Investigation Of The Relationship Between TCM Syndrome And Disease Activity Of Ankylosing Spondylitis

ObjectiveTo study the association of Blood analysis,C-reative protein(CRP),erythrocyte sedimentation rate(ESR),white blood cell(WBC),neutrophilic granulocyte(GRAN),haematoglobin (Hb),platelet(PLT),and immunoglobulin(Ig) with 5 TCM syndromes of ankylosing spondyhtis(AS).And to study the relationship beteen TCM syndrome and the Bath ankylosing spondylitis activity index(BASDAI).Material and Methods120 AS patients including the outpatients and inpatients in the department of Rheumatology, to be selected in this study.Each patient was asked for BASDAI:fatituge,morning stiffness, neck,back or hip pain,pain/swelling in joints other than neck,back or hips,and discomfort from any areas tender to touch or pressure.Each patient was determined for Blood analysis CRP,ESR,WBC,GRAN,PLT,Hb and Ig.To record clinic symptoms,picture of the tongue, and pulse tracings.The chest expansion,modified Schober test and pillow-wall dist were recorded.Disease activity was assessed by the criterion of the Bath ankylosing spondy- litis activity index(BASDAI).The activity of disease was divided into three levels according to BASDAI:no activity,ambiguous activity and definite activity.The relation- ships of the pictorial of TCM syndromes with Blood analysis CRP,ESR,WBC,GRAN,PLT,Hb and Ig were analyzed.The association of TCM syndrome with BASDAI was studied.ResultsThe pencents of five TCM syndromes in order as follow:the retention of damp-heat syndrome 52.5%(63/120),the deficiency of kidney-yang syndrome 20.8%(25/120),the retention of damp-cold syndrome 10.8%(13/120),the deficiency of gan-kidney syndrome 8.3% (10/120),and the retention of stagnated blood syndrome 7.5%(9/120).It was different between the active stage and inactive stage.For the laboratory index,the ESR,CRP,GRAN,PLT, Hb and IgA of each syndrome was significantly different,while the comparison with the data ofWBC,IgG,IgM was no evident diference.Damp-heat syndrome:CRP(23.32±9.95)ng/ml, ESR(35.02±15.13)mm/h,IgA(3.58±1.16)g/L.Damp-cold syndrome:CRP(17.39±6.10)ng/ml, ESR(27.38±7.30)mrn/h,IgA(3.19±0.57)g/L.The retention of stagnated blood syndrome:CR-P (10.47±2.97)ng/ml,ESR(18.00±7.20)mm/h,IgA(2.88±0.68)g/L.The deficiency of gankidhey syndrome:CRP(8.81±2.68)ng/ml,ESR(14.11±5.99)ram/h,IgA(2.80±0.60)g/L.The deficiency of kidney-yang syndrome:CRP(7.66±2.59)ng/ml,ESR(11.80±6.94)mm/h,IgA (2.71±0.44)g/L CRP,ESR and IgA of Damp-heat syndrome were significantly higher than any other syndrome.There were correlations between TCM syndrome and BASDAI.There was no correlation among the Schober test chest expansion,pillow-wall dist and TCM syndromes.ConclusionThe distribution of AS TCM syndrome was mainly about the retention of damp-heat,active stage is mainly about the retention of damp-heat,and the in active stage is mainly on deficiency of kidney-yang syndrome.Compared with other syndromes,CRP,ESR,GRAN and IgA in the syndrome of retention of damp-heat were significantly higer.PLT of the rete- ntion of stagnated blood syndrome was lower than any other TCM symdrome.Hb of the rete- ntion of stagnated blood syndrome and the deficiency of gan-kidney syndrome was signican-tly lower than other three TCM syndromes.There were no significant changes of syndrome on IgG,IgM and WBC.The abnormal rates of ESR,CRP,GRAN and IgA in definite activity group were higher than those in no activity group,while the levels of CRP and IgA in definite activity group were higher than those in no activity group.There were corre- lations between TCM syndrome and BASDAI.There were correlations between TCM syndrome and BASDAI.there was no correlation among the Schober test chest expansion,pillow-wall dist and TCM syndrome.