Clinical Study Of Rheumatoid Arthritis-related Syndromes And Disease Activity

Objective: RA is a chronic erosive arthritis, often recurrent, current treatment goal is to seek clinical remission and lower disease activity. This study is to analyze the patients with rheumatoid arthritis disease activity and distribution of clinical syndromes investigation to explore active rheumatoid arthritis syndromes distribution, with a view to the rule of disease differentiation in order to find macroscopic and micro combined more scientific understanding of RA dynamic and provide differentiation based on Chinese medicine treatment of RA.Methods: With literature review and consultation with relevant experts, the design of clinical epidemiology and Clinical Survey tables, we have collected outpatient and inpatient clinical information on490cases of RA patients, in Guang An Men Hospital, China Academy of Chinese Medical Sciences syndromes classified according to the national standard of Chinese Medicine Authority in2010to develop Wangbi (rheumatoid arthritis) of clinical pathways and new Chinese medicine and clinical guidelines for the development of the actual situation goes into six syndromes, cold Blockage certificate, heat stasis, phlegm and blood stasis card, two blood deficiency, kidney deficiency syndrome. All investigations and case review, data entry, etc. have been completed by the graduate. After finishing the survey data and calculating the DAS28value, using epidata3.1data entry, statistical analysis with SPSS20.0. General descriptive analysis, measurement data using one-way ANOVA, pairwise comparisons using rank sum test when heterogeneity of variance, P<0.05was considered statistically significant. Count data to calculate proportions and frequency, using the chi-square test, test level a=0.05, P<0.05was considered statistically significant.Results:490patients surveyed, women (80.2%) is about men’s (19.8%)4-fold; grouped by age, the age group of45to the highest proportion (43.5%), followed by60to sort the rest of the group (40.2%),18to the age group (15.7%),0-age group (0.6%); syndromes highest proportion of heat stasis (62.0%), followed by the rest of sorting Phlegm Blockage accounting (10.4%), wind and dampness Blockage (9.6%), qi and blood deficiency (8.6%), insufficiency of kidney and liver (8.0%), cold blockage (1.4%). In patients surveyed syndromes with age and gender differences were not statistically significant. There were significant differences syndromes with the course, and further using Kruskal-Wallis multiple comparison univariate differences (all pairwise comparisons) between any two tests, the results showed that wind and dampness blockage group and qi and blood deficiency group, wind and dampness Blockage group and liver and kidney deficiency group, the differences between any two groups, and liver and kidney disease duration less heat stasis group was statistically significant (P<0.05), no statistically significant differences between the two groups the remaining duration of the syndrome (P>0.05).The difference between joint tenderness in patients with rheumatoid arthritis and several different syndromes between the number of swollen joints was statistically significant, which shows that the dampness and heat syndrome is the most and rheumatism blockage syndrome is minimum. Different syndromes DAS28score was statistically significant difference in climate, and further using Kruskal-Wallis multiple comparison univariate differences (all pairwise comparisons) between any two tests, the results showed that group and Phlegm rheumatoid Blockage blockage group, rheumatism Blockage of heat stasis between patient groups and DAS28score was statistically significant (P<0.05), and the remaining group of syndromes DAS28score was not statistically significant (P>0.05). Differences of DAS28score level between different syndromes of rheumatoid arthritis patients were statistically significant. With further using Kruskal-Wallis multiple comparison univariate differences (all pairwise comparisons) between any two tests, the results showed that rheumatoid Blockage groups and humid stasis group, between groups and Phlegm rheumatoid Blockage blockage group, heat stasis and kidney deficiency patients DAS28score levels are pairwise significant difference (P<0.05), the remaining group of syndromes DAS28score level two has no statistically significant difference between the two (P>0.05). Differences in platelet of patients of different syndromes were not statistically significant. ESR differences of patients of different syndromes were statistically significant, erythrocyte sedimentation rate which is higher than the heat stasis syndrome rheumatoid Blockage (P<0.05), phlegm and blood erythrocyte sedimentation rate higher than rheumatic syndrome Blockage Blockage (P<0.05), Blockage card Phlegm highest ESR values (x±s=55.0±34.7), rheumatoid Blockage card minimum. Different C-reactive protein in patients were statistically significant differences between the situation further using Kruskal-Wallis multiple comparison univariate differences (all pairwise comparisons) between any two tests, the results showed that rheumatoid Blockage groups and damp heat resistance between C-reactive protein values between two groups was statistically significant (P<0.05), the remaining C-reactive syndrome group was not statistically significant (P>0.05). C-reactive protein values in the highest heat stasis type (x±s=32.5±37.6).Conclusion: DAS28score from high to low is heat stasis syndrome> phlegm blockage syndrome> deficiency of both qi and blood syndrome> liver and kidney deficiency syndrome> syndrome, with the highest disease activity is dampness and heat stasis syndrome, wind and dampness blockage syndrome is the minimum; this study investigated the proportion of syndromes in descending order are: dampness and heat stasis> phlegm blockage> wind and dampness blockage blockage>qi and blood deficiency> liver and kidney insufficiency> cold blockage, stasis is most common in damp, cold Blockage card minimum; rheumatoid blockage card shortest duration, liver and kidney deficiency syndrome longest duration; damp stasis in patients with joint tenderness, swelling up to a few, and rheumatoid Blockage syndrome minimum; platelet in no statistically significant difference between the syndromes, and elevated platelet have appeared in various syndromes, bleeding throughout the RA all the way; Phlegm blockage card ESR values was higher than other syndromes, rheumatoid Blockage least; humid Stagnation highest titer C-reactive protein, and liver and kidney deficiency syndrome was lowest.