Study On Characteristics Of TCM Syndromes In Patients With Active Rheumatoid Arthritis Complicated With Anemia

Objective:Adopting the method of retrospective analysis,to analyse the correlation between hemoglobin(Hb)counts and various syndromes on 261 cases of active rheumatoid arthritis(RA)patients,as well as correlation analysis between Hb and,inflammatory markers,general information,laboratory and imaging examination,symptoms or signs in each syndrome of activity.So as to guide clinical diagnosis,treatment based on syndrome differentiation,and as the basis to use Chinese Herbology.Methods:The study’s cases entry from Guang’an men Hospital of China Academy Of Chinese medicai is the patients with rheumatoid arthritis during the Period of 2016-2017 in department of rheumatism.It contains 261 cases in Activity,The main research project is general information:patient ID number,name,gender,age and course of disease;Clinical symptoms and signs;Joint local symptoms and signs,systemic symptoms;(3)laboratory and imaging examination:joint X-ray stage,lung high-resolution computed tomography(CT),lung function,joint ultrasound examination,routine blood examination,iron metabolism,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),anti CCP antibody(anti cyclic citrulline peptide antibodies),etc.;The diagnosis,syndrome,tongue coating and pulse of Chinese medicine;Other:pain VAS score,DAS28(CRP),DAS28(ESR),etc.,and using SPSS 17.0 software to analyse the results.Results:(1)In this study there are 261 cases includee meet the conditions in active RA cases.Among these cases,male 39 and female 222,The minimum age of the patient was 23 years old,the maximum age was 95,and the average age was 60.71 years.and there were 143 patients with anaemia.Among them,128 were female and 15 were male,and the incidence of anemia was 54.79%,mostly mild and moderate anemia.(2)Comparing the two group;male patients with RA Hb>120 and Hb<120,there are significant differences between the MCHC,red blood cell(RBC),CRP,ESR and pain VAS score(P<0.05),and the RBC in patients with Hb>120 is higher than patients with Hb<120,however,the ESR and CRP in patients with Hb<120 are higher than patients with Hb≥120.(3))Comparing the two group;female patients with RA Hb≥110 and Hb<110,there are significant differences between the swollen joint count,tender joint count,MCV,MCH,RBC,PLT,CRP,ESR,DS28(ESR),DS28(CRP),and pain VAS score(P<0.05),and the swollen joint count,tender joint count,PLT,CRP,ESR,DS28(ESR),DS28(CRP),and pain VAS score in patients with Hb<110 are higher than patients with Hb≥110,however,the MCV,MCH,MCHC in patients with with Hb≥110 are higher than patients with Hb<110.(4)The number of cases of various syndromes distribute as follows:damp-heat type>deficiency type>phlegm-blood stasis type.Comparing the damp-heat type and deficiency type,there are significant differences between the age,course of disease and joint deformity count,and age,course of disease and joint deformity count in deficiency type are higher than damp-heat type.Comparing the deficiency type and phlegm-blood stasis type or damp-heat type,there are significant differences between the Hb and RBC,and Hb,RBC in deficiency type are lower than damp-heat type or damp-heat type..Comparing the deficiency type and damp-heat type,there are significant differences between the CRP,DS28(CRP)and PLT;and CRP,DS28(CRP),PLT in damp-heat type are higher than deficiency type.(5)In active RA,comparision of Hb with the indexs shows:Hb and MCHC,CRP,ESR,DS28(CRP),DS28(ESR),pain VAS score has positive correlation(P<0.05).(6)In active RA,comparision of Hb with the with the indexs shows:Hb and folic acid,VB12,SI,SF,Tfs,TIBC,RET%has no correlation(P>0.05).(7)Comparing the the age,course of disease,RET%,RF,CCP in anemia group and non-anemia group,there are no difference(P>0.05)between two groups.But ESR,CR P,DS28(CRP),DS28(ESR),PLT,pain VAS score in anemia group and non-anemia gro up,there are significant differences(P<0.05)between twogroups,ESR,CRP,DS28(CRP),D S28(ESR),PLT,pain VAS score in anemia group are higher than non-anemia grou P.Conclusion:(1)In the three syndromes of RA activity period,the patient in deficiency type is older,the course of disease is longer,and the joint deformity is mostly false.(2)Hb and RBC has positively correlation with deficiency type.(3)Hb is related to the activity of RA disease and can be used as an indicator of disease activity,the disease activity of anemia group was higher than that of non-anemia group.(4)There were differences in erythrocyte morphology in women RA patients with anemia group and non-anemia group.(5)Anemia caused by RA may be a combination of factors.