Clinical Characteristics Of Polymyositis/Dermatomyositis Complicated With Interstitial Lung Disease And The Rule Of Differentiation And Treatment In TCM

Objective:To observe the clinical characteristics of myositis/dermatomyo-sitis complicated with interstitial lung disease,and to explore the rul-e of differentiation and treatment in Chinese medicine,so as to provid e new ideas for early prevention,diagnosis and treatment of the disease.Methods:Collect a definitive diagnosis of multiple myositis/dermatomyositis patients with multiple myositis/dermatomyositis were retrospectively analyzed with interstitial lung disease(PM/DM-ILD)in 40 patients without an interstitial lung disease(PM/DM-without ILD)in patients with 28 cases for comparison,patient age,gender,course,clinical manifestation,laboratory indexes,such as high resolution CT results,statistical analysis,summarizes the clinical characteristics;Collect syndrome types and prescriptions,explore the rule of treatment,in order to elaborate the treatment method and concept.Results:1.The proportion of patients with a duration of less than 1 year in the PM/DM-ILD group was higher than that in the PM/DM-without ILD group(P<0.05).Lung symptoms were the highest in the first PM/DM-ILD group,and rash was the highest in the first PM/DM-without ILD group.In the PM/DM-ILD group,the proportion of mechanic’s hand was significantly higher than that of the PM/DM-without ILD group(P<0.05).2.The value of c-reactive protein in the PM/DM-ILD group was higher than that in the PM/DM-without ILD group(P<0.05).The serum ferritin value of the PM/DM-ILD group was higher than that of the PM/DM-without ILD group(P<0.001).The proportion of positive anti-ro-52 antibody in the PM/DM-ILD group was higher than that in the PM/DM-without ILD group(P<0.001).3.The PM/DM-ILD group had the most NSIP(42.5%),followed by OP(27.5%),UIP(15%),DAD(10%),and unformed(5%).4.More than half of the patients in the PM/DM-ILD group and the PM/DM-without ILD group had hot pathogens.TCM syndrome type:the proportion of phlegm and blood stasis syndrome in PM/DM-ILD group was higher than that in PM/DM-without ILD group(P<0.05).Conclusions:1.Patients with PM/DM-ILD had a shorter course of disease than patients with PM/DM-without ILD,suggesting that they were more likely to be in the acute or subacute phase of the disease.2.The rise of c-reactive protein may be associated with ILD,but the possibility of an infectious lesion cannot be ruled out and further study is needed.The presence of mechanic’ s hand,serum ferriti,and positive anti-ro-52 antibody all suggested the possibility of a combination of ILD with PM/DM.3.The incidence of all histological types in the PM/DM-ILD group NSIP>OP>UIP>DAD.4.Heat toxin accumulation and phlegm and blood stasis in PM/DM-ILD were the main etiology and pathogenesis.In the treatment,we should pay attention to the rule of the transformation of deficiency and reality and treat it by stages.Pay attention to the dynamic change of syndromes;And a combination of Chinese and western medicine.