| 引用本文:王林1，李贞玉2，周彩云3.活动期类风湿关节炎中医证型与凝血/纤溶指标的相关性研究[J].世界中医药,2020,(17):. |
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| 活动期类风湿关节炎中医证型与凝血/纤溶指标的相关性研究 |
| Clinical Observation of Relationship Between Traditional Chinese Medicine Syndromes and Oagulation/Fibrinolysis Indicators in Active Rheumatoid Arthritis |
| 投稿时间：2019-05-29 |
| DOI：10.3969/j.issn.1673-7202.2020.17.026 |
| 中文关键词: 类风湿关节炎 中医证型 证候要素 凝血/纤溶指标 炎性反应 高凝状态 类风湿关节炎患者病情评价 相关性研究 |
| English Keywords:Rheumatoid arthritis TCM syndrome type Syndrome elements Coagulation/fibrinolysis indicator Inflammatory response Hypercoagulable state Disease activity Correlation study |
| 基金项目:国家中医药管理局“十二五”中医痹病学重点学科建设项目(国中医药人教发[2012]32号) |
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| 中文摘要: |
| 目的：观察不同中医证型活动期类风湿关节炎（RA）患者血液高凝状态的差异，探讨RA凝血/纤溶异常与中医学“热、湿、瘀、肾虚”等病邪的关系。方法：选取2013年8月至2015年1月中国中医科学院西苑医院风湿病科收治的活动期RA患者209例作为研究对象，检测D-二聚体（DD）、纤维蛋白原（Fbg）、血小板计数（PLT），并进行中医证型分类，最后将采集的数据进行统计分析。结果：活动期RA患者DD、Fbg、PLT水平明显高于健康对照组；与肝肾阴虚、肾气虚寒2组“虚”性证候比较，湿热痹阻、寒湿痹阻、瘀血痹阻证、湿热夹瘀等“实”性证候的DD、Fbg、PLT水平的升高更为显著。RA患者DD、Fbg水平与病情活动均显著正相关，PLT与类风湿关节炎患者病情评分亦呈正相关，但相关性较DD、Fbg低。结论：DD、Fbg、PLT等凝血/纤溶指标在RA湿热夹瘀、瘀血痹阻等实性证型中的含量显著高于肾气虚寒型等虚性证型。DD、Fbg可能成为新的RA病情活动度监测指标。 |
| English Summary: |
| To observe the differences of hypercoagulation of patients in active rheumatoid arthritis in different active period of TCM syndrome types，and to explore the relationship between RA coagulation/fibrinolysis abnormality and “heat，dampness，blood stasis，kidney deficiency” in traditional Chinese medicine.Methods:A total of 209 RA admitted to Rheumatology Department of Xiyuan Hospital，China Academy of Chinese Medical Sciences were selected as the study objects.D-dimer(DD)，fibrinogen(Fbg)，and platelet count(PLT)were detected for classification of TCM syndromes，and finally the collected data was used for statistical analysis.Results:DD，Fbg and PLT levels of RA patients in active period were significantly higher than those of healthy control group; compared with the“deficiency”syndromes of liver and kidney yin deficiency and kidney qi deficiency and cold，the DD，Fbg，and PLT levels and other“excess”syndromes of damp heat blockade，cold dampness blockade，blood stasis blockade are more significantly increased.The levels of DD and Fbg in RA patients are significantly positively correlated with disease，and PLT is also positively correlated with RA disease，but the correlation is comparatively low.Conclusion:The content of coagulation/fibrinolysis indexes such as DD，Fbg，PLT and other excess syndromes in RA damp-heat and stasis，stasis and blood blockade is significantly higher than the deficiency syndromes of kidney qi deficiency and cold type，indicating dampness，heat，stasis and other excess pathogen are closely related to the development of RA coagulation/fibrinolysis system abnormalities and microcirculation disorders.DD and Fbg may become new monitoring indicators of RA disease activity. |
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