| Objective:To explore the distribution of TCM syndrome elements in patients with Rheumatoidarthritis(RA)with increased platelet,study the combination of location syndrome elements and pathological syndrome elements,and analyze the correlation between pathological syndrome elements and general data,joint signs,laboratory indicators,and DAS28 score,so as to guide clinical syndrome differentiation and treatment.Data and methods:Inpatients with rheumatoid arthritis with thrombocytopenia in the Department of Rheumatology and rheumatology Rehabilitation of our hospital from October2019 to September 2022 were collected.Case data were screened strictly according to the inclusion and exclusion criteria,and 231 qualified cases were selected.The case data were sorted out,and the relevant disease locations and syndrome elements of the patients were summarized and a database was established.Statistical software SPSS25.0 was used to collect data for statistical analysis,and the conclusion was drawn.Results:1.General data: A total of 231 cases were collected,including 38 males(16.45%)and 193 females(83.55%),with a male-female ratio of 1:5.There were 25 young patients aged 18-44 years old(10.82%),89 middle-aged patients aged 45-59 years old(38.53%),117 elderly patients aged over 60 years old(50.65%),and most of them were elderly patients.124 patients(53.68%)had a course of disease < 5 years,33 patients(14.29%)had a course of disease 5-9 years,37 patients(16.02%)had a course of disease 10-14 years,37 patients(16.02%)had a course of disease ≥15 years,and the majority of patients had a course of disease < 5 years.2.Distribution of disease activity(DAS28 score):There were 0 patients(0%)with low disease activity(2.6 points < DAS28≤3.2 points),33 patients(14.29%)with moderate disease activity(3.2 points < DAS28≤5.1 points),and 198 patients(85.71%)with high disease activity(DAS28 > 5.1 points),mostly patients with high disease activity.3.Distribution of syndromes of disease location: the three syndromes with the highest frequency were kidney syndromes,liver syndromes and spleen syndromes in turn;In the distribution of disease location syndrome element combination,the combination of double disease location syndrome element accounted for the highest proportion,114 cases,accounting for 49.35%,among which liver + kidney accounted for the highest proportion,36 cases,accounting for 15.58%.Followed by 75 cases of three-disease combination,accounting for 32.47%,in which liver + spleen + kidney accounted for the highest proportion,22 cases,accounting for 9.52%;The combined distribution of single and four disease sites was less.4.Distribution of pathogenic syndromes: Among the 11 pathogenic syndromes,the three with the highest frequency were blood-stasis syndromes,phlegm-dampness syndromes and heat syndromes in turn.In the distribution of combination of pathogenic syndrome-elements,123 cases(53.25%)were the most distributed in the three-pathogenic combination,among which34 cases(14.72%)were blood stasis + phlegm-dampness + heat.The second was the dual-disease combination of 94 cases,accounting for 40.69%,in which blood stasis and heat were the majority,accounting for 7.36% in 17 cases.There were 11 cases(4.76%)of the four syndrome-element combinations,among which blood stasis + phlegm-dampness + heat + Yin deficiency was the majority(5 cases),accounting for 2.16%.The combination of single disease and five disease syndromes was less distributed.5.Correlation analysis between pathogenic syndrome elements and general data,joint signs,laboratory indicators and DAS28 scores showed that PLT,ESR,CRP and anti-CCP antibody had statistical differences in the distribution of pathogenic syndrome elements(P < 0.05),among which the values of PLT,CRP and anti-CCP antibody increased significantly in patients with heat,phlegm and blood stasis syndrome elements.Patients with wind,heat,phlegm-dampness syndrome elements had higher ESR value and more serious disease activity.There were no significant differences in the distribution of syndrome elements in patients with gender,age,course of disease,number of joint swelling,number of joint tenderness,RF,Ig A,Ig G,Ig M,complement C3,complement C4 and DAS28 scores(P > 0.05).Conclusion:1.Most of the patients with rheumatoid arthritis and thrombocytopenia were elderly women,the course of disease was less than 5 years,and most of the patients had high disease activity.2.Kidney syndrome,liver syndrome and spleen syndrome were the most common syn dromes in rheumatoid arthritis patients with increased platelet.Blood stasis syndrome,phlegm-dampness syndrome and heat syndrome were the most common syndromes.3.The distribution of syndromes was correlated with PLT,ESR,CRP and anti-CCP antibody in patients with rheumatoid arthritis and thrombocytopenia.The values of PLT,CRP and anti-CCP antibody increased significantly in patients with heat,phlegm-dampness and blood stasis syndrome.Patients with wind,heat,phlegm-dampness syndrome elements had higher ESR value and more serious disease activity. |
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