Analysis Of The Syndrome And Treatment Rules Of Systemic Sclerosis And The Clinical Characteristics Of Related Interstitial Lung Change

Purpose:Through retrospective analysis of the patient’s medical records,the TCM pathogenesis and diagnosis and treatment methods of systemic sclerosis were explored,and the clinical characteristics and related risk factors of pulmonary interstitial changes related to systemic sclerosis were studied,providing a basis for further research and clinical treatment.Material and method:The TCM syndromes,TCM prescriptions,basic information,clinical symptoms and laboratory indicators of patients with systemic sclerosis in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from May 2012 to June 2021 and in the outpatient department of rheumatology from January 2020 to June 2021 were collected using Microsoft Excel and SPSS Modeler 18.0,SPSS Statistics 23.0 Conducted frequency analysis of basic situation,clinical symptoms,syndromes,syndrome elements,drugs and sexual and taste regression,conducted clustering and association rule analysis of high-frequency drugs,and performed visual display of association rules using Cytoscape.The measurement data of SSc-ILD and SSc-NILD were compared by two independent sample T test,and the count data were analyzed by Chi-square test and multivariate Logistic regression analysis.Results:1.Male SSc patients:Female ≈1:5,the onset age was 52.05±14.11 years old,there was no statistical difference in the incidence of patients throughout the year(P=0.311 > 0.05),There was statistical difference in incidence between different solar terms(P=0.011 < 0.05)2.The first symptom of SSc patients is joint swelling and pain,and skin sclerosis is the most common clinical change.In terms of complications,SSc is more likely to be associated with respiratory diseases.3.Syndrome type analysis showed that cold and dampness obstruction was the most common syndrome.4.Analysis of syndromes showed that blood stasis was the most common syndromes in SSc.5.The commonly used TCM flavor of SSc is mainly sweet and warm,and the meridian of SSc is mainly in liver,lung and spleen.The drug effect is mainly tonic for deficiency,and Glycyrrhiza has the highest frequency.6.A total of 12 association rules were obtained from high-frequency drug association analysis,among which the correlation degree of Glycyrrhiza-Pinellia was the highest.7.Cluster analysis showed four effective prescriptions,namely C1: Aconiti lateralis radix praeparata,zingiberis rhizoma,cinnamomi ramulus and atractylodis macrocephalae rhizoma;C2: Radix angelicae pubescentis,ephedra herb,achyranthis bidentatae,notopterygium,radix aconiti,radix paeoniae rubra and astragali radix;C3: Angelica sinensis,chuanxiong rhizome,radix rehmanniae praeparata,flos carthami,persicae semen,spatholobi caulis,salvia miltiorrhiza and rehmannia radix;C4: Glycyrrhiza,paeoniae radix alba,poria,citri reticulatae pericarpium,coicis semen,atractylodis rhizoma and radix scutellariae.8.Compared with SSc-NILD and SSc-ILD,in terms of initial symptoms,SSc patients with initial symptoms of Reynolds phenomenon were more likely to have ILD,the difference was statistically significant(P= 0.037,P < 0.05).9.Compared with SSc-NILD and SSc-ILD,in terms of clinical symptoms,SSc-ILD was more prone to cough and expectoration symptoms,the difference was statistically significant(P=0.029,P < 0.05).10.Compared with SSc-NILD and SSc-ILD,in terms of complications,SSc-ILD was more likely to be complicated with osteoporosis,the difference was statistically significant(P=0.019,P < 0.05).11.In terms of laboratory indicators,the proportion of ESR and SCL-70 abnormalities in the SSc-ILD group was significantly higher than that in the SSc-NILD group,with statistical significance(P < 0.001).12.Logistic regression results showed that ESR,SCL-70 antibody,first-onset Raynaud’s phenomenon and osteoporosis were related to the occurrence of SSc-ILD.Conclusion:1.Among the 92 patients,the male to female ratio was 1:5.Middle-aged and elderly patients were mainly affected,and lung was the most frequently involved organ.2.Blood stasis is the main pathological factor of systemic sclerosis,According to the efficacy analysis of Chinese medicine the deficiency may be the basis of its morbidity.3.Clustering new formula Ⅰ: Aconiti lateralis radix praeparata,zingiberis rhizoma,cinnamomi ramulus and atractylodis macrocephalae rhizoma are suitable for cold dish,The spleen and kidney Yang deficiency,joint cramps,tight skin and cold.4.Clustering new formula Ⅱ: Radix angelicae pubescentis,ephedra herb,achyranthis bidentatae,notopterygium,radix aconiti,radix paeoniae rubra and astragali radix are mainly suitable for the treatment of cold dampness and blood stasis,mainly for the treatment of joint symptoms.5.New clustering formula Ⅲ: Angelica sinensis,chuanxiong rhizome,radix rehmanniae praeparata,flos carthami,persicae semen,spatholobi caulis,salvia miltiorrhiza and rehmannia radix are suitable for SSc patients with blood stasis and collateral obstruction.6.Clustering new formula Ⅳ:Glycyrrhiza,paeoniae radix alba,poria,citri reticulatae pericarpium,coicis semen,atractylodis rhizoma and radix scutellariae are suitable for skin swelling,joint swelling and pain caused by dampness and heat trapped spleen,accompanied by cough and sputum.7.The initial symptoms were Raynaud’s phenomenon,combined with osteoporosis,elevated ESR and positive SCL-70 which were associated with SSc-ILD.