Research On TCM Syndrome Of Rheumatoid Arthritis Complicated With Pulmonary Interstitial Changes

Purpose:To explore the relationship between rheumatoid arthritis(RA)and interstitial Lung disease(ILD)and TCM syndrome types,general conditions,clinical manifestations and laboratory indicators,and to explore the pathogenesis of RA-ILD in Chinese medicine.And effective diagnosis and treatment strategies provide an objective basis for clinical prevention,early diagnosis,accurate syndrome differentiation and effective treatment.Material and method:Retrospective analysis of 244 hospitalized patients with rheumatology in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from August 2017 to October 2018.According to the Western diagnostic criteria of RA-ILD,patients were divided into RA-NILD group and RA-ILD group.According to the Chinese Traditional Medicine Association's group standard "Guidelines for the diagnosis and treatment of rheumatoid arthritis syndrome" issued by the Chinese Academy of Traditional Chinese Medicine Rheumatology Branch in July 2017,the syndrome differentiation is rheumatoid arthritis syndrome,cold dampness syndrome,damp heat.There are 8 syndromes of phlegm block,phlegm block,blood stasis syndrome,qi and blood deficiency syndrome,liver and kidney deficiency syndrome,and qi and yin deficiency syndrome[1].Exploring the probability of different TCM syndromes combined with ILD;combining traditional Chinese medicine syndrome with modern serology and other factors by statistical methods;observing the general situation,clinical manifestations and serological indicators of RA-NILD group and RA-ILD group Differences between the two-handed X-ray grading,etc.;and the CT findings and results of the patient's chest were collected.Results:There were significant statistically significant differences in the probability of combined ILD between 8 patients with T-type syndrome(P<0.01).The incidence of each syndrome was as follows: rheumatism and stasis syndrome was 16.70%,cold and dampness was 26.30%,and dampness and heat resistance was 26.80%,phlegm stasis syndrome 51.90%,blood stasis syndrome 25.00%,qi and blood deficiency syndrome 33.30%,liver and kidney deficiency syndrome 52.60%,Qiyin deficiency syndrome 83.30%.Comparing the two groups,the incidence of ILD in Qi and Yin deficiency syndrome is higher than that of rheumatoid arthritis syndrome,cold dampness syndrome,dampness and heat stasis syndrome,blood stasis syndrome,qi and blood deficiency syndrome,and there are statistical differences(P<0.05);the incidence of ILD in liver and kidney deficiency syndrome was higher than that of rheumatoid arthritis syndrome,cold dampness syndrome,dampness and heat stasis syndrome,blood stasis syndrome,qi and blood deficiency syndrome,all of which were statistically significant(P<0.05);the incidence of ILD in phlegm and blood stasis syndrome is higher than that of rheumatoid arthritis syndrome,cold dampness syndrome,dampness and heat stasis syndrome,blood stasis syndrome,qi and blood deficiency syndrome,and there are statistical differences(P < 0.05).There were no significant differences between the three types of syndromes of qi and yin deficiency,liver and kidney deficiency and phlegm resistance(P>0.05).There were significant differences in gender,age of onset,smoking,morning stiffness,clinical manifestations,inflammatory markers ESR,CRP,activity index DAS28 scores,and autoantibody CCP levels between the RA-NILD group and the RA-ILD group(P< 0.05);There was no significant difference between the two groups(P>0.05).Conclusion:The syndromes of Qi and Yin deficiency,liver and kidney deficiency syndrome,and phlegm and stasis syndrome may be more likely to be associated with the onset of ILD.The older the age of onset of RA,the history of smoking,the longer the morning stiffness,and the more clinical manifestations.For the serious,laboratory indicators ESR,CRP,CCP and activity indicators DAS28 higher the easier to merge with ILD;qi and yin deficiency syndrome at the same time there is a rise in CCP and smoking situation RA patients with a significant increase in the probability of ILD;The status of syndromes in RA syndrome differentiation;regular early examination of pulmonary CT contributes to the early diagnosis and effective treatment of RA-ILD,thereby improving the quality of life of patients.