Clinical Observation And Traditional Chinese Medicine Differentiation Of SAPHO Syndromes

Objective:To investigate the clinical manifestations, TCM syndrome characteristics of SAPHO syndrome, the population characteristics of patients, risk factors and syndrome features were studied. To explore the relationship between SAPHO syndrome and ESR、 CRP, the levels of serum ESR and CRP were detected in patients. This could provide the further treatment of SAPHO syndrome.Methods:38patients with SAPHO syndrome were included in this clinical trial study. The potential risk factors, age, gender, symptoms and signs were analyzed. The misdiagnosis factors and syndrome characteristics were also studied in this report. The relationship between SAPHO syndrome and the inflammatory markers (ESP and CRP) was determined. We also observed the patients VAS score, BASDAI score and BSAFI score.Results:1Gender and Age:In the38SAPHO Syndrome Patients, there are10male,28female. Women were more than men. Compared with domestic and foreign research groups such as PUBMED, CNKI and Wanfang databases, there are more females than males. The average onset age were various according to reports, but middle-aged patients in this study were much more than other ages.2Seasonal incidence:Late winter was the most important onset season.3Pathogenic factors:In the38patients,37patients had risk factors, such as season changing, improper diet, emotional disorders, genetic factors, irregular life and histories of inappropriate use of antibiotics before the onset of the disease.4Duration:The incidence was varying from one months to27years.5Clinical symptoms:The primary skin lesion was Palmoplantar pustulosis, followed by acne; and the primary bone damage is osteitis. The main clinical manifestations were intermittent palmoplantar pustulosis and shoulder, sternoclavicular, sacroiliac and other bone, joint pain, and also the majority patient had sternoclavicular damage. Skin lesions and bone damages were not paralleled.6Associated diseases and symptoms:one patient got systemic lupus erythematosus, and one case associated with Sjogren’s syndrome. Some patients had oral ulcers, vulva wet or excessive vaginal discharge and other syndromes.7Immune parameters:There was no specific immune parameter in this disease, but some patients ESR and CRP levels elevated when bone pains or skin lesions get worse.8TCM syndromes:Most syndromes of SAPHO syndrome were dampness heat blockage, liver and gallbladder qi stagnation, blood stasis blocking, and most deficiency syndromes were1iver and kidney deficiency, and blood deficiency was mainly wind dryness.Conclusions:1SAPHO syndrome can be attributed to the category of arthralgia syndrome of TCM. There are more female patients than male patients. It is probably related to improper diet, emotional disorders, genetic factors, irregular work and rest. Other factors as inappropriate using of antibiotics may also be predisposing factors of this disease. Seasons changing may be an aggravating factor in the disease and the onset period is mostly in winter.2Both bone lesions and skin lesions can lead to the elevating of ESR and CRP, but they are not always coexisting or getting worse at the same time.3Most excess syndromes of SAPHO syndrome are dampness heat blockage, liver and gallbladder qi stagnation, blood stasis blocking, and most deficiency syndromes are liver and kidney deficiency, and blood deficiency with wind dryness.