,and peripheral joints.It can be accompanied by extra-articular manifestations,and in severe cases,spinal deformities and ankylosis can occur.Inflammation is the initiating link of AS disability,and the irreversible structural joint injury that subsequently initiates is the fundamental cause of AS disability.The evaluation of disease activity in clinical practice is of great significance,determining the formulation of treatment plans and the implementation of targeted treatment strategies.AS belongs to the categories of "Da Lv","Kidney Bi",and "Bone Bi" in traditional Chinese medicine.Kidney deficiency is the foundation,dampness heat Bi obstruction is the standard,and blood stasis is the main characteristic of the pathogenesis of the disease.Therefore,Kidney deficiency and blood stasis syndrome and dampness heat stasis syndrome are the basic syndromes of AS.This study plans to carry out the research on the basic syndromes and disease activity characteristics of AS patients,so as to provide evidence-based support for disease assessment and accurate syndrome differentiation under the combination of disease and syndrome.Methods:Based on the diagnosis of ankylosing spondylitis in Western medicine,the diagnosis and treatment of ankylosing spondylitis are combined with the differentiation of symptoms and signs in traditional Chinese medicine.From the perspective of modern science,the overall characteristics of ankylosing spondylitis have been analyzed,and the etiology and pathogenesis of AS have been further understood from the perspective of traditional Chinese medicine.By combining syndrome differentiation with syndrome differentiation,a unified formula has been formulated,forming a model of combining disease and syndrome diagnosis and treatment for ankylosing spondylitis.Based on this,we will conduct research on traditional Chinese medicine syndromes of ankylosing spondylitis.Analyzing the important role of disease activity in the evaluation of ankylosing spondylitis,mainly based on disease activity,to explore the correlation between traditional Chinese medicine syndromes and disease activity in patients with ankylosing spondylitis.Using the data analysis software CiteSpace 6.2.R2,literature on the activity of ankylosing spondylitis disease in the past 10 years was retrieved from two databases:Web of Science(WOS)and China National Knowledge Infrastructure(CNKI),and the results were visualized and analyzed.From the disease database of ankylosing spondylitis of the China Academy of Chinese Medical Sciences,the cross-sectional survey method was used to review and analyze the data from Guang’anmen Hospital of the Chinese Academy of Traditional Chinese Medicine,Xiyuan Hospital of the China Academy of Chinese Medical Sciences,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Bethune International Peace Hospital of the Chinese People’s Liberation Army,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine A total of 1242 AS patients who met the inclusion and exclusion criteria were included in the outpatient data of the Rheumatology and Immunology Department of the Affiliated Hospital of Anhui University of Traditional Chinese Medicine from 7 centers nationwide.Observe different syndromes,namely the disease activity score(ASDAS-CRP,ASDAS-ESR),Bath ankylosing spondylitis activity index(BASDAI)score,overall patient evaluation(PGA),single symptom low back pain,peripheral joint pain/swelling,morning stiffness time,degree of morning stiffness,tenderness/tenderness and fatigue score,as well as C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR),in AS patients with kidney deficiency and stasis syndrome and damp heat stasis syndrome.Results:1 The results of literature research show that after screening and de duplication,88 articles were included in the CNKI database,and 3061 articles were included in the WOS core database.The statistical analysis of the annual number of publications shows that the research field both domestically and internationally shows an overall upward trend;The analysis of author collaboration network shows that the authors with the highest volume of publications both domestically and internationally are Zhu Jian and Huang Feng,Desire van der Heijde.Maxime Dougados and Xenofon Baraliakos.Foreign authors have a much higher volume of English publications than Chinese authors;Analysis of institutional cooperation networks shows that the institutions with the highest volume of publications both domestically and internationally are the Rheumatology Department of the General Hospital of the People’s Liberation Army and the Research Library of the United Kingdom;Keyword analysis shows that research in this field at home and abroad mainly focuses on the evaluation of patient clinical research outcomes,especially in terms of efficacy evaluation of biological agents and patient quality of life.2 The clinical study included 558 AS patients with dampness heat stasis syndrome and 684 AS patients with kidney deficiency stasis syndrome.Among them,the ASDAS-CRP,ASDAS-ESR,and BASDAI scores of patients with dampness heat stasis syndrome were higher than those of patients with kidney deficiency stasis syndrome(P<0.05).3 In the ASDAS-CRP level distribution,there was no significant statistical difference(P>0.05)in the distribution of AS patients with dampness heat stasis syndrome and kidney deficiency blood stasis syndrome among different disease activity groups.The two groups of people are mainly concentrated in low disease activity and high disease activity.The damp heat stasis syndrome was 22.58%and 52.87%respectively,while the kidney deficiency stasis syndrome was 26.02%and 49.42%,respectively.4 In terms of single symptom score and PGA,in the scores of low back pain,peripheral joint swelling/pain,morning stiffness time,and tenderness/tenderness symptoms,patients with dampness heat stasis syndrome were significantly higher than those with kidney deficiency stasis syndrome(P<0.05).There was no significant statistical difference in the degree of morning stiffness,PGA,CRP,and ESR between the two syndromes(P>0.05).5 In the correlation analysis of PGA,single symptom,and inflammatory indicators,there was a strong correlation between PGA and single symptom(P<0.05).Conclusion:The overall level of disease activity in patients with dampness heat stasis syndrome is higher than that in patients with kidney deficiency stasis syndrome.This is consistent with the pathogenesis of AS in traditional Chinese medicine.Compared to the population with dampness heat obstruction syndrome mainly characterized by deficiency syndrome,the population with kidney deficiency syndrome mainly characterized by deficiency syndrome has a stronger evil energy and a more intense competition between good and evil.The overall population shows a trend of higher disease activity.It is suggested that in clinical practice,patients with dampness heat obstruction syndrome(AS)need more active treatment to reduce disease activity compared to kidney deficiency syndrome. |
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