2218 Cases Of Ankylosing Spondylitis Clinical Data Analysis And Tcm Syndrome Research

Objective:Ankylosing spondylitis(AS) is a systemic,autoimmune disease,mainly with chronic inflammation of axial joints,characterized by almost all involved for the sacroiliac joints.AS not only often happens in and around the intervertebral disc annulus fibrosus ligament calcification and bony ankylosis,but also involves peripheral joints,heart,lung, kidney,eye,nerve,muscle and other organs.The early symptoms of patients often appear as early as the Sacroiliac image changes 5-7 years,and the diagnostic criteria now used is New York Criteria revised in 1984,which means the patients meeting standard are with advanced AS and have lost good opportunity to treat.Early diagnosis and timely treatment has become a top priority.In this study,2218 confirmed case are retrospective analyzed,which are treated by Professor Yan Xiaoping from 2006 to 2009,to find the distinguishing features of ealy diagnosis.There is no appropriate technical term of AS in Traditional Chinese medicine.AS is categories in BI disease approximately.At present,the classifications of AS-type are not yet unified,which hinder the Chinese medicine treatment to some extent.Professor Yan Xiaoping cures AS by traditional Chinese medicine Differential Treatment in long-term,and categories AS in DALV term.She accumulates plenty of practical experience and acquires good therapeutic effect.This study combines the use of four diagnostic parameters of the dialectical thinking of traditional Chinese medicine with modern methods of mathematical statistics to preliminary explore the AS TCM syndrome distribution,of basic,scientific,objective clinical instructors to verify the feasibility of Syndromes,established ankylosing spondylitis Differentiation Syndrome and the main elements of the diagnostic criteria for AS the establishment of Chinese medicine,syndrome differentiation type of work to lay a solid foundation of sound for the AS to provide reference for the prevention and treatment. Instructors for further academic thought summed up the scientific connotation of great practical importance.Methods:This study usd the forward-looking research method,by using the Epidata 3.02 data base,analyzed by SPSS12.0.Clinical data were analyzed by Descriptive analysis of frequency,Independent samples t test,Chi-square test,Correlation Analysis.Syndrome study was analyzed by Dialectical method of traditional Chinese medicine,modern Logistic regression,cluster analysis and principal component analysis.Results..AS male and female incidence ratio of 3.28:1,with an average onset age of 22.18±8.10 years old,women age at onset significantly later than male patients and female incidence ratio of childhood AS was significantly lower than male patients.AS patients with HLA-B27 positive rate of 86.94%for female patients with AS carry HLA-B27 was significantly lower than the ratio of male patients with AS,only 75.10%.There are 46.88%of AS patients have a clear predisposing factor,because of the feelings of wind,cold,wet and lead to diseases accounted for 26.06%,due to trauma caused by the total incidence of 8.12%,due to strenuous exercise resulted in the incidence accounting for 3.92%,fatigue lead to diseases,accounting for 4.10%.Involved a wide range of AS to lumbosacral,back the most common,followed by hip,hip deep,knee and neck,shoulder,groin,sternum,ribs,ankle and so on.34.13%of AS patients have joint swelling,mainly for the knee,and ankle joints,such as large limbs.AS childhood morbidity in patients with joint swelling was significantly higher than the probability of AS in patients with adult onset.AS iridocyclitis is easily associated with extra-articular lesions,the study of AS patients with iridocyclitis had accounted for 16.19%of the patients,and complicated by the rate of men and women showed no significant difference. AS diagnosis was delayed for an average period of 5.30±5.75 years,the misdiagnosis rate was 88.82%,JAS misdiagnosis rate of 92.17%,significantly higher than the adult onset group. The misdiagnosis of gender on the AS number of years and no significant effect on the rate of misdiagnosis,and positive family history of AS patients was significantly shorter average length of misdiagnosis in patients with non-AS family history,HLA-B27 negative AS