Research On TCM Syndrome Law Of Systemic Sclerosis

Purpose:Through a retrospective analysis of clinical data of 78 patients with systemic sclerosis(SSc),the distribution characteristics of TCM syndromes in patients with systemic sclerosis and their correlation with general information,first symptoms,clinical manifestations,laboratory indicators,etc.were explored.Sex,to provide some evidence-based evidence for guiding the clinic.Method:Collect clinical data of inpatients with rheumatology and dermatology SSc from the affiliated hospital of Liaoning University of Traditional Chinese Medicine from January2013 to December 2019,strictly follow the inclusion and exclusion criteria,establish a database,conduct statistical analysis,and explore the distribution of different TCM syndrome types Regularity;observe the correlation between TCM syndrome types and general information,first symptoms,clinical manifestations,and laboratory tests.Results:1.Distribution of syndrome types: the frequency of cold dampness syndrome is the highest(51 / 65.38%),followed by lung and spleen Qi deficiency syndrome and spleen and kidney yang deficiency syndrome(8 / 10.26%),Damp-heat syndrome(6 / 7.69%),the frequency of phlegm,poisoning and stasis syndrome was the lowest(5 / 6.41%).2.Gender: Among the five syndrome types,there were 8 male patients and 70 female patients.The male-to-female ratio was 1: 8.75.There was no statistical significance in the gender of each syndrome type(P> 0.05).3.In terms of age and course of disease: In the age of onset,the majority of patients are 40-60 years old(44 / 56.41%);there is no statistical difference in age between the syndrome types(P> 0.05).There were statistical differences in the course of the disease(P <0.05).Cold dampness syndrome and spleen and kidney yang deficiency syndrome,cold dampness syndrome and lung and spleen Qi deficiency syndrome,dampness and heat syndrome syndrome and lung and spleen Qi deficiency syndrome,dampness and heat syndrome syndrome Compared with the spleen and kidney yang deficiency syndrome,there was astatistical difference(P <0.05).4.Clinical manifestations: In terms of the first symptoms,Raynaud's phenomenon is the most(59 / 75.6%),followed by skin tightening(17 / 21.8%);the various types have no statistical significance in the first symptoms(P> 0.05);In terms of symptoms and signs,the frequency of occurrence is joint muscle pain> joint tenderness> skin sclerosis> Raynaud phenomenon>joint swelling = unfavorable joint flexion and extension> limited tongue extension> restricted mouth opening> dysphagia = acid reflux / heartburn> weight loss> Flattened fingertips>shortened phalanx> fingertip ulcer = joint fever> skin atrophy> skin edema.Each type had statistical differences in terms of skin sclerosis,joint swelling,restricted mouth opening,and restricted tongue extension(P <0.05).Among the cold and dampness syndromes,there were statistics in the skin sclerosis group,joint swelling group,mouth opening limitation group,and tongue extension group compared with no skin sclerosis group,no jointless swelling group,no mouth opening limitation group,and no tongue extension group.The significance was statistically significant(P <0.05);the spleen-kidney yang deficiency syndrome in the presence of skin sclerosis group and dysphagia group was statistically significant compared with the group without skin sclerosis and no dysphagia group(P <0.05).5.System involvement: Pulmonary interstitial lesions are mostly involved(52 / 66.67%),and the skeletal and muscular system are secondly affected(48 / 61.54%);Each syndrome type has statistical significance in digestive system involvement and endocrine system involvement(P<0.05).Among them,the lung and spleen qi deficiency syndrome in the pulmonary hypertension group and the skeletal muscle system involvement group was statistically significant compared with the non-pulmonary hypertension group and the skeletal muscle system involvement group(P <0.05);cold dampness syndrome and damp heat syndrome syndrome The group with endocrine system involvement had statistical significance compared with the group without endocrine system involvement(P <0.05).6.The biochemical indicators(white blood cell count,hemoglobin,platelet count,AST,ALT,urea,creatinine),inflammatory indicators(ESR,CRP),immune indicators(Ig A,Ig M,Ig G,C3,C4),specific antibodies(Anti-Scl-70,ACA)was not statistically significant(P> 0.05).After correlation analysis,anti-Scl-70 antibody was correlated with pulmonary interstitial fibrosis(P <0.05),not related to pulmonary hypertension(P> 0.05);ACA antibody was notrelated to pulmonary interstitial fibrosis and pulmonary hypertension(P> 0.05).Conclusion:1.Distribution of TCM syndromes: cold and dampness obstruction syndrome> lung and spleen qi deficiency syndrome = spleen and kidney yang deficiency syndrome> dampness and heat obstruction syndrome> phlegm poisoning and stasis syndrome.2.The first symptom of this disease is mostly Raynaud's phenomenon,followed by hard skin;joint disease and respiratory system involvement are the most common;the age of onset is40-60 years old,women are higher than men;as the course of the disease prolongs,cold and dampness syndrome,dampness and heat Arthralgia syndrome is more likely to develop into syndromes of deficiency of lung and spleen qi and syndrome of deficiency of spleen and kidney yang.3.Clinical manifestations: cold dampness obstruction syndrome is prone to skin sclerosis and joint swelling;spleen and kidney yang deficiency syndrome is prone to swallowing difficulties.4.System involvement: PAH involvement is prone to appear in the syndrome of deficiency of lung and spleen Qi;endocrine system involvement is likely to occur in dampness-heat syndrome.5.There is no difference in laboratory indicators of each syndrome type;positive anti-Scl-70 antibody is a risk factor for pulmonary interstitial fibrosis.