基于临床辨证的类风湿关节炎常见中医证候Logistic回归分析
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摘要
目的:采用Logistic回归分析方法探讨类风湿关节炎(RA)症状、舌脉与常见中医证候之间的关系,为指导临床辨证提供科学依据。方法:采用前瞻、多中心的横断面观察性研究方法,于北京、杭州两地5家医疗机构共采集302例RA患者,应用SPSS 20.0软件对所得数据进行Logistic回归分析。结果:通过Logistic回归分析,得到了RA 6个常见证候中与证候诊断相关的症状表现。风湿痹阻证:关节疼痛游走不定和怕风怕凉;寒湿痹阻证:舌体胖大、舌质淡暗、舌质淡白;湿热瘀阻证:关节触热、舌苔薄黄、舌苔黄腻、脉率数、脉势滑;痰瘀痹阻证:关节刺痛、关节周围或皮下结节、舌质青紫、脉位沉、脉形弦;气血两虚证:神疲乏力;肝肾不足证:腰膝酸软无力、肢体沉重、舌苔少苔、脉形细。结论:本研究借助Logistic回归分析方法,归纳出RA主要证候与症状、舌脉之间的相关关系,为临床辨证提供了客观依据。
Objective: To explore the relationship between rheumatoid arthritis(RA) symptoms, tongue and pulse with common TCM syndromes by Logistic regression analysis. To provide scientific evidence for clinical syndrome differentiation. Methods: Three hundred and two patients with RA were collected from five hospitals in Beijing and Hangzhou in China by using the prospective, multi-center and cross-sectional observational method. The data were analyzed by SPSS 20.0 software and Logistic regression analysis. Results: Logistic regression analysis showed that the symptoms of RA were related to syndrome diagnosis. Six common syndromes of RA were obtained. The symptoms of the syndrome of winddampness blockage were as follows: migratory joint pain and fear of the wind and cold. The symptoms of the syndrome of cold-dampness blockage were as follows: fat and large tongue, pale and dark tongue, and pale tongue. The symptoms of the syndrome of stagnant dampness-heat were as follows: touching hot joint, greasy yellow tongue coating or thin yellow, quick slippery pulse. The symptoms of the syndrome of phlegm stasis blockage were as follows: tingling joint, subcutaneous nodules, tongue bruising and deep string pulse. The symptoms of the syndrome of deficiency of both qi and blood were as follows: fatigue. The symptoms of the syndrome of deficiency of liver and kidney were as follows: lumbar debility weakness, physically heavy, little coating tongue, thin pulse. Conclusion: The correlation between syndromes, tongue, pulse, and symptoms of RA are summarized by using Logistic regression analysis, which could provide objective evidence for clinical syndrome differentiation.
Objective: To explore the relationship between rheumatoid arthritis(RA) symptoms, tongue and pulse with common TCM syndromes by Logistic regression analysis. To provide scientific evidence for clinical syndrome differentiation. Methods: Three hundred and two patients with RA were collected from five hospitals in Beijing and Hangzhou in China by using the prospective, multi-center and cross-sectional observational method. The data were analyzed by SPSS 20.0 software and Logistic regression analysis. Results: Logistic regression analysis showed that the symptoms of RA were related to syndrome diagnosis. Six common syndromes of RA were obtained. The symptoms of the syndrome of winddampness blockage were as follows: migratory joint pain and fear of the wind and cold. The symptoms of the syndrome of cold-dampness blockage were as follows: fat and large tongue, pale and dark tongue, and pale tongue. The symptoms of the syndrome of stagnant dampness-heat were as follows: touching hot joint, greasy yellow tongue coating or thin yellow, quick slippery pulse. The symptoms of the syndrome of phlegm stasis blockage were as follows: tingling joint, subcutaneous nodules, tongue bruising and deep string pulse. The symptoms of the syndrome of deficiency of both qi and blood were as follows: fatigue. The symptoms of the syndrome of deficiency of liver and kidney were as follows: lumbar debility weakness, physically heavy, little coating tongue, thin pulse. Conclusion: The correlation between syndromes, tongue, pulse, and symptoms of RA are summarized by using Logistic regression analysis, which could provide objective evidence for clinical syndrome differentiation.
引文
[1]栗占国,张奉春.类风湿关节炎.北京:人民卫生出版社,2009:9-11
[2]Barrett E M,Symmons D P M,Seott D G L.Employment attrition in a community based inception cohort of rheumatoid arthritis patients.Br J Rheumatol,1996,35(3):235
[3]张乃峥.中国风湿性疾病流行情况的调查研究.中华风湿病学杂志,1997,1(1):31-35
[4]曹昧,马伯艳.多元统计分析方法在中医证候研究中的应用.中医药信息,2008,25(3):76-78
[5]Arnett F C,Edworthy S M,Bloch D A,et al.The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.Arthritis Rheum,1988,31:315-324
[6]Aletaha D,Neogi T,Silman A J,et al.2010 Rheumatoid arthritis classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative.Arthritis Rheum,2010,62:2569-2581
[7]CFDA.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002:115-117
[8]国家中医药管理局医政司.22个专业95个病种中医临床路径(合订本).北京:中国中医药出版社,2010:247[9邓冬,李雪丽,赵慧辉,等.411例冠心病不稳定性心绞痛患者中医证候要素分布特征探讨.中华中医药杂志,2017,32(11):4889-4892
[10]王忠,张伯礼,申春悌,等.中医中风病证候的多元统计分析.中国中西医结合杂志,2003,23(2):106-110
[11]张敏,黄俊山,张娅,等.1 447例失眠患者中医证候分布规律研究.中华中医药杂志,2017,32(4):1778-1781
[12]张家放.医用多元统计分析方法.武汉:华中科技大学出版社,2002:231-236
[2]Barrett E M,Symmons D P M,Seott D G L.Employment attrition in a community based inception cohort of rheumatoid arthritis patients.Br J Rheumatol,1996,35(3):235
[3]张乃峥.中国风湿性疾病流行情况的调查研究.中华风湿病学杂志,1997,1(1):31-35
[4]曹昧,马伯艳.多元统计分析方法在中医证候研究中的应用.中医药信息,2008,25(3):76-78
[5]Arnett F C,Edworthy S M,Bloch D A,et al.The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.Arthritis Rheum,1988,31:315-324
[6]Aletaha D,Neogi T,Silman A J,et al.2010 Rheumatoid arthritis classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative.Arthritis Rheum,2010,62:2569-2581
[7]CFDA.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002:115-117
[8]国家中医药管理局医政司.22个专业95个病种中医临床路径(合订本).北京:中国中医药出版社,2010:247[9邓冬,李雪丽,赵慧辉,等.411例冠心病不稳定性心绞痛患者中医证候要素分布特征探讨.中华中医药杂志,2017,32(11):4889-4892
[10]王忠,张伯礼,申春悌,等.中医中风病证候的多元统计分析.中国中西医结合杂志,2003,23(2):106-110
[11]张敏,黄俊山,张娅,等.1 447例失眠患者中医证候分布规律研究.中华中医药杂志,2017,32(4):1778-1781
[12]张家放.医用多元统计分析方法.武汉:华中科技大学出版社,2002:231-236