Department of Rheumatology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Chin J Integr Med. 2012 Aug;18(8):575-81. doi: 10.1007/s11655-012-1172-1. Epub 2012 Aug 2.
To investigate a method for quantitative differential diagnosis of damp-heat and cold-damp impeding syndrome of rheumatoid arthritis (RA) in Chinese medicine (CM).
Laboratory parameters were collected from 306 patients with RA. The clinical symptoms and laboratory parameters were compared between patients with these two syndromes (158 with RA of damp-heat impeding syndrome, and 148 with RA of cold-damp impeding syndrome), and a regression equation was established to facilitate discrimination of the two RA syndromes.
There were significant differences in disease activity score in 28 joints [DAS28 (4)], erythrocyte sedimentation rate (ESR), white blood cell count (WBC), C-reactive protein (CRP), platelet count (PLT), albumin (ALB) and globulin (GLB) between the two syndrome of RA (P<0.05). Logistic regression analysis showed that the parameters ESR, WBC, CRP, joint pyrexia, joint cold, thirst, sweating, aversion to wind and cold, and cold extremities were statistically useful to discriminate damp-heat from cold-damp impeding syndrome. The regression equation was as follows: P=1/{1+exp[-(3.0-0.021X (1)-0.196X (2)-0.163X (3)-1.559X (4)+1.504X (5)-0.927X (6)-1.039X (7)+1.070X (8)+1.330X (9))]}. The independent variables X (1)-X (9) were ESR, WBC, CRP, hot joint, cold joint, thirst, sweating, aversion to wind and cold, and cold limbs. A P value > 0.5 signified cold-damp impeding syndrome, and a P value < 0.5 signified damp-heat impeding syndrome. The accuracy was 90.2%.
The regression equation may be useful for discriminating damp-heat from cold-damp impeding syndrome of RA.
探讨一种中医湿热痹阻证和寒湿痹阻证类风湿关节炎（RA）的定量鉴别诊断方法。
收集 306 例 RA 患者的实验室参数。比较两种证型（湿热痹阻证 158 例，寒湿痹阻证 148 例）患者的临床症状和实验室参数，建立回归方程，便于两种 RA 证型的鉴别。
两种 RA 证型的 28 关节疾病活动评分[DAS28（4）]、红细胞沉降率（ESR）、白细胞计数（WBC）、C 反应蛋白（CRP）、血小板计数（PLT）、白蛋白（ALB）和球蛋白（GLB）差异有统计学意义（P<0.05）。Logistic 回归分析显示，ESR、WBC、CRP、关节发热、关节发冷、口渴、出汗、怕风畏寒、四肢发冷等参数对湿热证与寒湿痹阻证的鉴别有统计学意义。回归方程如下：P=1/{1+exp[-(3.0-0.021X(1)-0.196X(2)-0.163X(3)-1.559X(4)+1.504X(5)-0.927X(6)-1.039X(7)+1.070X(8)+1.330X(9))]}。自变量 X(1)-X(9)为 ESR、WBC、CRP、热关节、冷关节、口渴、出汗、怕风畏寒、四肢发冷。P 值>0.5 提示寒湿痹阻证，P 值<0.5 提示湿热痹阻证。准确率为 90.2%。
回归方程可用于鉴别 RA 的湿热痹阻证和寒湿痹阻证。
