有家族史与无家族史强直性脊柱炎临床表现异同研究.docVIP

有家族史与无家族史强直性脊柱炎临床表现异同研究 　　【摘 要】目的：探?有家族史与无家族史的强直性脊柱炎临床表现的异同及对强直性脊柱炎中医辨证的临床意义。方法：将河南风湿病医院强直性脊柱炎数据库（HFAS数据库）中收录的379例患者按有无家族史分为有家族史组和无家族史组，采用SPSS 19.0统计软件分析2组在关节表现、关节外表现及体格检查方面的区别与联系。结果：379例强直性脊柱炎患者中，有家族史组166例，无家族史组213例，其中有家族史组占患者总数的43.80%，且病程较无家族史组更长。通过对2组185个关节表现及关节外表现、7项体格检查进行统计分析，2组间差异有统计学意义（P 无家族史组；全身畏寒喜暖，疼痛性质（凉痛），有家族史组 无家族史组。结论：有家族史的强直性脊柱炎患者在“瘀血、阴虚”的临床表现上较无家族史明显，而无家族史的强直性脊柱炎患者在“阳虚、寒邪”的临床表现上较有家族史明显。故对有家族史的强直性脊柱炎，在祛邪的同时，更应重视活血及补肾阴；而无家族史的强直性脊柱炎，在活血的同时，更应重视补肾阳及祛寒邪。 　　【关键词】 脊柱炎，强直性；家族史；遗传；临床表现；HFAS数据库；中医辨证；临床研究 　　On Clinical Similarities and Differences of Ankylosing Spondylitis with Family History and Without Family History 　　CHEN Yong-qian，LOU Yu-qian 　　【ABSTRACT】Objective：To explore clinical similarities and differences of ankylosing spondylitis with family history and without family history and their clinical significance for TCM syndrome differentiation.Methods：Three hundred and seventy-nine cases of ankylosing spondylitis selected from the ankylosing spondylitis database of Henan Rheumatism Hospital（HFAS database）were divided into a family history group and a non-family history group，using SPSS 19.0 statistical software to analyze the difference and relation between the two groups on the aspects of articular manifestation，extra-articular manifestation and physical examination.Results：Among the included patients，166 cases had family history，accounting for 43.80% and the other 213 cases 　　hadn’t.The disease course of the former was longer that the latter.According to the statistical analysis for 　　185 articular and extra-articular manifestations and 7 physical examinations，the differences of 7 clinical manifestations were statistically significant between the two groups（P 0.05），among which back stiffness，pain impact factors（being relieved at night and aggravated in the morning，being relieved after activity）feeling hot consciously were more common in the group with family history than the other group. 　　Conclusion：Clinical manifestations “blood stasis a