Exploring The Classification Of Inflammatory Myopathy Based On Cluster Analysis And Correlation Between Inflammatory Myopathy And TCM Syndromes Of Flesh Impediment

IntroductionThe idiopathic inflammatory myopathies(IIMs),known collectively as myositis,constitute a large spectrum of clinical phenotypes.the classical clinical manifestations of IIMs,such as mus-cle weakness,relate to chronic inflammation in skele-tal muscle.This inflammation frequently affects other organs,including the skin,joints,lungs,gastrointestinal tract and heart,indicating the systemic nature of this disease.Based on the recognition of myositis-specific antibodies and histopathological features in the past decade,the importance of extramuscular clinical symptoms of myositis may improve the accuracy of classification of myositis.Based on this,the clinical characteristics of patients with myositis were analyzed,and the clinical features of myositis patients were re-clustered and summarized by statistical methods of cluster analysis.Myositis belongs to the category of " dermatomyositis " or "arthralgia bi disease " of traditional Chinese medicine.In view of the heterogeneity of clinical manifestations of myositis,the syndrome differentiation of traditional Chinese medicine of myositis has a coincidence with the classification of myositis subgroup in modern medicine.Therefore,at the same time,it is necessary to explore whether there is a correlation between the existing myositis classification and the TCM syndrome type of dermatomyositis.ObjectivesTo analyze the clinical characteristics of patients with myositis,and to analyze the clinical features of myositis patients by statistical methods of cluster analysis,and to study the correlation between idiopathic inflammatory myopathy and dermatomyositis syndrome.MethodsA retrospective study was conducted on 34 patients with myositis diagnosed with IIM at Nanfang Hospital of Southern Medical University from January 2015 to January 2019.The patient diagnosis met the IIM classification diagnostic criteria recommended by the 2004 International Myopathy Team.Collect general clinical data,clinical manifestations and clinical indicators of myositis patients,analyze the clinical characteristics of myositis,and apply cluster analysis to classify and classify myositis patients.In the study of the relationship between idiopathic inflammatory myopathy and dermatomyositis syndrome of traditional Chinese medicine,it satisfies the diagnostic basis of the dermatomyositis of the diagnosis and treatment of Chinese medicine in May 2017.The classification of TCM syndrome refers to.the 2017 version of TCM treatment plan.And "Traditional Chinese Medicine Diagnosis and Treatment Standards",collect the diagnosis of myositis and TCM syndromes,and analyze the correlation between them.ResultsThe clinical features of 34 myositis patients were retrospectively analyzed.Polymyositis is mainly characterized by myasthenia gravis,interstitial pneumonia and arthritis.It can be combined with other rheumatism.Anti-synthetase antibodies,anti-Ro52 antibodies and anti-nuclear antibodies are the main antibodies.The clinical manifestations of dermatomyositis are mainly rash and interstitial pneumonia.The muscle enzymes are slightly elevated,and anti-MDA5 antibodies are mainly seen in the antibody.The clinical manifestations of myositis dermatomyositis are mainly rash,fever and interstitial pneumonia.The antibodies are anti-MDA5 antibody,anti-Mi-2βantibody,anti-PL-7 antibody,anti-Ro52 antibody and anti-nuclear antibody,and can be seen in multiple The case where myositis-specific antibodies coexist.In patients with necrotizing myositis,muscle weakness is the main cause,muscle enzyme levels are significantly increased,and antibodies are mainly anti-SRP antibodies.Cluster analysis analyzed 34 patients with myositis into 3 categories,and 13 patients in the first category,of which no myositis dermatomyositis was the most.In terms of clinical manifestations,fever,rash and interstitial pneumonia are the main features,while the level of muscle enzymes is normal or slightly elevated,and the antibody is most prominent with anti-MDA5 antibody.There are 7 patients in the second category,of which most of the necrotic myopathy.The clinical manifestations are characterized by muscle weakness,and the level of muscle enzymes is significantly increased.The antibody is most prominent with anti-SRP antibodies.There were 14 patients in the third category,including polymyositis.The clinical manifestations were fever,joint pain and interstitial pneumonia.The level of muscle enzymes was normal or significantly elevated.The antibody is mainly composed of anti-synthetase antibodiesThe association between idiopathic inflammatory myopathy subtypes and traditional Chinese medicine tendon syndrome,the results show that dermatomyositis and damp-heat collaterals are closely related,no myopathy dermatomyositis and spleen and kidney deficiency syndrome are closely related,multiple muscles Inflammation,necrotizing myopathy is closely related to spleen deficiency and dampness syndrome,and cold dampness and stasis syndrome.ConclusionsThis study highlights the clinical features of the IIM subgroup,and clusters of myositis patients into three categories,suggesting that anti-synthetase antibody syndrome may exist as a new subgroup of myositis,although it is impossible to define a new classification of myositis,but it is a An early basic work on the new classification of myositis.The characteristics of idiopathic inflammatory myopathy subtypes and TCM syndromes of traditional Chinese medicine.The TCM syndrome differentiation of dermatomyositis is mostly a syndrome of dampness and heat resistance.The syndrome differentiation of non-myopathy dermatomyositis is mostly due to spleen and kidney deficiency syndrome.The syndrome differentiation of polymyositis and necrotic myopathy is mostly spleen deficiency and dampness syndrome and cold dampness and stasis syndrome.