| Objective:Our study aims to explore the relationship between hip involvement and TCM syndrome differentiation,determine the clinical factors and laboratory measures that are related to predict the radiographic Severity of patients with AS,explore the regularity of the use of Chinese herbal medicine in the treatment of ankylosing spondylitis with hip involvement or not by Dr.XiaoPing Yan.Methods:A retrospective study was performed.A total of 266 patients were involved in the study,classified into 2 groups based on the Bath Ankylosing Spondylitis Radiology Hip Index(BASRI-hip):AS with hip-involvement and AS without hip-involvement.The following clinical data were collected from all patients:age,sex,disease duration,age at disease onset,family history of AS,Clinical examinations were performed by the same observer and included Modified Schober,chest expansion,Tragus to wall distance,Occiput to wall distance.The cervical and lumbar X-rays,sacroiliac joint CT,hip CT,or hip X-ray were collected,scored and graded by 2 imaging doctors with 5 years imaging diagnostic experience.The following laboratory data:C-reactive protein,erythrocyte sedimentation rate,HLA-B27 were collected,and BASMI,BASFI,BASDAI,ASDAS-CRP were calculated.All Patients were classified into 2 TCM Syndrome Differentiation,among those patients who visit Professor XiaoPing Yan their first outpatient Chinese herbal medicine prescription were collected.Results:-Patients with hip joint involvement had earlier age of onset(P<0.01),longer duration(P<0.01),more patients with family history(P<0.05),than patients without hip involvement.The occipital wall distance,screen wall distance,and finger-to-ground distance were all significantly longer in patients with hip involvement(P<0.01).Chest expansion and Modified Schober in Patients with hip involvement were shorter than those in patients without hip involvement(P<0.01).BASMI,BASDAI,BASFI,and ASDAS-CRP in Patients with hip joint involvement were significantly greater than those in patients without hip involvement(P<0.01),and there was no statistical difference in weight,height,alcohol and tobacco history between the two groups(P>0.05).).In TCM syndrome differentiation,67(61.61%)patients with hip joint syndrome were identified as shenxuduhan syndrome 40(37.78%)were identified as shenxushire syndrome,and 119(79.86%)Patients without hip involvement were identified as shenxuduhan syndrome,30(20.13%)were identified as shenxushire syndrome;in the two groups,patients identified as shenxuduhan syndrome were more than patients identified as shenxusire syndrome,among which the ratio of shenxusire syndrome in patients with hip involvement was higher than that of in patients without hip involvement.The analysis of Professor XiaoPing Yan's PrescriPtion of Chinese herbal medicine:The basic drug combination is:buganshen qiangjingu drugs+huoxuehuayu drugs+jianPi drugs.The commonly used drugs are:Guizhi Chishao,Gusuibu Buguzhi,Chuandusan Sangjisheng,Chuanshanjia Qinjiao,Xiqiancao HaitongPi;Sangzhi Xuchangqing;most commonly used drugs:Chuanduan(91.89%),Sangjisheng(91.89%),Fangfeng(86.49%),Yuanhu(85.14%),Duhuo(84.46%).Gouji(80.41%),Qingfengteng(77.70%),Shenjin.chao(72.97%),Pianjianghuang(72.30%),and Sangzhi(70.95%).Conclusion:Hip involvement is an important cause of disability in ankylosing spondylitis.patients who have earlier the age of onset,longer duration of disease,are more likely to developed hip joint involvement.Patients with hip joint involvement are more likely to have family history and have more severe systemic ossification than those without hip involvement.Hip joint flexion,spinal flexion and chest expansion are superior in patients without hip involvement than those with hip involvement.In TCM syndrome differentiation,patients identified as Shenxuduhan syndrome is more than patients identified as Shenxushire syndrome.There 5 basic rules in Professor XiaoPing Yan's prescription of Chinese herbal medicine when treating AS. |
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