patients with HLA misdiagnosis rate was significantly higher than that -B27-positive patients. AS is often misdiagnosed as lumbar disc herniation,rheumatoid arthritis,and diseases such as lumbar muscle strain.The occipital-wall distance,stem from the jaw means to distance, Schober test,spinal activity of female patients with AS was significantly better than male patients with AS;B27 gene does not carry spinal activity limitation in patients with AS were significantly better than to bring the level of HLA-B27 The AS patients;and the pathogenesis of age on the neck,waist,spine little effect on the activity.AS associated with the rate of abnormal ECG was 7.45%,abdominal B-abnormal ratio of 24.62%.AS the incidence of hip involvement was 57.09%,and male AS patients with hip involvement was significantly higher than female patients;HLA-B27 positive AS patients with the affected hip was significantly higher than that in patients with HLA-B27 negative;childhood morbidity in patients with AS higher than the rate of hip joint involvement in patients with adult onset; family history of AS in patients with the affected hip was no significant impact.In this study, bone mass and reduce the incidence of osteoporosis in patients with AS accounts for 54.45%, and male patients with lumbar and femoral bone mass reduction in the incidence of osteoporosis were significantly higher than female patients.AS male patients with gradeⅡsacroiliitis change accounted for 26.71%,Ⅳ-class accounting for 30.71%of female patients with AS levelⅡsacroiliitis change accounted for 47.68%,Ⅳ-class accounting for 10.23%. HLA-B27 negative patients with gradeⅡsacroiliitis was significantly higher than the rate of change in HLA-B27-positive patients,Ⅳlevel was significantly lower than the rate of change in HLA-B27 positive patients.Syndrome research:the frequency of TCM symptoms for AS were:fatigue fatigue, weakness in the knee waist,hi chills warm,morning stiffness,disturbed sleep soundly the night,sweating,spontaneous,four at the end of non-temperature,hi drink thirst,chest rib Inter-feel oppressed,thin stool soft,humpback deformity and upset irritability,not shiny face, shortness of breath,man or woman scrotum cold winter leucorrhea Waterloo,palpitations,hot hand-foot-heart,dizziness ringing in the ears,a long clearance urine,fever,dry stool,pain stick greasy,evil hot-hi cold eye red red heads,short red urine.Tongue pulse frequency appears bleak followed by the tongue,tongue ecchymosis blood,the tongue side of a similar fat teeth tender to bite marks,light red tongue,sublingual blood Mailuoning Qu,dark purple tongue,red tongue tip side,crack the tongue,bright red tongue,tongue atrophy,thin white coating,thin yellow moss,white greasy moss,greasy moss and with yellow and white,yellow greasy moss,moss thick white,yellow thick moss,moss,or spend less peeling moss,pulse Shen,small,string,feet weak,Waterloo,Mathematics,Shibuya,ease.According to constituent ratio of classification of syndromes due to TCM,there were 55.82%cases with syndrome of deficiency in kidney and Du Channel with cold manifestations cases with syndrome of obstruction in joints attacked by pathogenic factors accounting for 18.44%, syndrome of pathogenic factors encroaching on the Liver and the Lung accounting for 13.07%,with syndrome of accumulated pathogenic factors transforming into fire accounting for 10.60%,and syndromes of impairment of kidney by damp-heat accounting for 2.07%.Lumbosacral pain,chills warm hi,four at the end of non-isothermal,dizziness ringing in the ears,runny stool thin,urine-ching Cheung,sublingual blood Mailuoning Qu,thin white coating,small pulse,Shen pulse,the pulse string for deficiency in kidney and Du Channel with cold designate the main symptoms of the diagnosis.Fever,Bitter and viscous mouth feel, fear of heat,like cold,dizziness ringing in the ears,runny stools soft,palpitations,thick and greasy coating of white,thick and greasy yellow coating on impairment of kidney by damp-heat Syndrome higher contribution rate of diagnosis;Hip pain,knee pain,waist apathy, back pain,thigh muscle pain,groin pain,aggravating the cold face is obstruction in joints attacked by pathogenic factors permit diagnosis;pathogenic factors encroaching on the Liver syndrome elements for the upset irritability,chest and threatened the two feel