岭南强直性脊柱炎证型分布及Bath量表评价研究
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摘要
研究目的
本研究旨在:1、以文献回顾的方法总结强直性脊柱炎的中医证型分布规律;2、调查分析岭南地区强直性脊柱炎临床各个证型与Bath量表的相关性。
研究方法
全面检索近10年核心期刊中有关强直性脊柱炎中医证型和辩证治疗的文献25篇,采用医学统计分析方法;对岭南地区121例强直性脊柱炎患者按中医证型分组,采用Bath强直性脊柱炎疾病活动指数(BASDAI)和Bath强直性脊柱炎功能指数(BASFI)进行临床调查,研究不同证型与病情的关系。
研究结果
文献研究:强直性脊柱炎中医临床上尚无统一辨证分型,常见证型依次是湿热型、寒湿型、瘀血痹阻、肝肾不足、肝肾阴虚等:
临床调查:岭南地区强直性脊柱炎中医证型分布依次是湿热型(47.1%)、瘀血痹阻型(23.1%)、肝肾亏虚型(16.5%)、肾阳虚型(9.9%)和寒湿型(3.3%);邪实证组(主要为湿热型、瘀血痹阻)的BASDAI指数高于本虚证组(肝肾亏虚型、肾阳虚型),两者比较有显著性差异(P＜0.05):各证型与BASFI指数经过统计学处理无显著性差异(P＞0.05),但从其趋势上可看到本虚证组(肝肾亏虚型、肾阳虚型)低于其他邪实证组。
结论
岭南地区强直性脊柱炎中医证型分布与全国存在一定差异,湿热型是最常见的证型;邪实证组(主要为湿热型、瘀血痹阻)病情较本虚证组(肝肾亏虚型、肾阳虚型)活跃,而各个证型的功能并无明显差别。
Objecive
The purpose,of the research was to explore on literature review and investigate in clinic the distributing rules of different TVM syndromes in ankylosing spondylitis,evaluate the BASDAI and BASFI of ankylosing spondylitis.
Methods
To analyze 25 pieces of learned paper about the differentiation of syndrome in TCM of AS from various types of medical periodicals.To group 121 patients of ankylosing spondyfitis in the south of China based on different syndromes,study and evaluate the relationship between different TCM syndromes and state of illness with BASDAI and BASF1.
Results
The literature review show:there wasn't a unification adout the syndromes in TCM of AS at a clinic.The common syndrome types in TCM are damp-heat,cold-damp,blockage with stagnant blood,deficiency with kidney and liver,and deficiency of kidney-YIN and liver-YIN.
Investigate in clinic:The common syndrome types in TCM of AS in the south of China in order are damp-heat(47.1%),blockage with stagnant blood(23.1%), deficiency with kidney and liver(16.5%),deficiency of kidney-YANG(9.9%) and cold-damp(3.3%);The BASDAI index is significant higher in state of evil domination syndrome group than in deficiency in origin syndrome group;By statistical treatment there is no significant difference between all the TCM syndrome types about the BASFI.
Conclusion
Distributing rules of different TCM syndromes of AS in the south of China exist some difference with the north.Damp-heat is the most common syndrome type.Patients' condition is more active in state of evil domination syndrome, and all patiens' function seem hardly any contrast.
本研究旨在:1、以文献回顾的方法总结强直性脊柱炎的中医证型分布规律;2、调查分析岭南地区强直性脊柱炎临床各个证型与Bath量表的相关性。
研究方法
全面检索近10年核心期刊中有关强直性脊柱炎中医证型和辩证治疗的文献25篇,采用医学统计分析方法;对岭南地区121例强直性脊柱炎患者按中医证型分组,采用Bath强直性脊柱炎疾病活动指数(BASDAI)和Bath强直性脊柱炎功能指数(BASFI)进行临床调查,研究不同证型与病情的关系。
研究结果
文献研究:强直性脊柱炎中医临床上尚无统一辨证分型,常见证型依次是湿热型、寒湿型、瘀血痹阻、肝肾不足、肝肾阴虚等:
临床调查:岭南地区强直性脊柱炎中医证型分布依次是湿热型(47.1%)、瘀血痹阻型(23.1%)、肝肾亏虚型(16.5%)、肾阳虚型(9.9%)和寒湿型(3.3%);邪实证组(主要为湿热型、瘀血痹阻)的BASDAI指数高于本虚证组(肝肾亏虚型、肾阳虚型),两者比较有显著性差异(P＜0.05):各证型与BASFI指数经过统计学处理无显著性差异(P＞0.05),但从其趋势上可看到本虚证组(肝肾亏虚型、肾阳虚型)低于其他邪实证组。
结论
岭南地区强直性脊柱炎中医证型分布与全国存在一定差异,湿热型是最常见的证型;邪实证组(主要为湿热型、瘀血痹阻)病情较本虚证组(肝肾亏虚型、肾阳虚型)活跃,而各个证型的功能并无明显差别。
Objecive
The purpose,of the research was to explore on literature review and investigate in clinic the distributing rules of different TVM syndromes in ankylosing spondylitis,evaluate the BASDAI and BASFI of ankylosing spondylitis.
Methods
To analyze 25 pieces of learned paper about the differentiation of syndrome in TCM of AS from various types of medical periodicals.To group 121 patients of ankylosing spondyfitis in the south of China based on different syndromes,study and evaluate the relationship between different TCM syndromes and state of illness with BASDAI and BASF1.
