Study On The TCM Syndrome And Treatment Rules Of Ankylosing Spondylitis Associated With Uveiti

Purpose: To explore the distribution characteristics of TCM syndrome types and medication patterns of patients with ankylosing spondylitis(AS)associated with Uveitis in The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,to provide guidance for the treatment of AS associated with uveitis based on syndrome differentiation in traditional Chinese medicine in Liaoning region.Method: The data of patients with AS associated with Uveitis from the Department of Rheumatology and the Department of Rheumatology Rehabilitation,The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2013 to December2022 were analyzed retrospectively,collect patients’ age,sex,syndrome type,prescription medication,according to the inclusion criteria and exclusion criteria to screen and conclude the cases.Frequency analysis by Excel,complex network analysis and association analysis by SPSS Modeler 18.0,cluster analysis by SPSS Statistics 26.0 were used to mine the data,and the distribution characteristics of syndromes and the rule of medication in AS associated with uveitis were obtained.Results:1.General Situation: The number of cases collected was 80 in this study.The ratio of male to female was about 1.76:1.The average age was 48.1 ± 12.56 years old.The age of onset of AS mostly concentrated in 21-40 years old,accounting for 66.25% of the total.2.Distribution of syndrome types: According to the proportion of syndrome from high to low,kidney deficiency damp heat syndrome(53.75%),liver and kidney deficiency syndrome(26.75%),kidney deficiency blood stasis syndrome(17.50%),kidney deficiency governor cold(2.50%).3.The use of traditional Chinese medicine: In 80 prescriptions,involving 163 Chinese herbal medicine,and the total frequency of medication was 1444 times,the types of Chinese medicines was 17.Achyranthis Bidentatae Radix,Glycyrrhizae Radix et Rhizoma,Rhizoma Cibotii,Cortex Phellodendr,Taxillus sutchuenensis,Radix Angelicae Sinensis,Coicis Semen,Eucommiae Cortex,Saposhnikovia divaricata,Atractylodes lancea were high-frequency Chinese medicine for the treatment of AS associated with uveitis.Restorative CHMs,CHMs for clearing interior heat,CHMs for dispelling wind and dampness and CHMs for Invigorating Circulation and Removing Blood were the common types of Chinese medicine for AS associated with uveitis.From the point of view of four natures,warm used most,followed by cold and neutral.From the point of view of five flavors,bitter used most,followed by sweet and pungent.From the point of view of herb’s meridian tropism,liver meridian used most,followed by kidney meridian and spleen meridian.4.Association rule analysis: The Chinese medicine prescription network showed that the six strong links were: Rhizoma Cibotii and Achyranthis Bidentatae Radix,Cortex Phellodendr and Achyranthis Bidentatae Radix,Saposhnikovia divaricata and Achyranthis Bidentatae Radix,Achyranthis Bidentatae Radix and Taxillus sutchuenensis,Glycyrrhizae Radix et Rhizoma and Achyranthis Bidentatae Radix,Radix Angelicae Sinensis and Achyranthis Bidentatae Radix.The combinations of Chinese medicine with higher percentage of correlation support were Cortex Phellodendr and Atractylodes lancea and Achyranthis Bidentatae Radix,Atractylodes lancea and Coicis Semen and Rhizoma Cibotii,Coicis Semen and Alisma orientalis and Atractylodes lancea,Cortex Phellodendr and Alisma orientalis and Atractylodes lancea,Rhizoma Cibotii and Alisma orientalis and Atractylodes lancea.5.Cluster Analysis: There were 20 herbs in the prescription which were uesd more than or equal to 20 times,and six groups were obtained: Class 1were Rhizoma Cibotii,Achyranthis Bidentatae Radix,Taxillus sutchuenensis,Glycyrrhizae Radix et Rhizoma,Radix Angelicae Sinensis,Eucommiae Cortex,Saposhnikovia divaricata;Class 2 were Atractylodes lancea,Cortex Phellodendr,Semen Coicis,Alisma orientalis;Class 3 were Rhizoma Dioscorear and Cornus officinalis;Class 4 were Radix Paeoniae Alba and Poria Cocos Wolf;Class 5 was Trachlospermi Caulis Et Folium;Class 6 were Rhizoma Ligustici Chuanxiong,Radix Angelicae Pubescentis,Rhizoma et Radix Notopterygii,Rhizoma Anemarrhenae.Conclusion:1.AS associated with Uveitis is more common in men in this study.2.AS associated with Uveitis is deficiency in origin and excess in superficiality,deficiency in origin is inadequate of kidney essence,liver deficiency is also found in some cases,the pathological factors of the excess in superficiality are damp,hot,blood stasis and cold.3.In the clinical treatment of AS associated with Uveitis,the main types of Chinese medicine are Restorative CHMs,CHMs for clearing interior heat,CHMs for dispelling wind and dampness and CHMs for Invigorating Circulation and Removing Blood.We should pay attention to use of warm,cold and neutral medicine,focus on bitter,sweet and pungent medicine,and pay attention to the regulation and care of the three internal organs of liver,kidney,spleen.4.The combination of core Chinese medicine for AS associated with Uveitis are Achyranthis Bidentatae Radix,Rhizoma Cibotii,Cortex Phellodendr,Coicis Semen,Atractylodes lancea and Alisma orientalis.