oppressed,chest pain,neck pain,dizziness ringing in the ears,eyes red head red,dry eye pain,exfoliative moss; Fever,bad cold-hi heat,sweating,dry stool,urine short,hi thirsty drink,lumbosacral pain, groin pain,knee swelling for accumulated pathogenic factors transforming into fire of the diagnosis.And the five card-based diagnostic accuracy rate of prediction models are more than 90%.Way through the system confirmed that AS clustering can be divided into 5 clinical categories,corresponding to mentor Professor yanxiaoping evil Syndrome Differentiation and syndrome of pathogenic factors encroaching on the Liver and the Lung,syndrome of obstruction in joints attacked by pathogenic factors,syndrome of deficiency in kidney and Du Channel with cold,syndromes of impairment of kidney by damp-heat,syndrome of accumulated pathogenic factors transforming into fire.Through principal component analysis: specific symptoms of pathogenic factors encroaching on the Liver and the Lung,rib pain, chest pain,shortness of breath,red eyes red head,the main symptoms of hip pain,groin pain, dizziness ringing in the ears,tongue blood ecchymosis,the secondary symptoms of upset irritability,Dark purple tongue,pulse and other strings.The specific syndrome of obstruction in joints attacked by pathogenic factors:knee pain,ankle pain,heel pain,mainly light red tongue symptoms,secondary symptoms such as upper extremity joint pain.syndrome of deficiency in kidney and Du Channel with cold -specific symptoms of chills warm hi,four at the end of non-temperature,urine-money long,bleak tongue,thin white coating,the main symptoms of lumbosacral pain,neck pain,weakness in the waist and knee,hump-back deformity secondary symptoms for dilute stool soft,weak pulse foot,back pain,aggravated at night,pulse Shen,hip deep in pain,man or woman scrotum leucorrhea cold cold slippery moss,such as greasy,syndromes of impairment of kidney by damp-heat -specific permit for the mouth was bitter and sticky,greasy yellow coating,the main symptoms of hand,foot and heart fever,symptoms of secondary side of a sharp red tongue,syndrome of accumulated pathogenic factors transforming into fire of the specific symptoms of joint swelling heat pain, the main symptoms,fever,bad cold-hi heat,dry stool,urine short,thin yellow tongue coating, pulse a few,minor symptoms of moming stiffness,palpitations,sublingual Choroid blood Qu, greasy and yellow and white with moss,and other small pulses.Conclusions:This study of 2218 cases of clinical data of AS patients with a more comprehensive analysis,to improve the understanding of the clinical characteristics of the disease,suggesting that attention should be paid to younger age at onset of AS trend;attention to male patients with juvenile onset AS ratio;attention to female patients with AS HLA-B27 negative ratio;attention to the first part of the distribution of AS characteristics;importance of AS peripheral joint disease;importance of AS and the involved hip bone mass reduction in the incidence of osteoporosis and so on.Differentiation of clinical instructors of the five types of AS activity Syndromes Logistic regression analysis to establish a prediction model differentiation tests,clinical evidence syndrome of obstruction in joints attacked by pathogenic factors correct prediction rate of 83.2 percent,and the remaining four card-based clinical prediction accuracy are large at 90%, suggesting that differentiation prediction model suitable for clinical use to improve the clinical feasibility.This study used cluster analysis of the TCM Syndrome AS objective elements of the induction,classification,to avoid the differentiation of the subjective judgments of the defects, cluster analysis of the results of clinical syndromes and the teacher basically consistent with classification on clinical syndromes mentor Category have high scientific,objective,realistic and worthy of further promotion.The use of principal component of the load on the AS number of TCM Syndrome for quantitative assessment,the TCM Syndrome symptoms in a more simplified and quantified for the differentiation of clinical classification. Cluster analysis combined with principal component analysis to achieve a clinical syndrome of AS elements into traditional Chinese medicine and the purpose of extraction,it is worth further study and application.