The Effect Of Depression On TCM Syndrome Types Of Rheumatoid Arthritis

Objective:By studying the influence of depression on traditional Chinese medicine(TCM)syndromes of rheumatoid arthritis(RA),to explore the distribution characteristics of TCM syndromes and clinical indexes of RA patients with depression,and to provide an objective theoretical basis for syndrome differentiation and treatment of RA patients with depression.Methods:A total of 284 RA patients were selected as the study subjects.According to the Chinese Traditional Medicine Association's 2017 Guidelines for Diagnosis and Treatment of Rheumatoid Arthritis based on Combination of Disease and Syndrome,the TCM Syndrome Differentiation Standards.Depression assessment was performed using a self-rating depression scale(SDS)in each group of RA patients.Divided into no depression state,depression state.Collect general clinical data of RA patients and assessment of disease activing score in 28 joints(DAS28),modified health assessment questionnaire(MHAQ),visual analogue scale(VAS),rheumatoid factor detection(RF),anti-cyclic peptide containing citrulline(anti-CCP).Data analysis using SPSS 20.0 software.To explore the effect of depression on TCM syndromes in patients with RA and the distribution difference in age,gender,disease duration,educational background,employment status,DAS28,MHAQ,VAS scores,RF,anti-CCP antibody titers of RA patients with different TCM syndromes with or without depression status.Results:(1)The distribution of TCM syndromes in 284 RA patients were mainly sputum-stasis obstruction syndrome,a total of 63 cases,accounting for 22.20%of TCM syndrome types.(2)The prevalence of depression in RA patients was 41.90%.The distribution of TCM syndromes in RApatients with depression was sputum-stasis obstruction syndrome(34.50%)>qi-blood deficiency syndrome(16.00%)>liver and kidney deficiency Syndrome(14.30%)>damp-heat obstruction syndrome(9.20%)/qi-yin deficiency syndrome(9.20%)>cold-dampness syndrome(8.40%)>stagnation of blood stasis syndrome(5.00%)>rheumati sm obstruction syndrome(3.40%),mainly included sputum-stasis obstruction syndrome,qi-blood deficiency syndrome,liver and kidney deficiency syndrome.(3)There were no statistically significant differences in gender(x~2=13.297,P=0.065),age(x~2=3.351,P=0.851),and educational background(x~2=3.493,P=0.836)in different TCM syndromes.But the distribution of employment status(x~2=23.094,P=0.002)and depression status(x~2=22.070,P=0.002)was statistically significant.(4)The age of RA patients with different TCM syndromes with/without depression(except for sputum-stasis obstruction syndrome,P=0.070),duration of disease,DAS28 scores,MHAQ scores,VAS scores(except for rheumatism obstruction syndrome,P=0.069),RF titers,anti-CCP antibody titers were statistically significant.(5)The distribution of the educational background(x~2=44.396,P<0.001)and employment status(x~2=16.778,P<0.001)in patients with or without depression were statistically significant.But gender(x~2=1.264,P=0.261)in patients with or without depression was not statistically significant.(6)There was no significant difference in the distribution of depression/non-depression among different TCM syndromes of RA patients with college education or above(x~2=3.565,P=0.828),but there was significant difference in unemployment(x~2=20.828,P=0.004).Conclusions:(1)There was a difference in the distribution of depression in different TCM syndromes of RA patients.The distribution of RA patients with depression mainly includes sputum-stasis obstruction syndrome,qi-blood deficiency syndrome,and liver and kidney deficiency syndrome.(2)There were differences in age,duration,DAS28,MHAQ,VAS scores,RF and anti-CCP antibody titers distribution in different TCM syndromes of RA patients with or without depression.RA patients with depression have lower age,shorter course of disease,higher DAS28,MHAQ,VAS scores and higher titers of RF and anti-CCP.(3)The distribution of depression in RA patients with different education background and employment situation is different.The patients with depression have higher education background and are mostly unemployed.