| Objective:In this study,the incidence of anemia in rheumatoid arthritis patients in our hospital was studied to provide reference for the diagnosis of rheumatoid arthritis combined with anemia in our hospital.In this subject,general information,symptoms and signs,laboratory examination and other indicators were selected and compared between male and female anemia groups and non-anemia groups to find differences.The subject explores the correlation between hemoglobin and general information,symptoms and signs,laboratory examination and other indicators.Study the relationship between hemoglobin and general data,symptoms and signs,laboratory examination,Tradition Chinese Medicine syndromes in rheumatoid arthritis patients,so as to provide evidence for the prevention and treatment of rheumatoid arthritis with anemia by Tradition Chinese Medicine.Methods:Patients with rheumatoid arthritis were screened for inclusion criteria and exclusion criteria,and 253 clinical data of patients with rheumatoid arthritis who met the criteria were finally collected.This study retrospectively analyzed the clinical data of 253 patients with rheumatoid arthritis treated in Guang'anmen hospital from July 2018 to July 2019.The project collected clinical data of patients and established information base.The information base includes the following items:?general information:patient ID number,name,gender,age;?symptoms and signs:course of disease,number of joint swelling,number of joint tenderness,number of joint deformity,DAS28(CRP),data of four traditional Chinese medicine diagnosis;? laboratory examination:ESR,CRP,CCP,RF,WBC,RBC,Hb,MCV,MCH,MCHC,PLT,SF,TIBC,TRF,Fe,FOL,VB12,total protein,albumin,globulin.Firstly,the collected information was sorted into Excel,and then the simple statistics and chart drawing of the data were completed in Excel.Finally,the statistics software SPSS20.0 was used to collect the data.The data were divided into measurement data and counting data.T test and F test were used to compare the measurement data consistent with normal distribution.Non-parametric test was used for non-normal distribution data.The enumeration data were obtained by chi-square test or Fisher's exact probability method.Pearson correlation and Spearman rank correlation analysis were used for correlation analysis.P<0.05 was considered to be statistically significant.Results:1 General information:This study included 253 patients with rheumatoid arthritis.Among 253 patients with rheumatoid arthritis included in this study,38(15%)were males and 215(85%)were females.The prevalence rate of rheumatoid arthritis females was higher than that of males,and the prevalence rate of rheumatoid arthritis males and females was about 1:5.7.The oldest of all rheumatoid arthritis patients was 86 years old,the youngest rheumatoid arthritis was 20 years old,and the average age of the rheumatoid arthritis patients was 57.24 years old.In all age groups,the number of people over 60 years old is the largest,the number of people between 40 and 59 years old is the second,and the number of people between 20 and 39 years old is the least.Rheumatoid arthritis is most common in middle-aged and elderly women,with 87.7%of patients over 40 years old.The incidence of anemia in rheumatoid arthritis patients was 77.5%,and the incidence of anemia in females(79.1%)was higher than that in males(68.4%).2 Comparison of anemia group and non-anemia group in rheumatoid arthritis patients:2.1 Comparing the two group;male patients with rheumatoid arthritis between the anemia group and the non-anemia group,there was no statistical difference in age,course of disease,number of joint tenderness,number f joint deformity,WBC,PLT,MCV,SF,Fe,FOL,VB12,CCP,RF,total protein between the two groups(P>0.05);There were significant differences in the number of joint swelling,RBC,MCH,MCHC,TIBC,TRF,ESR,CRP,albumin and globulin between the two groups(P<0.05).RBC,MCH,MCHC,TIBC,TRF and albumin in the anemia group were all smaller than those in the non-anemia group;The number of joint swelling,ESR,CRP and globulin in the anemia group were all greater than those in the non-anemia group.2.2 Comparing the two group;female patients with rheumatoid arthritis between the anemia group and the non-anemia group,there was no statistical difference in the number of joint swelling,age,course of disease,WBC,FOL,VB12,CCP,globulin(P>0.05).There were significant differences in the number of joint tenderness,number