Classifying rheumatoid arthritis by Traditional Chinese Medicine Zheng: a multi-center cross-sectional study
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摘要
OBJECTIVE:To assess the relationship between disease symptoms and traditional Chinese medicine(TCM)syndrome(Zheng)in rheumatoid arthritis(RA)patients.METHODS:RA Patients were recruited in Guang'anmen Hospital,China Academy of Chinese Medical Sciences and in the Second Affiliated Hospital of Zhejiang Chinese Medical University,and diagnosed with a particular RA Zheng from their symptoms.Demographic characteristics,self-reported symptoms,and blood samples were collected from patients.All data were input into EpiData and analyzed using SPSS software.RESULTS:The study included 302 RA patients(age range:18-86 years).All patients were Chinese,and 85.1%were women.Cold and fatigue triggers were reported by 8.6% of patients,followed by triggers such as childbirth(4.3%),cold(3.0%),dampness(2.0%),menopause(1.3%),and psychentonia(0.7%).The most prevalent Zheng was dampness and heat blockage(Shire Yuzu in Chinese,SRYZ),diagnosed in 39.4% of patients(119),followed by phlegm and stagnation blockage(Tanyu Bizu,TYBZ)in 21.5%,liver and kidney deficiency(Ganshen Buzu,GSBZ)in 18.5%,dual deficiency of Qi and blood(Qixue Liangxu,QXLX)in 9.6%,cold and dampness blockage(Hanshi Bizu,HSBZ)in6%,and wind and dampness blockage(Fengshi Bizu,FSBZ)in 5%.Increased length of time since RA diagnosis was associated with the GSBZ group.Patients diagnosed with the SRYZ Zheng had the highest disease activity score.Patients diagnosed with the QXLX Zheng had the lowest blood platelet counts; patients diagnosed with the QXLX and HSBZ Zhengs had lower C-reactive protein levels and lower health assessment questionnaire scores.Patients diagnosed with the GSBZ and QXLX Zhengs had the highest health assessment questionnaire scores.CONCLUSION:The specific Zheng was related to RA characteristics.The findings suggest that eliminating dampness,cooling the patient,and promoting blood circulation may assist in treating severe RA.
OBJECTIVE:To assess the relationship between disease symptoms and traditional Chinese medicine(TCM)syndrome(Zheng)in rheumatoid arthritis(RA)patients.METHODS:RA Patients were recruited in Guang'anmen Hospital,China Academy of Chinese Medical Sciences and in the Second Affiliated Hospital of Zhejiang Chinese Medical University,and diagnosed with a particular RA Zheng from their symptoms.Demographic characteristics,self-reported symptoms,and blood samples were collected from patients.All data were input into EpiData and analyzed using SPSS software.RESULTS:The study included 302 RA patients(age range:18-86 years).All patients were Chinese,and 85.1%were women.Cold and fatigue triggers were reported by 8.6% of patients,followed by triggers such as childbirth(4.3%),cold(3.0%),dampness(2.0%),menopause(1.3%),and psychentonia(0.7%).The most prevalent Zheng was dampness and heat blockage(Shire Yuzu in Chinese,SRYZ),diagnosed in 39.4% of patients(119),followed by phlegm and stagnation blockage(Tanyu Bizu,TYBZ)in 21.5%,liver and kidney deficiency(Ganshen Buzu,GSBZ)in 18.5%,dual deficiency of Qi and blood(Qixue Liangxu,QXLX)in 9.6%,cold and dampness blockage(Hanshi Bizu,HSBZ)in6%,and wind and dampness blockage(Fengshi Bizu,FSBZ)in 5%.Increased length of time since RA diagnosis was associated with the GSBZ group.Patients diagnosed with the SRYZ Zheng had the highest disease activity score.Patients diagnosed with the QXLX Zheng had the lowest blood platelet counts; patients diagnosed with the QXLX and HSBZ Zhengs had lower C-reactive protein levels and lower health assessment questionnaire scores.Patients diagnosed with the GSBZ and QXLX Zhengs had the highest health assessment questionnaire scores.CONCLUSION:The specific Zheng was related to RA characteristics.The findings suggest that eliminating dampness,cooling the patient,and promoting blood circulation may assist in treating severe RA.
