Clinical Investigation On Fatigue Symptoms Of Rheumatoid Arthritis And Related Research On TCM Syndrome Types

BackgroundFor disease symptoms,currently,clinical treatment is mainly inclined to pathologically based description,because the basic pathological change of rheumatoid arthritis(RA)is synovitis of the joint,so the description of RA clinical symptoms focuses on joint manifestations,and treatment is mainly aimed at joint symptoms.With the development of rheumatoid arthritis(RA)research,strict cont:rol and targeted treatment and management have a good effect on joint symptoms and imaging manifestations of joint damage,which can effectively alleviate disease activities.However,RA patients still suffer from severe fatigue.40?80%of RA patients are in a state of fatigue,which seriously affects their life.As far as patients are concerned,reducing fatigue is an important treatment requirement,but it is often ignored in clinical practice,and there is a lack of effective intervention measures at present.ObjectiveTo Investigate the fatigue overview of patients with RA through clinical observation of their fatigue level.To analyze the relationship between RA patients' fatigue and TCM syndromes and the etiology and to preliminarily explore the etiology and pathogenesis of RA fatigue.By determining the RA patients' rheumatoid factor(RF),cyclic citrullinated peptide(CCP)antibody,and c-reactive protein(CRP)indicators,analyzing the correlation between the traditional Chinese medicine(TCM)syndromes of patients with significant fatigue and laboratory indicators.(3)In order to focus on the clinical RA related fatigue,give play to the advantages of TCM,applied to the clinical prevention and treatment of the disease.MethodsRA patients admitted to the outpatient department of dongzhimen hospital of Beijing university of TCM from December 2017 to December 2018 were screened,and cases were collected according to the corresponding inclusion and exclusion criteria.All RA patients signed the informed consent and gathering general information,testing the RF,CCP,CPR,fill in the data calculation table,and according to the TCM new medicine clinical research guiding principles for the treatment of rheumatoid arthritis(2002)combined with TCM colleges teaching of diagnostics of TCM about the content of the TCM four diagnostic data fill in TCM symptoms questionnaire,finally will adopt sets of data for statistical analysis.ResultsBasic data:a total of 80 patients were included in this study,with an average age of 54.19±13.77 years old.The youngest was 23 years old,and the oldest was 74 years old.The average course of disease was 88.79±89.99 months,among which the shortest course was 1 month and the longest was 364 months.Among them,there were13 males and 67 females.The damp-heat stagnation syndrome is the mainly distribution among the RA patients' TCM syndrome types,accounting for 42.50%,liver-kidney yin deficiency syndrome accounted for 18.75%,cold and dampness syndrome accounted for 20.00%and kidney qi deficiency and cold syndrome accounted for 12.50%,blood stasis syndrome accounted for 6.25%.There was no statistically significant difference in CPR between RA and different TCM syndromes(P>0.05).There were statistically significant differences in RF and CCP among different TCM syndromes of RA(P<0.05).Fatigue profile:the average fatigue severity score of 80 RA patients was 4.94±1.19.Among them,61 patients(FSS>4)had obvious fatigue,accounting for 76.25%of the total number,and their average fatigue severnty score was 5.44±0.85.Among the RA patients with damp-heat stagnation syndrome,those with obvious fatigue were the most,accounting for 55.74%.Secondly,the obvious fatigue was found in the type of kidney qi deficiency and cold syndrome,accounting for16.39%.Cold and dampness syndrome accounted for 13.11%and liver-kidney yin deficiency syndrome accounted for 11.48%;blood stasis syndrome accounted for 3.28%.The five TCM syndrome types and syndromes involved were decomposed into seven syndrome elements of cold and dampness,dampness and heat,blood stasis,qi deficiency,qi stagnation,yin deficiency and yang deficiency,and the frequency of each syndrome element in patients with obvious fatigue was counted.The results showed that the most frequent syndrome elements were damp-heat(38 times),blood stasis(23 times),yin deficiency(18 times),followed by yang deficiency(15 times),qi deficiency(12 times),cold and dampness(14times),and qi stagnation(7 times).There was a weak correlation between FSS score and CRP in patients with obvious fatigue(r=0.266,P<0.05)and no correlation between RF and FSS score(P>0.05).There was a positive correlation between VAS score and anti-ccp antibody in patients with apparent fatigue(r=0.360,P<0.05),but no correlation between VAS score and RF(P>0.05).Conclusion1.Fatigue symptoms widely exist in patients with rheumatoid arthritis,which should be paid attention to.2.Fatigue can reflect the severity of RA to some extent.3.Fatigue symptom distribution and fatigue degree of RA patients with different TCM syndromes are different,among which damp-heat stagnation syndrome is the most common,and kidney qi deficiency and cold syndrome is the most serious.4.Damp-heat may be an important pathogenic factor for RA fatigue development,so the treatment of damp-heat should be emphasized.