Study On The Characteristics Of TCM Syndromes In Systemic Lupus Erythematosus

Purpose : The general data,clinical manifestations,laboratory indicators and TCM syndrome types of patients with Systemic lupus erythematosus(SLE)were collected.The correlation between TCM syndrome types of SLE and clinical data was analyzed by statistical methods,and the TCM syndrome characteristics of SLE were summarized,aiming at exploring new ideas and methods of TCM syndrome differentiation of SLE and providing evidence-based basis for clinical syndrome differentiation and treatment.Material and method:The data of SLE inpatients in the Department of Rheumatology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from October2014 to September 2020 were collected,and the cases were screened strictly according to the inclusion and exclusion criteria.Excel was used to establish SLE patient case information database,SPSS 25.0 was used to analyze and summarize the database,and the distribution characteristics of TCM syndrome types in general data,clinical manifestations,laboratory indicators and other aspects were explored,and finally a conclusion was reached.Results:1.General situation:(1)Among 176 SLE patients,the distribution of syndrome types is as follows: Deficiency of both qi and blood(54/30.68%)>Yin deficiency and internal heat syndrome(39/22.16%)>Rheumatic arthralgia syndrome(25/14.20%)>Spleen and kidney yang deficiency syndrome(23/13.07%)> Yin deficiency of liver and kidney(18/10.23%)> Excessive heat toxin(9/5.11%)>Syndrome of stagnation of blood stasis and heat(8/4.55%).(2)There were 161 females and 15 males,the ratio of male to female was 1:10.73,and there was no statistical difference among different syndromes(P>0.05).(3)The onset age of Yin deficiency of liver and kidney is the oldest,which is statistically different from that of Yin deficiency and internal heat,deficiency of both qi and blood,and deficiency of spleen and kidney yang(P<0.05),and is significantly different from that of stagnation of heat and rheumatism(P<0.01).There was no statistical difference in the course of disease among the syndrome types(P>0.05).2.Clinical manifestations:(1)Initial symptoms: joint swelling and pain(55/31.25%)> fever(39/22.16%)> skin erythema(36/20.45%)> fatigue(28/15.91%)> edema(13/7.39%)> alopecia(5/2.84%).(2)Incidence of common clinical manifestations: fatigue(76.70%)> joint swelling and pain(73.30%)> skin erythema(66.48%)> fever(57.95%)> alopecia(49.43%)> oral ulcer(31.82%)> edema(29.55%)> photosensitivity(26.14%)> loose stool(17.61%)> dry mouth and sore throat(14.77%).87.5% of the syndrome of blood stasis and heat obstruction appeared oral ulcer and skin erythema;79.49% of yin deficiency and internal heat syndrome showed fever;43.48% of spleen and kidney yang deficiency syndrome showed edema and loose stool;Dry mouth and sore throat occurred in 33.33% of cases with excessive heat toxin.There is statistical difference(P<0.05).In other clinical manifestations,there was no statistical difference among different syndromes(P>0.05).3.Laboratory indicators:(1)In WBC,the WBC of excessive heat-toxin syndrome is the lowest,with statistical significance(P<0.05).In HGB,deficiency of both qi and blood is the lowest,and deficiency of liver and kidney yin is the highest,with significant difference(P<0.01).In PLT,the syndrome of excessive heat toxin is the lowest,which is significantly different from the syndrome of yin deficiency of liver and kidney and rheumatism(P<0.01).(2)The positive rate of urine protein was significantly different(P<0.01),and the highest rate was spleen and kidney yang deficiency syndrome(86.96%).(3)The ALT of stasis-heat obstruction syndrome is the highest,with statistical significance(P<0.05);AST of yin deficiency and internal heat syndrome is the highest,while spleen and kidney yang deficiency syndrome is the lowest,with statistical difference(P<0.05).GLOB is the highest in the syndrome of excessive heat toxin,followed by the syndrome of yin deficiency and internal heat,which is significantly different from the syndrome of deficiency of both qi and blood and deficiency of spleen and kidney yang(P<0.01).There was no statistical difference among the syndrome types in albumin,urea,creatinine and blood lipid(P>0.05).(4)The ESR and CRP of the syndrome of excessive heat and toxin are the highest,while the ESR and CRP of the syndrome of deficiency of both qi and blood are the lowest,and the difference between the two syndromes is statistically significant(P<0.05).(5)There were statistical differences in anti-ds-DNA antibodies among the seven syndromes(P<0.05),and the positive rate of spleen and kidney yang deficiency syndrome was the highest(65.22%),followed by heat toxin(55.56%).There was no statistical difference in other related antibodies and immune function(P>0.05).4.SLEDAI score: the score of excessive heat toxin syndrome is the highest,followed by spleen and kidney yang deficiency syndrome,which is significantly different from qi and blood deficiency syndrome(P<0.01).Conclusion:1.Deficiency of liver and kidney yin is common in senile SLE.2.The syndrome of stagnation of heat and blood stasis is more prone to skin erythema and oral ulcer;Yin deficiency and internal heat syndrome are more prone to fever symptoms;The syndrome of excessive heat toxin is more prone to dry mouth and sore throat;Spleen and kidney yang deficiency syndrome is more prone to edema and loose stool.3.WBC and PLT are more likely to decrease and GLOB and ESR are more likely to increase in excess of heat toxin.Deficiency of both qi and blood is more likely to cause HGB decrease.Spleen and kidney yang deficiency syndrome is more prone to urine protein and anti-ds-DNA antibody positive;ALT elevation is more likely to occur in blood stasis and heat obstruction syndrome;AST elevation is more likely to occur in yin deficiency and internal heat syndrome.4.The active stage of illness is more likely to be manifested as the excess of heat and toxin and the deficiency of spleen and kidney yang.