Correlation Between Sleep Quality And TCM Syndrome Types In Patients With Rheumatoid Arthritis

Objective:By studying and exploring the distribution characteristics of sleep quality in in different TCM syndrome types and laboratory indicators in patients with rheumatoid arthritis,to provide a reference for the diagnosis and treatment of RA patients with sleep quality problems.Methods:According to the diagnostic criteria and inclusion and exclusion criteria,208RA patients were selected as the study objects.The Pittsburgh Sleep Quality Index was used to evaluate whether they were accompanied with sleep quality problems.Collect general clinical data and visual analogue scores（VAS）,assessment of disease activing score in 28 joints（DAS28）.Collect laboratory indicators including erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,rheumatoid factor（RF）,anti cyclic peptide containing peptide（anti CCP）.Statistical analysis was conducted through SPSS 25 to discuss the distribution characteristics of sleep quality in TCM syndromes of RA patients.The distribution characteristics of gender,age,course of disease,education,employment,VAS score,DAS28_（ESR）,RF,anti-CCP titer in different TCM syndromes of RA patients with or without sleep quality problems,the independent influencing factors of sleep quality.Results:（1）The distribution of TCM syndromes in 208 RA patients was mainly based on sputum-stasis obstruction syndrome,a total of 56 cases,accounting for 26.92%of TCM syndromes.（2）In this study,the incidence of RA patients with sleep quality problems was58.65%,The distribution of TCM syndrome types according to the composition ratio was sputum-stasis obstruction syndrome（26.92%）>cold-dampness syndrome（15.38%）>damp-heat obstruction syndrome（11.06%）>liver and kidney deficiency Syndrome（10.10%）>rheumatism obstruction syndrome（9.62%）/stagnation of blood stasis syndrome（9.62%）/qi-yin deficiency syndrome（9.62%）>qi-blood deficiency syndrome（7.69%）.mainly included sputum-stasis obstruction syndrome,cold-dampness syndrome,damp-heat obstruction syndrome.（3）There was no significant difference in age（?²=22.558,P=0.058）,gender（?²=8.930,P=0.258）and educational background（?²=8.390,P=0.299）of RA patients with different TCM syndrome types,but there was significant difference in sleep quality（?²=27.473,P<0.001）.（4）The age and DAS28_（ESR）scores of patients with different TCM syndromes of RA with or without sleep quality problems were statistically significant.There was no statistically significant difference in the course of disease,pain VAS score（except cold-dampness syndrome,P=0.020）,RF（except cold-dampness syndrome,P=0.007）and the titers of anti-CCP.（5）There was a statistically significant difference in the distribution of sleep quality among RA patients in different employment situations（?²=10.856,P=0.001）.There were no statistically significant differences in different educational backgrounds（?²=2.988,P=0.224）and different genders（?²=1.540,P=0.215）.（6）DAS28_（ESR）scores were independent influencing factors of RA with/without sleep quality problems.Conclusions:（1）There are differences in the distribution of sleep quality problems in RA patients with different TCM syndromes.The distribution of RA patients with sleep quality problems is mainly based on the syndrome of sputum-stasis obstruction syndrome,cold-dampness syndrome,damp-heat obstruction syndrome.（2）There are differences in the age and DAS28_（ESR）score distribution of RA patients with different TCM syndromes with or without sleep quality problems.RA patients with sleep quality problems are older and have higher DAS28_（ESR）scores.（3）DAS28_（ESR）score is an independent factor influencing sleep quality problems in RA patients.The higher the disease activity,the greater the possibility of sleep quality problems.