Study On The Syndrome And Treatment Characteristics Of Rheumatoid Arthritis Complicated With Intestinal Flora Imbalance

Objective:Through the methods of epidemiological investigation,patients with rheumatoid arthritis and intestinal disorder would be treated reasonably.Then to study their syndrome distribution rules,clairy the connection between dieases and the gender condition,joints symptoms,inflammation of the joints and the proportion of intestinal flora.Methods:The patients from rheumatology department and gastrology department of The First Hospital of Hunan University of Chinese Medicine in January 2019-November 2020,who conform to the diagnostis criteria,referencing to the national standard of the People's Republic of China,we will specification of the syndrome differentiation type name,and accroding to the records,getting the messages such as the gender condition,joints symptoms,inflammation of the joints and the proportion of intestinal flora.In the end,we using the SPSS 21 to analyze the distribution rules of TCM syndromes in patients with rheumatoid arthritis complicated with intestinal flora imbalance.Results:1.There were 60 patients with rheumatoid arthritis and intestinal disorder,,and we can see 5 common types of TCM syndromes now,from high to low were damp-heat syndrome(16 cases),cold-dampness syndrome(15 cases),deficiency of spleen and stomach sydrome(11 cases),liver-stagnation and spleen-deficiency syndrome(10 cases),and mixed cold and heat syndrome(8 cases).2.Analyses of 5 groups in general condition:(1)Course of disease: The results showed the differences between groups were statistically significant(P<0.05),and the were connection between disease and TCM syndrome classification.Deficiency of spleen and stomach sydrome were more longest,which course of diseas continued more than 5 years,and mixed cold and heat syndrome were shortest with only less than a year.Others were form 2 to5 years.(2)Age:There was no significant difference in the composition ratio of syndromes with different age groups(P>0.05),and age had no significant significance for the distribution of traditional Chinese medicine syndromes at present.(3)Gender:male:Female was equal to 1:3,which was the same as the rate of rheumatoid arthritis.We found that there were significant differences in the composition ratio of male and female among all syndromes(P<0.05).There were more females than males in each syndrome,and the syndrome of liver-stagnation and spleen-deficiency syndrome was only found in female patients,which was closely related to the hormone level in the female body at this age.3.Analyses of 5 groups in serological indicator(CRP and ESR):The distribution of TCM sydrome and ESR were not obvious significant difference(P>0.05),but with CRP,we can see significant difference(P<0.05),which could be that CRP had a more closely relationship with inflammatory activity,and compared to ESR,CRP was less affected by factors such as anemia,high globulin hematic disease,it reflect the situation of the disease more accurately.4.Analyses of 5 groups in inflammation of the joints: The number of joint pain,the number of joint swelling,DAS28-ESR,DAS28-CRP and other typical clinical symptoms were statistically analyzed,which was found that these two clinical indicators had no significant statistical significance(P>0.05).Only DAS28-CRP and the number of joint swelling have significant difference in distribution rules of TCM sydrome(P < 0.05).5.Analyses of 5 groups in the proportion of intestinal flora: Through taking fresh dung for patients with bacterial culture and identification,we found that the difference between gram positive bacillus ratio(%)and gram negative bacillus ratio(%)don't have obvious significance(P>0.05),while the gram positive coccus ratio(%)was statistically significant with the distribution of TCM syndrom.It could't exclude the imbalance of gram positive coccus ratiom more obvious for patients with rheumatoid arthritis and intestinal disorder,and which maybe that positive cocci can produce a variety of toxin including hemolytic element,and possessing extremely strong pathogenic sex.Once the ratio imbalance can rapidly lead to pathological changes associated.Conclusion:1.There were 5 types of TCM syndromes of rheumatoid arthritis and intestinal disorder,and their distribution was correlated with disease course,sex,CRP,DAS28-CRP and gram positive coccus ratio.2.There was no significant correlation between the distribution of TCM sydrome and age,the score of inflammation of the joints?ESR and bacillus ratio in rheumatoid arthritis and intestinal disorder.