TCM Pathogenesis Evolution Study Of Rheumatoid Arthritis Based On Pathogenesis Factors

This research is based on 'pathogenesis factors'theory, to investigate TCM pathogenesis evolution ruls of rheumatoid arthritis(RA) in theoretical and clinical sections.Theoretical research:Study of etiology and pathogenesis are crucial for medical practice. With the development of science and technology, pathogenesis research has been deep into the cellular, genetic, molecular level, and has made some progress. However, the pathogenesis and causes are so complex for some diseases that we are still unable to fully explain their pathogenesis, and rheumatoid arthritis belongs to the group. Current studies suggest that rheumatoid arthritis is an antigen-mediated, multiple factors involved autoimmune diseases, closely related to infectious, genetic, endocrine, environmental, gender and other factors. Because the development of RA has multi-factor interactions and multiple routes, till now we have not yet been able to form an overall understanding of it.TCM theoretical system is chracterised by its overall concept and syndrome differentiation, and has its own advantages. In the development of TCM, every leap is symbolized by the innovations of the pathogenesis theory. Professor ZHOU Zhongying always attaches importance to the theoretical study of pathogenesis, stresses'seek of pathogenesis in syndrome differentiation'. In recent years, combining with years of clinical experience, he raised two new conceptions "complex pathogenesis" and "Pathogenesis elements," in order to exceed the rigid syndrome differentiation model in textbooks, and establish a new system of syndrome differentiation based on pathogenesis element and Zang-fu Organs Syndrome Differentiation, which may give better directions to clinical practice.This study is based on'Pathogenesis factors'theory. After gathering ancient and modern physicians'theories of rheumatoid arthritis, we established the 10 pathogenesis factors and their identification standards, and then conduct the clinical epidemiological investigation.Clinical Research:This study adopted the vertical way of clinical epidemiology at multiple time points(first visit,15 days,30 days,60 days,90 days,180 days 6 points) and conducted prospective research, and collected 83 cases of rheumatoid arthritis patients, and investigated general information, Chinese medicine four diagnosis information, laboratory results, etc. in order to reveal the rule of TCM pathogenesis evolution of rheumatoid arthritis, and the relevance between pathogenesis factors and general information, joint inflammation manifestations, activity or relief period, joint function, quality of life, laboratory tests, etc.After statistical analysis, final conclusions are as follows:RA is mainly in the female, especially age between 45 to 59 years old. The onset of the disease is significantly correlated with a variety of factors, including the menstruation, pregnancy and births, wet or cold living conditions, exposure to chemical products, family heredity history, and so on. Cold, damp and blood stasis are always existed throughout the evolution of rheumatoid arthritis, no matter during activity or remission period. In addition to cold, damp and blood stasis, qi, wind and heat are the major pathogenesis factors for the onset period, while wind, qi or yin deficiency for the remission period. Heat and qi deficiency are relavant to the activity of the disease; qi deficiency and yin deficiency are the main weak pathogenesis factors of remission period. Long course of disease, old age, heavy classification of joint function, severe joint symptoms are significantly associated with deficient pathogenesis factors. Joint inflammation manifestations such as joint pain, swelling, tenderness, morning stiffness are relevant to wind, cold and damp. Laboratory examination results are relevant to pathogenesis factors.