| Objective: Rheumatoid arthritis (RA) is a inflammatory, heterogenous, autoimmunity, disease. Traditional Chinese Medicine (TCM) confines RA as "Bi Syndrome ". Up to now, great quantity of internal and external researchs didn't discover categorical pathogen, but correlation between etiology of RA and infection always was one of focuses that medical experts attented and studied . TCM pointed out that "the combination of the three abnormal wind, cold and moist can develop into Bi Syndrome"in canon of medicine. Phyicians in different perfected gradally the theory, they believed that six exopathogens all resulted in "Bi Syndrome ". To discuss theory that exogenous factor lead to"Bi Syndrome ", we plan to investigate human parvovirus B19(B19) and Epstein-Barr(EB) virus infection in patients with Rheumatoid Arthritis(RA), to analyze the relationalship between virus infection and the index of RA activity, correlative cytokine (CK), arthralgia syndrome classification of "Bi Syndrome", etal, to primary discuss potential mechanism of "exogenous factor lead to Bi Syndrome ", and to explore integrative Chinese and western medicine (ICWM) approach in treating patients with RA. Methods: Blood serum(SB) from 93 patients with RA and 20 persons with normal control were examined .Among the RA group, 63 patients with active RA , the female to male ratio was 3:1, and the age range was 20-69 year with a mean of 52.26 year, the duration of rheumatiod disease ranged from 3 month to 20 year with a mean of 84.96 mouth; 30 parents with stable RA, the female to male ratio was 5:1, and the age range was 19-68 year with a mean of 48.71 year, the duration of rheumatiod disease ranged from 0.5 to 20 year with a mean of 86.53 mouth. To registered in particular all patients'case history, family history, medical examination (include clinical symptom, objective sign, joint and besides arthrosis symptom, principal syndrome , tongue and pulse ), correlative imaging and laboratory examination. All BS were conserved in -70 ℃refrigeratory. By PCR analysis DNA of B19, and by ELISA analysis anti-EBV IgA/VCA antiboby, IL-6, TNF-α, IL-8, IL-1βin BS. Results: (1) B19-DNA was detected in 35/93 (37.63%) of RA, 32/63 (50.72%) of active RA, 3/30(10%) of stable RA, and 1/20 (5%) of normal control. Which show edastriking difference between active RA and the orther groups (P<0.01). B19-DNA of RA group was rather different from the control group (P<0.05), and no striking difference exicted in stable RA group and the control group (P>0.05). (2) It showed that Morning stiffness time,number of painjoint count,number of swelling joint count,level of erythrocyte sedimentation rate(ESR), C-reactive protein (CRP), theumatoid factor (RF) and immunoglobulin (Ig) in B19-DNA positive group were higher than negative group ,but there was no significance between B19-DNA positive group and negative group in RA (P>0.05). Patients of B19-DNA positive group was rather different from that of negative group in hemoglobin (P<0.01). (3) Anti-EBV IgA/VCA antiboby in BS was detected in 34/93 (36.6%) of RA, 30/63 (47.6%) of active RA, 4/30(13.3%) of stable RA, and 1/20 (5%) of normal control. The positive rate of IgA/VCA antibody in the serum of active RA patients which was significantly higher than that in stable patients and normal subjects(P<0.01). Anti-EBV IgA/VCA antiboby of RA group was rather different from normal subjects(P<0.05), and no striking difference exicted in stable RA group and normal group(P>0.05). (4) The positive rate of RF in anti-IgA/VCA antiboby positive group was significantly higher than that negative group (P<0.05), No striking difference existed in the positive rate of antinuclear antiboby(ANA) , Morning stiffness time, number of pain joint count, number of swelling joint count, course,age, CRP, ESR, immunoglobulin(Ig) in EB IgA/VCA antiboby positive group and negative group. (5) BS in patients of RA was rather different from that of stable group of RA and control group in IL-6, TNF-α, IL-8,IL-1βin BS((P<0.01).No striking difference existed in four above CK in B19-DNA positive group and negative group in 93 with RA (P>0.05). there was also no significance between IgA/VCA antiboby positive group and negative group in RA (P>0.05). (6) There are 13 people who are RA patients in active ghase that B19 DNA and EB IgA/VCA antibody positive , 16 people B19 DNA positive and EB IgA/VCA antibody negative, 16 people EB IgA/VCA antibody positive and B19 DNA negative, there are 45 people who infected ether of the two virus,and 18 people who infected nether of them.the infectious of virus (B19 or EB) rate is 71.4%, and the rate of negative is 28.6%. Syndrome classidication of 63 patients with active RA: 21 people(33.3%) of cold-damp blockage of collaterals syndrome, 12(19.1%) damp-heat blockage of collaterals syndrome, 16 (25.4%)people of cild-heat complicated syndrome, 14(22.2%) people of both hepatorenal sathenia and interelation phlegm and stasis syndrome. There are 15 patients who belong to cold-damp blockage of collaterals syndrome infected virus(B19 or EBV), and 10 patients belong to damp-heat blockage of collaterals syndrome, 13 patients belong to cild-heat complicated syndrome, 7 patients belong to hepatorenal sathenia and interelation phlegm and stasis syndrome. There are 28 patients of Pyretic arthralgia (damp-heat blockage of collaterals syndrome and cild-heat complicated syndrome), Among the Pyretic arthralgia group,23... |
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