Research On The Correlation Between 25-hydroxyvitamin D And TCM Syndromes Of Active Rheumatoid Arthritis

Objective:To explore the correlation between 25(OH)D level and active TCM syndromes and disease activity index of RA in order to provide reference and basis for clinical treatment.Methods:A retrospective research method was used to collect and organize active rheumatoid arthritis patients admitted to the rheumatology department of Guang'anmen Hospital from September 2018 to December 2019.190 eligible RA patients were selected,and related data were collected and statistically analyzed.The main research items include:? general information:patient ID number,name,gender,age,course of disease;? clinical symptoms and signs;local symptoms and signs of joints,systemic symptoms;? laboratory and imaging tests:routine blood tests,C-Reactive protein(CRP),erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),25(OH)D,joint X-ray,joint ultrasound examination,dual-energy X-ray bone density,etc.? TCM syndrome typing,tongue coating,Pulse;? Others:DAS28(ESR),pain VAS score.Results:? A total of 190 patients were included in this study,including 162 women and 28 men,with a male to female ratio of 1:5.8.The maximum age was 86 years old,the minimum age was 19 years old,and the average age was 55.98 ± 12.79 years old.There were 67 cases in the 25(OH)D normal group and 123 cases in the abnormal group.The abnormal incidence rate of 25(OH)D was 64.7%.The statistical analysis of male and female 25(OH)D level P<0.05,female 25(OH)D level is lower than male.The level of 25(OH)D in each age group was statistically analyzed,P<0.05,the difference was statistically significant,and the level of 25(OH)D was lower in the group of age<45.?Comparison of clinical data of each syndrome type:The distribution of the number of cases of each syndrome type is:dampness and heat resistance>phlegm and blood resistance>deficiency syndrome group>wind,cold and dampness.In terms of the number of joint swellings,P<0.05 between the damp-heat bi-block and wind-cold damp bi-block,phlegm-stasis bi-block,and deficiency syndrome groups,the difference was statistically significant.The number of joint swelling in the deficiency syndrome group;in terms of the number of joint tenderness,P<0.05 between dampness and heat resistance,wind and cold dampness resistance,phlegm and blood stasis resistance,the difference is statistically significant,the number of joints with dampness and heat resistance is greater than that of wind and dampness resistance,Phlegm and blood stasis block joint tendermess;ln terms of PLT,P<0.05 between the damp-heat paralysis and deficiency syndrome groups,the difference was statistically significant.The damp-heat paralysis resistance had a higher PLT count than the deficiency syndrome group;in terms of CRP,the damp-heat paralysis resistance and wind-cold dampness resistance,phlegm and blood stasis P<0.05 between the resistance and deficiency syndrome groups,the difference is statistically significant,the dampness and heat paralysis resistance is higher than the wind cold dampness resistance,phlegm and blood stasis resistance,deficiency syndrome group CRP;P<0.05 between phlegm and blood stasis resistance,the difference was statistically significant,damp heat syndrome was faster than wind cold dampness resistance,phlegm stasis resistance blood sedimentation.In terms of DAS28(ESR),P<0.05 between the damp-heat paralysis and wind-cold damp paralysis,phlegm-stasis paralysis,and deficiency syndrome groups,the difference was statistically significant.The DAS28(ESR)score was higher in the syndrome group;in terms of pain VAS scores,P<0.05 between the wind-cold dampness-blocking and damp-heat-blocking and deficiency syndrome groups,the difference was statistically significant.Higher;the VAS score of the deficiency syndrome group is higher than that of wind,cold,dampness,and dampness;in the level of 25(OH)D,the difference between the dampness and heat resistance and the deficiency group is P<0.05,the difference is statistically significant,and the dampness and heat resistance is less than the deficiency syndrome Group 25(OH)D levels were lower.?Comparison of clinical data between 25(OH)D normal abnormal groups of different syndrome types:in terms of age,the comparison of damp heat syndrome block group P<0.05,the difference is statistically significant,the group with low 25(OH)D level is older than the normal group On the low side;in terms of disease course,the comparison between the phlegm and blood stasis and deficiency syndrome groups was P<0.05,the difference was statistically significant,and the group with low 25(OH)D level was shorter than the normal group.In terms of joint swelling,joint tenderness,RBC,and DAS28(ESR)scores,the comparison of damp heat syndrome between groups was P<0.05,the difference was statistically significant,and the number of joints swelling was lower in the group with low 25(OH)D level than the normal group More,more joint tenderness,lower RBC count,higher DAS28(ESR)score;in PLT,damp heat paralysis,deficiency syndrome group comparison P<0.05,the difference was statistically significant,25(OH)D The PLT count in the low-level group was higher than that in the normal group.?P<0.05 in the age,number of joint swelling,number of joint tenderness,RBC,PLT,DAS28(ESR)scores between 25(OH)D normal abnormal groups,the difference was statistically significant,25(OH)D<30 group age Smaller,more joint swelling and joint tenderness,lower RBC count,higher PLT count,and higher DAS28(ESR)score?Comparison of 25(OH)D with age,joint swelling,joint tenderness,RBC,PLT,DAS28(ESR),P<0.05,the difference was statistically significant.25(OH)D was negatively correlated with joint swelling,joint tenderness,PLT,DAS28(ESR).25(OH)D was positively correlated with age and RBCConclusions:1.RA patients generally have 25(OH)D deficiency,and the incidence of insufficient 25(OH)D levels is as high as 64.7%.2.There are gender and age differences in the level of 25(OH)D.The level of 25(OH)D in female and young patients is low.3.In the RA active period,the damp-heat paralysis type accounts for the largest proportion.The damp-heat paralysis type disease has a higher degree of activity,a heavier condition,and a lower 25(OH)D level.4.Damp-heat paralysis type 25(OH)D lower level group has more joint swelling and tenderness,lower RBC count,higher PLT count,higher DAS28(ESR)score and more serious disease.5.25(OH)D level is negatively correlated with RA disease activity,and can be used as an indicator of RA disease activity.6.25(OH)D deficiency is the combined effect of multiple factors,not a single factor.