of joint deformity,RBC,PLT,MCV,MCH,MCHC,SF,TIBC,TRF,Fe,ESR,CRP,RF,albumin,total protein between the two groups(P<0.05).The number of joint tenderness,joint deformity,PLT,ESR,CRP,RF,SF in the anemia group were greater than those in the non-anemia group.The RBC,MCV,MCH,MCHC,TIBC,TRF,Fe,albumin and total protein in the anemia group were all smaller than those in the non-anemia group.2.3 Comparison of Tradition Chinese Medicine syndromes in rheumatoid arthritis patients in anemia group and non-anemia group:According to?the guidelines for the combined diagnosis and treatment of rheumatoid rthritis syndrome?formulated in 2018,Tradition Chinese Medicine yndromes are divided into 8 syndromes:rheumatism bi syndrome,cold and wet bi syndrome,damp and hot bi syndrome,phlegm and blood stasis bi syndrome,static blood blocking syndrome,qi and blood deficiency yndrome,liver and kidney deficiency syndrome,qi and Yin deficiency syndrome.The four syndromes of rheumatism bi syndrome,cold and wet bi syndrome,phlegm and blood stasis bi syndrome,static blood blocking syndrome were less.When the data was analyzed,the four syndromes were combined to form the wind-cold-dampness and blood stasis group.At this time,it is necessary to make a statistical comparison between the five syndrome types of anemia group and non-anemia group,namely,damp and hot bi syndrome,wind-cold-dampness and blood stasis syndrome,qi and blood deficiency syndrome,liver and kidney deficiency syndrome,qi and Yin eficiency syndrome.?Among the five Tradition Chinese Medicine yndromes,the comparison of the incidence of anemia was as follows:damp and hot bi syndrome<wind-cold-dampness and blood stasis syndrome<liver and kidney deficiency syndrome<qi and Yin deficiency syndrome<qi and blood deficiency syndrome.?There was no statistical difference in age between the five syndromes anemia group and the non-anemia group(P>0.05).Among the five syndromes,only the course of disease of liver and kidney deficiency syndrome anemia group and non-anemia group was statistically different(P<0.05).The course of the anemia group with liver and kidney deficiency syndrome,qi and blood deficiency syndrome qi and Yin deficiency syndrome,wind-cold-dampness and blood stasis yndrome were all greater than that of the non-anemia group.The course of anemia group with damp and hot bi syndrome was less than that of the non-anemia group.There were statistically significant differences in the number of joint swelling,joint tenderness and joint deformity between the anemia group and the non-anemia group(P<0.05).There were tatistically significant differences in the number of joint alformations between the anemia group and the non-anemia group with qi and blood deficiency syndrome(P<0.05).The comparison of the number of joint swelling and joint tenderness between the wind-cold-dampness and blood stasis syndrome anemia group and the non-anemia group was tatistically significant(P<0.05).The number of joint swelling,joint tenderness and joint deformity in the anemia group were greater than those in the non-anemia group.The number of joint swelling in the anemia group with damp and hot bi syndrome was less than that in the non-anemia group.?There was no statistical difference in WBC between the five syndromes anemia group and the non-anemia group(P>0.05).The WBC of the anemia group was higher than that of the non-anemia group except the damp and hot bi syndrome.Except for the qi and blood deficiency syndrome,there were statistically significant differences between RBC groups in the other four syndrome groups(P<0.01).The RBC of the anemia group were all smaller than those of the non-anemia group.There were statistically significant differences between the groups of qi and blood deficiency syndrome and wind-cold-dampness and blood stasis syndrome(P<0.05).The MCV of anemia group was lower than that of non-anemia group.Except for liver and kidney deficiency syndrome,there were statistically significant differences in MCH between the anemia group and the non-anemia group(P<0.01).MCH in the non-anemia group was greater than that in the anemia group.There were statistically significant differences in MCHC between the five syndrome groups(P<0.05),and MCHC in the anemia group was smaller than that in the non-anemia group.There were statistically significant differences in the PLT between the anemia group and the non-anemia group in the damp and hot bi syndrome and qi and Yin deficiency syndrome(P<0.05).The