OBJECTIVE:To assess the relationship between disease symptoms and traditional Chinese medicine(TCM)syndrome(Zheng)in rheumatoid arthritis(RA)patients.METHODS:RA Patients were recruited in Guang'anmen Hospital,China Academy of Chinese Medical Sciences and in the Second Affiliated Hospital of Zhejiang Chinese Medical University,and diagnosed with a particular RA Zheng from their symptoms.Demographic characteristics,self-reported symptoms,and blood samples were collected from patients.All data were input into EpiData and analyzed using SPSS software.RESULTS:The study included 302 RA patients(age range:18-86 years).All patients were Chinese,and 85.1%were women.Cold and fatigue triggers were reported by 8.6% of patients,followed by triggers such as childbirth(4.3%),cold(3.0%),dampness(2.0%),menopause(1.3%),and psychentonia(0.7%).The most prevalent Zheng was dampness and heat blockage(Shire Yuzu in Chinese,SRYZ),diagnosed in 39.4% of patients(119),followed by phlegm and stagnation blockage(Tanyu Bizu,TYBZ)in 21.5%,liver and kidney deficiency(Ganshen Buzu,GSBZ)in 18.5%,dual deficiency of Qi and blood(Qixue Liangxu,QXLX)in 9.6%,cold and dampness blockage(Hanshi Bizu,HSBZ)in6%,and wind and dampness blockage(Fengshi Bizu,FSBZ)in 5%.Increased length of time since RA diagnosis was associated with the GSBZ group.Patients diagnosed with the SRYZ Zheng had the highest disease activity score.Patients diagnosed with the QXLX Zheng had the lowest blood platelet counts; patients diagnosed with the QXLX and HSBZ Zhengs had lower C-reactive protein levels and lower health assessment questionnaire scores.Patients diagnosed with the GSBZ and QXLX Zhengs had the highest health assessment questionnaire scores.CONCLUSION:The specific Zheng was related to RA characteristics.The findings suggest that eliminating dampness,cooling the patient,and promoting blood circulation may assist in treating severe RA.
引文
1 Helmick CG,Felson DT,Lawrence RC,et al.Estimates of the prevalence of arthritis and other rheumatic conditions in the United States.Part I.Arthritis Rheumatol2008;58(1):15-25.
2 Sokka T,Kautiainen H,Pincus T,et al.Work disability remains a major problem in rheumatoid arthritis in the2000s:data from 32 countries in the QUEST-RA study.Arthritis Res Ther 2010;12(2):R42.
3 Allaire S,Wolfe F,Niu J,et al.Contemporary prevalence and incidence of work disability associated with rheumatoid arthritis in the US.Arthritis Rheumatol 2008;59(4):474-480.
4 Laev SS,Salakhutdinov NF.Anti-arthritic agents:progress and potential.Bioorganic Med Chem 2015;23(13):3059-3080.
5 De Lemos LL,Costa Jde O,Machado MA,et al.Rituximab for rheumatoid arthrits treatment:a systematic review.Revista Brasileira de Reumatologia(English Edition)2014;54(3):220-230.
6 Jiang Q,Tang XP,Chen XC,et al.Will Chinese external therapy with compound Tripterygium wilfordii hook F gel safely control disease activity in patients with rheumatoid arthritis:design of a double-blinded randomized controlled trial.BMC Complement Altern Med 2017;17(1):444.
7 Lu AP,Jia HW,Xiao C,et al.Theory of traditional Chinese medicine and therapeutic method of diseases.World J Gastroenterol 2004;10(13):1854-1856.
8 Jiang WY.Therapeutic wisdom in traditional Chinese medicine:a perspective from modern science.Trends Pharmacol Sci 2005;26(11):558-563.
9 Lu C,Niu X,Xiao C,et al.Network-based gene expression biomarkers for cold and heat patterns of rheumatoid arthritis in traditional chinese medicine.Evid Based Complement Alternat Med 2012;2012:203043.
10 Aletaha D,Neogi T,Silman AJ,et al.2010 Rheumatoid arthritis classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative.Arthritis Rheumatol 2010;62(9):2569-2581.
11 Wells G,Becker J C,Teng J,et al.Validation of the 28-joint disease activity score(DAS28)and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis,and comparison with the DAS28 based on erythrocyte sedimentation rate.Ann Rheum Dis 2008;68(6):954-960.
12 Lee KE,Choi SE,Xu H,et al.HAQ score is an independent predictor of sustained remission in patients with rheumatoid arthritis.Rheumatol Int 2017;37(12):2027-2034
13 Li ZG.Comparative study on WHO western pacific region and world federation of Chinese medicine societies international standard terminologies on traditional medicine:diseases in internal medicine(part 6).Zhong Xi Yi Jie He Xue Bao 2012;10(10):1179-1184.
14 Li ZG,Liu RQ.Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine:diseases in internal medicine(part 7).Zhong Xi Yi Jie He Xue Bao 2012;10(11):1310-1315.
15 Li ZG,Tan JM.Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine:Diseases in Internal Medicine(Part 8).Zhong Xi Yi Jie He Xue Bao 2012;10(12):1497-1501.
16 The World Federation of Chinese Medicine Societies.International standard Chinese-English basic nomenclature of Chinese medicine.Beijing,China:People’s Medical Publishing House;2007:50-189.
17 Barrett EM,Symmons DPM,Seott DGL.Employment attrition in a community based inception cohort of rheumatoid arthritis patients.Br J Rheumatol 1996;35(suP-PI):235.
18 Zhang ZC(Qing Dynasty).Huang Di Nei Jing.Haerbin:Northern Literature and Art Publishing House,2007:3.
19 Oberle EJ,Harris JG,Verbsky JW.Polyarticular juvenile idiopathic arthritis-epidemiology and management approaches.Clin Epidemiol 2014;6:379-393.
20 Rasch EK,Hirsch R,Paulose-Ram R,et al.Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States:effect of different methods of case classification.Arthritis Rheumatol 2003,48(4):917-926.