Results
The literature review show:there wasn't a unification adout the syndromes in TCM of AS at a clinic.The common syndrome types in TCM are damp-heat,cold-damp,blockage with stagnant blood,deficiency with kidney and liver,and deficiency of kidney-YIN and liver-YIN.
Investigate in clinic:The common syndrome types in TCM of AS in the south of China in order are damp-heat(47.1%),blockage with stagnant blood(23.1%), deficiency with kidney and liver(16.5%),deficiency of kidney-YANG(9.9%) and cold-damp(3.3%);The BASDAI index is significant higher in state of evil domination syndrome group than in deficiency in origin syndrome group;By statistical treatment there is no significant difference between all the TCM syndrome types about the BASFI.
Conclusion
Distributing rules of different TCM syndromes of AS in the south of China exist some difference with the north.Damp-heat is the most common syndrome type.Patients' condition is more active in state of evil domination syndrome, and all patiens' function seem hardly any contrast.
引文
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[2]Calin A,Garrett S,Whitelock H,Kennedy LG,O' Hea J,Mallorie P,Jenkinson T(1994)A new approach to defining functional ability in ankylosing spondylitis:the development of the Bath Ankylosing Spondylitis Functional Index[J].J Rheumatol 21:2281-2285
[3]Garrett S,Jenkinson T,Kennedy LG,Whitelock H,Oaisford P,Calin A(1994)A new approach to defining disease status in ankylosing spondylitis:the Bath Ankylosing Spondylitis Disease Activity Index[J].J Rheumatol 21:2286-2291.
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[2]Calin A,Garrett S,Whitelock H,Kennedy LG,O' Hea J,Mallorie P,Jenkinson T(1994)A new approach to defining functional ability in ankylosing spondylitis:the development of the Bath Ankylosing Spondylitis Functional Index[J].J Rheumatol 21:2281-2285
[3]Garrett S,Jenkinson T,Kennedy LG,Whitelock H,Oaisford P,Calin A(1994)A new approach to defining disease status in ankylosing spondylitis:the Bath Ankylosing Spondylitis Disease Activity Index[J].J Rheumatol 21:2286-2291.
[4]Trontzas P,Andrianakos A,et al.Seronegative spondyloar-thropathies in Greece:a population-based study of prevalence,clinical pattern,and management[J].Clin Rh eumatol,2005,24(6):583-589.
[5]阎小萍等.强直性脊柱炎[M].中国医药科技出版社,2004:5.
[6]戴冽,汤美安.强直性脊柱炎的早期诊断和治疗进展[J].新医学,2001,32(8):495-496.
[7]郭粉莲,叶志中,等.深圳市强直性脊柱炎的患病率及患者生活质量调查[J].国际护理学杂志,2006,25(9):692-695.
[8]刘振帆,刘经民,等.山东农村地区脊柱关节病流行病学调查[J].中华风湿病学杂,2001,5(3)181-182.
[9]戴生明,韩星海,等.上海市杨浦区常见风湿性疾病的流行病学调查[J].现代康复,2001,5(1):42-43,51.
[10]曾庆馀.强直性脊柱炎的诊断[J].中国新药与临床杂志 1999,18(6):381-382.
[11]孔繁华,陈兴国,金荔.中国健康人和AS患者的HLA-B27亚型分析[J].中国中西医结合风湿病杂志,1998,7(1):30-31.
[12]阎小萍等.强直性脊柱炎[M].中国医药科技出版社,2004:31.
[13]Hoehler Thomas,Schaeper Thomas,Schnerder Peter M,et al.Association of different tumor necrosis factor a promoterallele frequencies with ankylosing spondylitis in HLA-B27 positive individuals[J].Arthritis Rheum,1998,41(8): 1489-1492.
[14]阎小萍等.强直性脊柱炎[M].中国医药科技出版社,2004:33.
[15]Uksila Jaakko,Gripenberg-lerche Christel,Toivanen,Raaro,et al.The rode of environmental factors and HLA-B27Der[J].Spondyloarthoropathies,1997,127:167-181.
[16]阎小萍等.强直性脊柱炎[M].中国医药科技出版社,2004:98.
[17]Calin A,Porta J,Fries JF,et al.The clinical history as a screening test for ankylosing spondylitis[J].JAMA,1997,237:2613-2619.
[18]Altinay Goksel,Karatepe Yesim,et.The Turkish versions of the Bath Ankylosing Spondylitis and Dougados Functional Indices:reliability and validity[J].Rheumatol Int,2005,25:612-618.
[19]阎小萍等.强直性脊柱炎[M].中国医药科技出版社,2004:54.
[20]韩善夯.金实教授治疗强直性脊柱炎经验[J].四川中医,2005,23(11):1-3.
[21]王义军.胡荫奇治疗强直性脊柱炎经验[J].中国中医药信息杂志,2004,11(12):1102-1103.
[22]焦树德.大偻(强直性脊柱炎)病因病机及辨证论治探讨(上)[J].江苏中医药,2003,24(1):1-3.
[23]赵诗哲.黄仰模辨治强直性脊柱炎经验[J].浙江中医杂志2003:38(3):99.
[24]张梅红,等.解毒利湿化瘀法治疗强直性脊柱炎机理初探[J].浙江中医杂志,2004,(5):198-199.
[25]张思胜,周雯,聂存平.中药辨证内服外用结合手法治疗强直性脊柱炎[J].安徽中医临床杂志,2002,14(3):195-197.
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