Study On The Correlation Between Risk Factors Of Rheumatoid Arthritis And Syndrome Elements Of Traditional Chinese Medicine

1 ObjectiveThrough the rheumatoid arthritis population and the general population to investigate the risk factors and characteristics of rheumatoid arthritis patients;Then explore the correlation between TCM syndrome elements and risk factors of clinical rheumatoid arthritis in order to make a certain contribution to the TCM clinical diagnosis and treatment of rheumatoid arthritis.2 Methods2.1 Study 1: Characteristics of risk factors for rheumatoid arthritisThe patients with rheumatoid arthritis and the normal control group without rheumatoid arthritis were collected from the mobile staff who came to the outpatient department and ward of the Second Affiliated Hospital of Tianjin University of Chinese Medicine from August 20 to January 20.Records of risk factors including demographic characteristics(gender,age,level of education,family history of RA,marital status),occupational characteristics(occupation,working environment,dust exposure),lifestyle(smoking history,drinking history)and complications(lung disease,periodontal disease),women collect menarche age alone.Data were input into SPSS25.0 for univariate analysis,and significant single factors were screened out.The binary logistic regression equation was established to analyze the risk values of major risk factors.2.2 Study 2: Study on the correlation between TCM syndrome elements and risk factors of rheumatoid arthritisThe risk factors of rheumatoid arthritis patients in Study I were collected,and the clinical symptoms and signs of the patients were recorded.Combined with the clinical symptoms of the patients and the expert advice of the research group,the TCM disease syndrome elements "Qi deficiency,Yang deficiency,Yin deficiency,cold,dampness,heat,blood stasis" were finally selected,and the syndrome elements were determined according to the syndrome integral diagnosis scale.The above information was incorporated into Excel to establish RA patient database,and SPSS25.0 software was used to analyze the correlation between TCM disease syndrome elements and risk factors.3 Results3.1 Results of Study 1(1)275 questionnaires were actually obtained.241 questionnaires were complete and qualified,with a pass rate of 87.6%.A total of 90 males and 151 females were included,with a male to female ratio of about 1:1.7.The mean age was(51.29±15.35)years old.(2)Univariate analysis: there were statistically significant differences in the prevalence of rheumatoid arthritis among people of different ages,genders,marital status,educational level and genetic factors(P<0.01).There were statistically significant differences in the prevalence of rheumatoid arthritis between exposure to dust at work and humidity at work(P<0.01).There was no significant difference in the prevalence of rheumatoid arthritis among smoking and drinking history(P>0.05).There was no significant difference in the prevalence of rheumatoid arthritis in patients with or without chronic lung disease(P BBB 0 0.05).The prevalence of rheumatoid arthritis with or without periodontal disease was statistically significant(P<0.05).The age of menarche was significantly different between the RA group and the non-RA group(P<0.01).The age of menarche was(14.82±2.27)years in the RA group and(13.63±1.43)years in the control group.(3)Bary Logistic regression analysis results of risk factors for RA: moist working environment(OR=14.11,95%CI: 2.84-70.14),dust exposure at work(OR=6.94,95%CI: 2.92-16.54),female sex(OR=4.36,95%CI: 1.80～10.55),first-degree relatives with RA(OR=4.19,95%CI: 1.05～16.72)were risk factors for RA in the respondents;The education level of middle OR high school(OR=0.30,95%CI: 0.13～0.73),junior college OR above(OR=0.02,95%CI: 0.00～0.11)were the protective factors for RA.3.2 Results of Study II(1)A total of 85 patients were included in this study,including 18 male patients,accounting for 21.2% of the total;There were 67 female patients,accounting for78.8% of the total study.The prevalence of RA in females was significantly higher than that in males: 3.7:1 in males.(2)General characteristicsDemographic characteristics: In terms of age,the youngest patient in this study was29 years old,and the oldest was 82 years old.The mean age was 59.26±9.90 years.According to the age distribution,the largest number of people were aged 41-60(37cases,43.5%),61 years old and above(44 cases,51.8%),and 40 years old and below(4 cases,4.7%).Among the patients included in this study,the number with the education level at or below primary school accounted for the largest proportion(41%,57%),while the number with the education level at or above junior college accounted for a relatively small proportion(2%).Of the 85 patients with marital status,the most common was married(79,92.9%),and unmarried,divorced,and widowed were in equal proportion(both 2,2.4%).From the perspective of family history,among the 85 patients,12 first-degree relatives(parents,children and biological brothers and sisters)had RA,accounting for 14.1% of the total,and 73 first-degree relatives did not have RA,accounting for 85.9% of the total.Occupational characteristics: From the perspective of occupational distribution,occupational proportion of 85 patients: worker(49.4%),> farmer(27.1%),>individual(9.4%),> white-collar worker(7.1%),> teacher(4.7%),> cadre(2.4%).In this study,47 cases(55.3%)were exposed to dust.The types of dust were sorted by frequency,and the proportions of cotton dust,silica dust and metal dust were the highest,followed by dust,chalk dust,chemical fiber dust,coal dust and grain dust.In terms of working environment,among the 85 patients,indoor working proportion(68.2%)> outdoor working environment(31.8%),non-working environment wet(70.6%)> working environment wet(29.4%).Living habits: had a history of smoking(24 cases,28.2%)< no history of smoking(61 cases,71.8%),had a history of drinking(12 cases,14.1%)< no history of drinking(85.9%).Feminine characteristics: A total of 67 women were included in this study,including 9 women of childbearing age and 58 postmenopausal women.Age of menarche: later than 14 years(30 cases,45%)>13 to 14 years(29 cases,43%)>earlier than 13 years(8 cases,12%).Menstrual cycle: > was greater than 29 days(47cases,70%)(13 cases,19%)and > was less than 27 days(7 cases,11%).Days of treatment: 5-7 days(53 cases,79%)> less than 5 days(10 cases,15%)> greater than7 days(4 cases,6%).Age of menopause: Post-49 years of menopause(39 cases,67%),>48 and pre-menopause(19 cases,33%).