21 Gaujoux-Viala C,Mouterde G,Baillet A,et al.Evaluating disease activity in rheumatoid arthritis:which composite index is best?A systematic literature analysis of studies comparing the psychometric properties of the DAS,DAS28,SDAI and CDAI.Joint Bone Spine 2012;79(2):149-155.
22 Pennington B,Davis S.Mapping from the Health Assessment Questionnaire to the EQ-5D:the impact of different algorithms on cost-effectiveness results.Value Health2014;17(8):762-771.
23 Smolen JS,Breedveld FC,Burmester GR,et al.Treating rheumatoid arthritis to target:2014 update of the recommendations of an international task force.Ann Rheum Dis 2015;75(1):3-15.
2 Sokka T,Kautiainen H,Pincus T,et al.Work disability remains a major problem in rheumatoid arthritis in the2000s:data from 32 countries in the QUEST-RA study.Arthritis Res Ther 2010;12(2):R42.
3 Allaire S,Wolfe F,Niu J,et al.Contemporary prevalence and incidence of work disability associated with rheumatoid arthritis in the US.Arthritis Rheumatol 2008;59(4):474-480.
4 Laev SS,Salakhutdinov NF.Anti-arthritic agents:progress and potential.Bioorganic Med Chem 2015;23(13):3059-3080.
5 De Lemos LL,Costa Jde O,Machado MA,et al.Rituximab for rheumatoid arthrits treatment:a systematic review.Revista Brasileira de Reumatologia(English Edition)2014;54(3):220-230.
6 Jiang Q,Tang XP,Chen XC,et al.Will Chinese external therapy with compound Tripterygium wilfordii hook F gel safely control disease activity in patients with rheumatoid arthritis:design of a double-blinded randomized controlled trial.BMC Complement Altern Med 2017;17(1):444.
7 Lu AP,Jia HW,Xiao C,et al.Theory of traditional Chinese medicine and therapeutic method of diseases.World J Gastroenterol 2004;10(13):1854-1856.
8 Jiang WY.Therapeutic wisdom in traditional Chinese medicine:a perspective from modern science.Trends Pharmacol Sci 2005;26(11):558-563.
9 Lu C,Niu X,Xiao C,et al.Network-based gene expression biomarkers for cold and heat patterns of rheumatoid arthritis in traditional chinese medicine.Evid Based Complement Alternat Med 2012;2012:203043.
10 Aletaha D,Neogi T,Silman AJ,et al.2010 Rheumatoid arthritis classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative.Arthritis Rheumatol 2010;62(9):2569-2581.
11 Wells G,Becker J C,Teng J,et al.Validation of the 28-joint disease activity score(DAS28)and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis,and comparison with the DAS28 based on erythrocyte sedimentation rate.Ann Rheum Dis 2008;68(6):954-960.
12 Lee KE,Choi SE,Xu H,et al.HAQ score is an independent predictor of sustained remission in patients with rheumatoid arthritis.Rheumatol Int 2017;37(12):2027-2034
13 Li ZG.Comparative study on WHO western pacific region and world federation of Chinese medicine societies international standard terminologies on traditional medicine:diseases in internal medicine(part 6).Zhong Xi Yi Jie He Xue Bao 2012;10(10):1179-1184.
14 Li ZG,Liu RQ.Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine:diseases in internal medicine(part 7).Zhong Xi Yi Jie He Xue Bao 2012;10(11):1310-1315.
15 Li ZG,Tan JM.Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine:Diseases in Internal Medicine(Part 8).Zhong Xi Yi Jie He Xue Bao 2012;10(12):1497-1501.
16 The World Federation of Chinese Medicine Societies.International standard Chinese-English basic nomenclature of Chinese medicine.Beijing,China:People’s Medical Publishing House;2007:50-189.
17 Barrett EM,Symmons DPM,Seott DGL.Employment attrition in a community based inception cohort of rheumatoid arthritis patients.Br J Rheumatol 1996;35(suP-PI):235.
18 Zhang ZC(Qing Dynasty).Huang Di Nei Jing.Haerbin:Northern Literature and Art Publishing House,2007:3.
19 Oberle EJ,Harris JG,Verbsky JW.Polyarticular juvenile idiopathic arthritis-epidemiology and management approaches.Clin Epidemiol 2014;6:379-393.
20 Rasch EK,Hirsch R,Paulose-Ram R,et al.Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States:effect of different methods of case classification.Arthritis Rheumatol 2003,48(4):917-926.
21 Gaujoux-Viala C,Mouterde G,Baillet A,et al.Evaluating disease activity in rheumatoid arthritis:which composite index is best?A systematic literature analysis of studies comparing the psychometric properties of the DAS,DAS28,SDAI and CDAI.Joint Bone Spine 2012;79(2):149-155.
22 Pennington B,Davis S.Mapping from the Health Assessment Questionnaire to the EQ-5D:the impact of different algorithms on cost-effectiveness results.Value Health2014;17(8):762-771.
23 Smolen JS,Breedveld FC,Burmester GR,et al.Treating rheumatoid arthritis to target:2014 update of the recommendations of an international task force.Ann Rheum Dis 2015;75(1):3-15.
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