PLT of anemia group was higher than that of non-anemia group.?Except for damp and hot bi syndrome,there were statistically significant differences in SF between the anemia group and the non-anemia group(P<0.05).The SF of the non-anemia group was lower than that of the anemia group.Among the five syndromes,only the TIBC group with damp and hot bi syndrome had a statistical difference(P<0.01),and the TIBC of the five syndromes anemia group was all smaller than that of the non-anemia group.There were tatistically significant differences in TFR between the anemia group and the non-anemia group in damp and hot bi syndrome,qi and Yin deficiency syndrome,wind-cold-dampness and blood stasis syndrome(P<0.05).The TFR of the five syndromes group in the non-anemia group was higher than that of the anemic group.There were statistical differences in Fe in damp and hot bi syndrome,liver and kidney deficiency syndrome,and wind-cold-dampness and blood stasis syndrome(P<0.01).Fe in the non-anemia group was greater than that in the anemia group.There was no statistical difference between FOL and VB12 in the five syndromes(P>0.05).The FOL of the anemia group with qi and blood deficiency syndrome was smaller than that of the on-anemia group,and the FOL of the other four syndromes were larger than that of the non-anemia group.The VB12 of damp and hot bi syndrome and wind-cold-dampness and blood stasis syndrome anemia group was less than that of non-anemia group.VB12 in qi and blood deficiency syndrome,liver and kidney deficiency syndrome,qi and Yin deficiency syndrome of anemia group was greater than that of non-anemia group.?Except for qi and blood deficiency syndrome,there were statistically significant differences among the ESR groups of the other four syndrome groups(P<0.01).The ESR of the non-anemia group in the five syndromes group was all smaller than that in the anemia group Except the qi and Yin deficiency syndrome,there were statistically significant differences among CRP groups in the other four syndrome groups(P<0.01).In the five Tradition Chinese Medicine syndromes groups,the CRP of non-anemia group was smaller than the anemia group.Through statistical analysis,CCP and RF in the five syndromes group were not statistically significant.?The total protein and globulin in the five syndromes group were not statistically significant.The total protein of the five Tradition Chinese Medicine syndromes of non-anemia group was greater than that of the anemia group,and the globulin of the five Tradition Chinese Medicine syndromes of non-anemia group was smaller than that of the anemia group.Except for the qi and blood deficiency syndrome,there were statistically significant differences among the four other syndrome groups among the albumin group(P<0.05).Among the five Tradition Chinese Medicine syndrome groups,the albumin of non-anemia group was greater than that of the anemia group.2.4 The correlation between HB and index:There was no correlation between HB and age,WBC,CCP(P>0.05)?HB was negatively correlated with the course of disease,number of joint swelling,number of joint enderness,number of joint deformity,PLT,globulin,DAS28(CRP),ESR,CRP and RF(P<0.05).HB was positively correlated with RBC,total protein and albumin(P<0.05).Conclusion:1 The incidence of anemia in rheumatoid arthritis patients in our hospital is 77.5%,and the incidence of anemia in females(79.1%)is higher than that in males(68.4%).2 Hemoglobin level is related to rheumatoid arthritis activity and inflammatory response.When Chinese medicine is used to treat rheumatoid arthritis patients complicated with anemia,it is necessary to use Chinese medicine for dispelling wind and dampness in a reasonable way so as to achieve the aim of treating both the sympotoms and root causes.3 Comparison of the incidence of anemia in Tradition Chinese Medicine syndromes:damp and hot bi syndrome<wind-cold-dampness and blood stasis syndrome<liver and kidney deficiency syndrome<qi and Yin deficiency syndrome<qi and blood deficiency syndrome.4 Platelets tend to accumulate more easily in anemia.Therefore,Chinese medicine should use the method of activating blood circulation to remove blood stasis and produce new blood.5 Rheumatoid arthritis patients with anemia often have low albumin,so the selection of medicine in traditional Chinese medicine should onsider the digestion and absorption function of spleen and stomach. |
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