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χ-2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。
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 mouth and low heat appeared more frequently in the heat joint group than those in the heat pain free group,and there was a statistically significant difference between the two groups（P〈 0.05）.Of 77 patients in the heat pain group,59 cases（76.62%）were averse to coldness and cold wind all over the body,57 cases（74.03%）felt an increasing pain while it＇s cold,33 cases（42.86%）had cold limbs while it＇s cold,18 cases（23.38%）had diarrhea while eating something cold and 12 cases（15.58%）felt chilly in limbs.Of the 332 cases in the heat pain free group,＂hot＂performances were as follows：dry mouth in 148 cases（44.58%）,bitter taste of mouth in 98 cases（29.52%）,yellow urine in 84 cases（25.30%）,dry throat in 75 cases（22.59%）,dry stool in 64 cases（19.28%）,dry eye in 63 cases（18.98%）,sore throat in 33 cases（9.94%）,dry nose in 24 cases（7.23%）,zygomatic red in 23 cases（6.93%）,and low heat in 19 cases（5.72%）.Conclusion：Heat pain in joint can not be regarded as a key indicator of heat bi for rheumatoid arthritis,a cold-heat complicated syndrome.The heat pain group dry mouth,bitter mouth,low heat were more than the heat pain free group,but at the same time with a cold was also very common.
作者
张子扬
许平英
娄玉钤
ZHANG Zi-yang XU Ping-ying LOU Yu-qian
出处
《风湿病与关节炎》
2016年第10期16-19,26,共5页
Rheumatism and Arthritis
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
arthritis
rheumatoid
heat pain in joint
join free of heat pain
heat bi
syndrome differentiation
HFRA database
clinical study
