| ObjectiveThis study based on the theory of syndrome elements,we investigated the distribution of syndrome elements based on CT grading in patients with ankylosing spondylitis(AS)and the sacroiliac joint lesions to provide reference for clinical diagnosis and treatments.MethodsOutpatients and inpatients with ankylosing spondylitis who attended the Department of Rheumatology of the Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine between March 2022 and February 2023 were used for the study,and 30 cases of CT grade Ⅰ,grade Ⅱ,grade Ⅲ and grade Ⅳ groups were collected respectively,totaling 120 patients.The patients’ basic data and information of the four examinations were collected using the four examination information collection forms,and the evidence element identification software and statistical software were used to study the distribution characteristics of the evidence elements of different grades of CT of the sacroiliac joint in AS.Results1.The difference in the gender distribution of patients with different grades of AS sacroiliac CT was not statistically significant(P>0.05);the difference in the age distribution was statistically significant(P<0.05),with the greatest number of young people in all four groups(frequencies of 93.33%,73.33%,43.33%,50.00%,respectively),while grades Ⅲ and Ⅳ also occupied a certain proportion in middle-aged people(frequencies of 36.67% and36.67%,respectively).The difference of course distribution was statistically significant(P<0.05).The disease duration in group Ⅳ was longer,with a difference in the duration of disease between grade Ⅳ and grades Ⅰ,Ⅱ and Ⅲ of the sacroiliac joint CT(P<0.05),,while there was no difference in the duration of disease between grades Ⅱ and Ⅲ(P>0.05).2.Distribution characteristics of the evidence elements of each group: the common syndrome elements of disease location of the sacroiliac joint CT grade Ⅰ and Ⅱ group were tendons and bones,kidneys,meridians and liver,and the common pathological elements were blood stasis,dampness,cold and heat;the common syndrome elements of disease location of the sacroiliac joint CT grade Ⅲ group were tendons and bones,kidneys and meridians,and the common pathological elements were dampness,blood stasis,cold,yang-deficiency and yin-deficiency;the common syndrome elements of disease location of the sacroiliac joint CT grade Ⅳ group were tendons and bones,kidneys and meridians,and the common pathological elements were dampness,blood stasis,cold and yang-deficiency.3.Correlation comparison: There was no significant difference between CT grade Ⅰ and grade Ⅱ of the sacroiliac joint in terms of the distribution of the disease location and pathogenic evidence(P>0.05);there was a difference between CT grade Ⅰ and grade Ⅲ in terms of the distribution of damp and heat evidence(P<0.05),and heat was an important influencing factor for the occurrence of grade Ⅲ(P<0.05,OR<1);there was a difference between CT grade Ⅰ and Grade Ⅳ differed in the grade distribution of meridians,blood stasis,dampness,yang-deficiency and heat(P<0.05),and heat was an important influencing factor for the occurrence of Grade Ⅳ(P<0.05,OR<1),with meridians and yang-deficiency being risk factors for the occurrence of Grade Ⅳ(both P<0.05,OR>1).Conclusion1.There is a correlation between the CT grading of the sacroiliac joint in ankylosing spondylitis and the age distribution,with a high frequency of grades Ⅲ and Ⅳ in middle-aged patients;there is a correlation with the duration of the disease,suggesting that the degree of CT grading of the sacroiliac joint increases with the duration of the disease.2.In terms of syndrome elements of disease location: Ankylosing spondylitis sacroiliac joint lesions are closely related to tendons,kidneys and meridians on different CT grading,and meridians(du)are risk factors for grade Ⅳ,suggesting that clinical diagnosis and treatment of AS sacroiliac joint grade Ⅳ patients should pay attention to strengthening the du.3.In terms of pathogenic elements: Ankylosing spondylitis sacroiliac joint lesions are closely related to blood stasis,dampness and cold on different CT grades.In addition,grades Ⅰ and Ⅱ are often associated with evidence of heat,while grades Ⅲ and Ⅳ are often associated with evidence of yang deficiency.Moreover,heat was an important influencing factor for grades Ⅲ and Ⅳ,and yang deficiency was a risk factor for grade Ⅳ,suggesting that clinical diagnosis and treatment of AS in the middle and late stages should pay attention to the application of the method of warming yang. |
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