Study Of Relativity Of TCM(Traditional Chinese Medicine) Constitution, Clinic Syndrome Types And Prognosis Of Rheumatoid Arthritis

Object iveTo study the relationship between prognostic factors and TCM syndrome types, physical constitution, try to find some Chinese medicine characters within patients in a poor prognosis. Then early TCM intervention can be taken on in the crowd of poor prognosis, in order to achieve the balance yin and Yang, dispel the excessiveness and reinforce the insufficiency, in addition to be strong gluten, to reduce the joint damage.MethodsCase report from 2014 October "2015 year in March 58 plus 148 cases retrospectively from 2011-2013 of rheumatoid arthritis patients hospitalized in the First Affiliated Hospital of Guangzhou University of Chinese Medicine Department of rheumatism. By collecting the clinical data from laboratory of Western Medicine, and from syndrome differentiation and constitution questionnaire of TCM, to determine whether patients get poor prognostic factors, which syndrome type and which constitution classification do they get,.And finally carries on the statistical analysis, to explore the whether there are some interesting findings between the poor prognosis, syndrome type and constitution classificationResults1. General situation:206 cases, female 165 cases,41 cases were male. Patients’average age (54.40±13.30) years, set on age (45.52±14.07) years, duration (8.94±7.84) years, hemoglobin level, (109.82±17.18g/L), erythrocyte sedimentation rate (59.23±34.43 mm/h), C reactive protein (39.74±44.05 mg/1), RF (574.50±934.38 iu/ml), CCP (108.06±80.10 u/ml).2. Poor prognosis:there were 288 times, including high titer RF (127 times), high titer CCP (139 times), vasculitis (2 time), rheumatoid nodules (4 times), pulmonary involve (16 times).3. The distribution of TCM syndromes:Deficiency of liver and kidney (55, 26%), Blockage of wind and wet (28,13%), Blockage of phlegm and blood stasis (20,10%), Deficiency of qi and blood (10,5%), Blockage of cold and wet(49, 24%), Blockage of heat and wet(46,22%);The distribution of TCM constitution:Mild (29,39%), Qi deficiency (7, 9%), Yang deficiency(12,16%), Yin deficiency (10,14%), Phlegm dampness (2, 3%), Heat dampness (3,4%), Qi depression (7,9%), Blood stasis (2,3%), Idiosyncrasy(2,3%).4. The correlation analysis between the general situation. The results suggest:age were correlated with CCP (r=0.137, P<0.05); set on age were correlated with ESR (r=0.195, P<0.01), and RF (r=0.155, P<0.05), and CCP (r=0.169, P<0.05); duration were correlated with RF(r=-0.201, P<0.01),and ESR(r=-0.167, P<0.05);HGB were correlated with ESR (r=-0.535, P<0.01), and CRP (r=-0.374, P<0.01);ESR were correlated with CRP (r=0.557, P<0.01), and RF (r=0.315, P<0.01);CRP were correlated with RF (r=0.246, P<0.01);RF were correlated with CCP (r=0.176, P<0.05).5. Comparison of the two groups:with and without poor prognosis:The level of ESR and CRP in the poor prognosis group, was significantly higher than the other.6. logistic regression analysis:6.1 TCM syndrome types and general situation Analysis showed that, level of hemoglobin is the predictor of "Blockage of wind and wet" (OR=1.063, P=0.003,95%CI,1.021-1.106); Age is the predictor of "Deficiency of liver and kidney" (OR=1.062, P=0.006,95%CI,1.017-1.108); Set on age is the protective predictor of "Blockage of cold and wet" (OR=1.062, P=0.006,95%CI,1.017-1.108).6.2 Physical constitution and general situation Analysis showed that, level of hemoglobin is the predictor of "Mild constitution" (OR=1.025, P=0.009,95%CI 1.013-1.092); age is a protective factor for prediction of " Qi deficiency" (OR=0.901, P=0.028,95%CI, 0.821-0.989); hemoglobin is a protective factor for prediction of "Yang deficiency" (OR=0.944, P= 0.017,95%CI 0.901-0.990); CRP is the predictor of "Yin deficiency" (OR=1.021, P=0.023,95%CI 1.003-1.040); the rest were not found significance to be a predictor of physical constitution.6.3 TCM syndrome types and prognosis The TCM syndrome types, age, age of onset, course of disease, hemoglobin, erythrocyte sedimentation rate, C reactive protein were included in the multiple regression analysis towards poor prognosis. Could not find any relations.6.4 Physical constitution and prognosis Because model has no significance, couldn’t find exact relation between Physical constitution and prognosis.Conclusions:This study did not find the syndrome types and the physical constitution can be a predictor of the poor prognosis of RA. This may be a bad prognosis syndrome type of traditional Chinese medicine and Western medicine, the physique classification does not exist corresponding relation between macro, but from the correlation between the laboratory data, TCM syndromes and physical constitution of the disease (seem upload:patients with "Deficiency of liver and kidney" may have a higher level of RF; patients with "Blockage of cold and wet" may have a lower level of CCP;patients with "Blockage of cold and wet" may have a longer duration, patients with "Yang deficiency "may have a greater risks of anemia, patients with "Yin deficiency "may get inflammation easier), we can see in course of the disease, there exists some connections between them at a micro level.