(3)Clinical featuresThe mean age of onset of 85 patients was(46.51±12.01)years,and the course of RA ranged from 0.5 to 48 years,with an average of(12.67±9.98)years.In terms of season of disease,in this study,the proportion of season of disease was the highest in summer,followed by winter and autumn,and the number of people with disease was the least in spring.In terms of the predisposing factors,no obvious predisposing factors(33%)and catching cold(47%)were the most,followed by tiredness and tiredness + catching cold.In women,there were 19 cases of perimenopause and puerperium,accounting for 32.8% of the total number of female patients.From the clinical manifestations,in 85 patients,small joint onset(50 cases,58.8%)and small joint onset(32 cases,37.6%)of > large joint onset(3 cases,3.5%).From the perspective of joint deformation,60 of the 85 patients had joint deformation,accounting for 70.6% of the total number of patients,and the duration of joint deformation was(6.87±6.85)years.In terms of complications,patients with chronic pulmonary disease(12 cases,14.1%)were lower than those without chronic pulmonary disease(73 cases,85.9%),and patients with periodontal disease(39 cases,45.9%)were lower than those without periodontal disease(46 cases,54.1%).The clinical characteristics of patients with periodontal disease were analyzed.The onset of periodontal disease was earlier than that of RA in 25 cases(64.1%),and the onset of RA was earlier than that of RA in 14cases(35.9%).(4)Characteristics of TCM disease syndrome elementsAmong the 85 patients,Yin deficiency was the main syndrome,followed by Yang deficiency and Qi deficiency.The main solid syndromes were dampness,followed by blood stasis,heat and cold.The distribution difference of 4 solid syndrome elements among 3 deficiency syndrome elements was statistically significant(P<0.01): Qi deficiency combined with blood stasis,Qi deficiency combined with cold,Yang deficiency combined with dampness,and Yin deficiency combined with blood stasis were the most common combination types of syndrome elements.(5)Correlation between characteristics of TCM disease syndrome elements and risk factorsSex: There was no significant difference in the distribution of asthenia syndrome elements and solid syndrome elements in different genders(P BBB 0 0.05).Age: Deficiency syndrome elements showed significant differences in different age groups(P<0.01).Among them,Qi deficiency syndrome elements were more common in patients aged 40 and below,Yang deficiency syndrome elements were more common in patients aged 41-60,and Yin deficiency syndrome elements were the most common in patients aged 61 and above.There was no significant difference in solid syndromes among different age groups(P Bb0 0.05).Dust exposure: there was a significant difference in the distribution of deficiency syndrome and solid syndrome elements in RA patients exposed to dust and non-exposed to dust(P<0.01).Yin deficiency and blood stasis were the most common TCM syndrome elements in RA patients exposed to dust,while qi deficiency and dampness were the most common TCM syndrome elements in RA patients not exposed to dust.Moist working environment: there were significant differences in the distribution of deficiency syndrome and solid syndrome elements between RA patients with damp working environment and those without damp working environment(P<0.05).The most common TCM syndrome elements were Yang deficiency and damp in RA patients with damp working environment,while the most common TCM syndrome elements were Yin deficiency and blood stasis in RA patients without damp working environment.Complications: there were significant differences in the distribution of deficiency syndrome elements with or without pulmonary diseases(P<0.01),and the specific proportion was Yin deficiency > Qi deficiency > Yang deficiency;There was no significant difference between the combination of pulmonary disease and the solid syndrome group(P>0.05).The distribution of deficiency syndrome elements with or without periodontal disease was significantly different(P<0.01),and the specific proportion was Yin deficiency >,Yang deficiency >,Qi deficiency;The distribution of solid syndromes with or without periodontal disease was significantly different(P<0.05),and the specific proportion was wet > blood stasis > heat > cold.It can be seen that the most common syndrome element of Yin deficiency and dampness in patients with periodontal disease.Lifestyle: The results of this study showed that there was no statistical significance in the deficiency syndrome elements and solid syndrome elements of RA patients with different living habits(P>0.05).4 Conclusion1.Female gender,exposure to dust at work,humid working environment,first-degree relatives suffering from RA,and low education level are risk factors for RA.2.The age of menarche in women with RA was significantly higher than that in women without RA.3.RA patients exposed to dust at work are more likely to have Yin deficiency combined with blood stasis,and RA patients in humid working environment are more likely to have Yang deficiency combined with dampness.RA patients with pulmonary diseases are more likely to have Yin deficiency syndrome,and RA patients with periodontal diseases are more likely to have Yin deficiency combined with dampness,Yin deficiency combined with blood stasis syndrome.