主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2020, Vol. 43 ›› Issue (1): 79-83.doi: 10.3969/j.issn.1006-2157.2020.01.014

• 临床研究 • 上一篇    下一篇

类风湿关节炎中医证候、证素分布的临床研究*

柳玉佳, 王莘智, 旷惠桃, 范伏元#   

  1. 湖南中医药大学第一附属医院 湖南 410007
  • 收稿日期:2019-09-12 发布日期:2020-02-21
  • 通讯作者: 范伏元,男,硕士,教授,主任医师,博士生导师,主要研究方向:中医内科临床,E-mail:ffy023@163.com
  • 作者简介:柳玉佳,男,硕士,主治医师
  • 基金资助:
    *国家自然科学基金资助项目(No.81403206),全国名老中医药专家传承工作室资助项目(No.GZYYRJF-201420),长沙市科技厅资助项目(No.K1508015-31),湖南中医药大学科研基金资助项目(No.2018XJJJ41)

Distribution of patterns and pattern elements in rheumatoid arthritis*

Liu Yujia, Wang Shenzhi, Kuang Huitao, Fan Fuyuan#   

  1. The First Hospital of Hunan university of Chinese Medicine, Hunan 410007, China
  • Received:2019-09-12 Published:2020-02-21
  • Contact: Prof. Fan Fuyuan, master, professor, Chief Physician, Doctoral Supervisor, The first hospital of Hunan university of Chinese Medicine, No.95 Shaoshan Road, Yuhua District Changsha City, Hunan 410007, China. E-mail: 605796782@qq.com
  • Supported by:
    National Natural Science Fund of China (No.81403206), Construction Project of Famous and Old Physicians of Traditional Chinese Medicine in China (No.GZYYRJF-201420)

摘要: 目的 通过流行病学调查的方法,对类风湿关节炎证候、证素的分布规律进行归纳总结,为类风湿关节炎的诊断和规范化治疗提供切实可靠的依据。方法 收集湖南中医药大学第一附属医院2016年5月至2017年12月风湿病科住院及门诊病人,对纳入的患者进行证候分析及证素提取,并分析其临床特点。结果 217例类风湿关节炎患者共得到证候12种,分解为病位证素5项和病性证素10项。常见临床证候由高到低依次为肝肾亏虚、湿热痹阻、寒湿痹阻、气血两虚、痰瘀痹阻、寒热错杂、风湿痹阻和气阴两虚,病位证素由高到低依次为经络、肾、肝、脾和表,病性证素由高到低依次为湿、热、寒、气虚、血虚、血瘀、痰、风、阴虚和阳虚。结论 肝肾亏虚、湿热痹阻、寒湿痹阻为类风湿关节炎的常见证候,经络、肾、肝、湿、热、寒为常见证素,建立以证素为核心的辨证体系,在类风湿关节炎临床诊治中可以起到执简驭繁的作用。

关键词: 类风湿关节炎, 证候, 证素, 临床研究

Abstract: Objective To provide a reliable basis for the diagnosis and standardized treatment of rheumatoid arthritis by summarizing its patterns and pattern elements. Methods Cases of the inpatients and outpatients from May 2016 to December 2017 in the rheumatology department of the First Hospital of Hunan University of Chinese Medicine were collected, and the included cases were analyzed for pattern analysis and pattern element extraction, and their clinical characteristics were analyzed. Results A total of 12 patterns were obtained in 217 patients diagnosed as rheumatoid arthritis, which were divided into 5 pattern elements of disease locations and 10 pattern elements of disease characters. Clinical common patterns from high to low were liver-kidney deficiency, dampness-heat obstruction, cold-dampness obstruction, qi-blood deficiency, phlegm and blood stasis obstruction, cold-heat complex, wind-dampness obstruction, qi-yin deficiency, pattern elements of disease locations from high to low were meridians and channels, kidney, liver, spleen, superficies, and pattern elements of disease characters from high to low were dampness, heat, cold, qi deficiency, blood deficiency, blood stasis, phlegm, wind, yin deficiency, yang deficiency. Conclusion Liver-kidney deficiency, dampness-heat obstruction, cold-dampness obstruction are the common patterns of rheumatoid arthritis; and meridian, kidney, liver, dampness, heat, cold are the common pattern elements. Establishing pattern differentiation system with pattern elements as the core could play a role of controlling complexity in clinical diagnosis and treatment of rheumatoid arthritis.

Key words: rheumatoid arthritis, patterns, pattern elements, clinical research

中图分类号: 

  • R255.6