关节热痛是否类风湿关节炎中医证候热痹关键指标的临床研究.docVIP

关节热痛是否类风湿关节炎中医证候热痹关键指标的临床研究 　　【摘 要】目的：探讨关节热痛是否类风湿关节炎中医证候热痹的关键指标。方法：将河南风湿病医院类风湿关节炎数据库（HFRA数据库）中收录的409例患者按有无关节热痛分为关节热痛组和无关节热痛组，并运用SPSS 19.0分析2组在关节表现及关节外表现方面的区别和联系。结果：关节热痛的聚类结果②中，出现了畏寒肢冷、凉痛、四肢不温等寒象，⑤中出现了全身怕风怕冷、食冷腹泻等寒象； 　　⑥中出现了遇冷痛增遇热痛减等寒象；在无关节热痛的聚类结果①中，出现了心烦、易怒等热象，②中出现了小便黄，③中出现了眼干、鼻干、多梦等热象，④中出现了口干、咽干、口苦、咽痛等热象；2组之间进行χ2检验，关节热痛组口干、口苦、低热等“热”的临床表现多于无关节热痛组，2组间差异有统计学意义（P 0.05）；关节热痛组77例患者中有“寒”的表现如全身怕风怕冷59例（76.62%）、遇冷痛增57例（74.03%）、畏寒肢冷33例（42.86%）、食冷腹泻18例（23.38%）、四肢不温12例（15.58%）；无关节热痛组的332例患者中有“热”的表现如口干148例（44.58%）、口苦98例（29.52%）、小便黄84例（25.30%）、咽干75例（22.59%）、大便干64例（19.28%）、眼干63例（18.98%）、咽痛33例（9.94%）、鼻干24例（7.23%）、颧红23例（6.93%）、低热19例（5.72%）。结论：关节热痛不能作为类风湿关节炎热痹的关键指标；类风湿关节炎寒热错杂证较为常见；关节热痛组出现口干、口苦、低热者多于无关节热痛组，但同时伴有寒象者也很常见。 　　【关键词】 关节炎，类风湿；关节热痛；无关节热痛；热痹；辨证；HFRA数据库；临床研究 　　【ABSTRACT】Objective：To investigate whether heat pain in join is the key indicator of heat bi for rheumatoid arthritis.Methods：Four hundred and nine cases of rheumatoid arthritis from the database of Henan Rheumatism Hospital（HFRA database）were divided into a heat pain group and a heat pain free group.SPSS19.0 was used to analyze the differences and relations in terms of joint performance and external joint performance.Results：Of the clustering results in the heat pain group，cold syndromes such as aversion to cold，cold pain and cold limbs appeared in the second result，cold syndromes such as aversion of the whole body to low temperature and cold wind and diarrhea due to cold food appeared in the fifth result，and cold syndromes of pain increasing when it’s cold and pain decreasing when it’s hot appeared in the sixth result.The clustering results in the heat pain free group：Upset and irritability appeared in the first result；yellow urine could be seen in the second result；dry eyes，dry nose and dreaminess appeared in the third result；and dryness of mouth and throat，mouth pain and sore throat appeared in the fourth result.Chi square test done between the two groups showed that heat manifestations such as dry mouth，bitter m