男性强直性脊柱炎患者骶髂关节骨髓水肿与中医证候的相关性研究
Correlation between bone marrow edema of sacroiliac joint and TCM syndromes in male patients with ankylosing spondylitis
- 北京中医药 2022年41卷第8期 页码：833-837
- 作者机构：
1.北京中医药大学研究生院，北京100029
2.中日友好医院中医风湿病科 免疫炎性疾病北京市重点实验室，北京100029
- 作者简介：
吴娟，女，25岁，硕士研究生。研究方向：中医风湿病学的临床与基础研究。
孔维萍，E-mail：kongweiping75@126.com
- 基金信息：中央高水平医院临床科研业务费资助项目(2022-NHLHCRF-LX-02-0104);国家自然科学基金青年基金项目(81403378);北京市自然科学基金项目(7182148);北京市中医药科技发展资金项目(JJ-2020-87)
DOI：10.16025/j.1674-1307.2022.08.002
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吴娟，杨悦，李月，等.男性强直性脊柱炎患者骶髂关节骨髓水肿与中医证候的相关性研究［J］.北京中医药，2022，41（8）：833-837.
WU Juan,YANG Yue,LI Yue,et al.Correlation between bone marrow edema of sacroiliac joint and TCM syndromes in male patients with ankylosing spondylitis[J]. Beijing Journal of Traditional Chinese Medicine,2022,41(08):833-837.
吴娟，杨悦，李月，等.男性强直性脊柱炎患者骶髂关节骨髓水肿与中医证候的相关性研究［J］.北京中医药，2022，41（8）：833-837. DOI： 10.16025/j.1674-1307.2022.08.002.
WU Juan,YANG Yue,LI Yue,et al.Correlation between bone marrow edema of sacroiliac joint and TCM syndromes in male patients with ankylosing spondylitis[J]. Beijing Journal of Traditional Chinese Medicine,2022,41(08):833-837. DOI： 10.16025/j.1674-1307.2022.08.002.
摘要
目的,2,探讨男性强直性脊柱炎（AS）患者骶髂关节骨髓水肿与中医证候的关系，并分析骶髂关节骨髓水肿的危险因素。,方法,2,收集2017年8月―2021年12月中日友好医院中医风湿病科门诊及住院男性AS患者143例，根据骶髂关节核磁共振成像加拿大脊柱关节病研究协会（SPARCC）评分将患者分为骶髂关节骨髓水肿组（SPARCC评分≥2，骨髓水肿组）和骶髂关节无骨髓水肿组（SPARCC评分<2，无骨髓水肿组），分析2组患者的疾病特征差异，采用logistic回归分析患者骶髂关节骨髓水肿的危险因素。,结果,2,骨髓水肿组男性AS患者肾虚湿热证多见，无骨髓水肿组男性AS患者肾虚督寒证多见；与无骨髓水肿组比较，骨髓水肿组HLA-B27阳性率、ESR及CRP水平升高（,P,<,0.05）。多因素logistic回归分析显示，肾虚湿热证、HLA-B27阳性及ESR是男性AS患者骶髂关节骨髓水肿的危险因素（,P,<,0.05）。,结论,2,骶髂关节骨髓水肿程度较高的男性AS患者更多见肾虚湿热证，肾虚湿热证、HLA-B27阳性和ESR水平是男性AS患者骶髂关节炎症的危险因素。
Abstract
Objective,2,To investigate the relationship between bone marrow edema（BME） on sacroiliac joints（SIJ）and TCM syndromes in male patients with ankylosing spondylitis （AS） and risk factors for BME on SIJ.,Methods,2,143 male AS patients treated in outpatient and inpatient departments of TCM Rheumatology in China-Japan Friendship Hospital from August 2017 to December 2021 were selected and according to the MRI of Sacroiliac Joint Canadian Association for the Study of Spinal Arthritis （SPARCC）， the patients were divided into sacroiliac joint bone marrow edema group （SPARCC score ≥2， bone marrow edema group） and none sacroiliac joint bone marrow edema group （SPARCC score < 2， none bone marrow edema group） to analyze the differences in disease characteristics of two groups of patients with or without BME on SIJ MRI， and the risk factors for BME on SIJ MRI by logistic regression.,Results,2,Kidney deficiency and dampness heat syndrome was more common in male AS patients in bone marrow edema group，and kidney deficiency and cold syndrome in Du meridian in male AS patients in none bone marrow edema group； compared with none bone marrow edema group， the HLA-B27 positivity rate，ESR and CRP levels were significantly higher in bone marrow edema group （,P,<,0.05）. Multivariate logistic regression analysis showed that kidney deficiency and dampness heat syndrome， HLA-B27 positivity and ESR were risk factors for BME on SIJ MRI （SPARCC score ≥2） in male AS patients （,P,<, 0.05）.,Conclusion,2,Severe BME on SIJ in male AS patients is more likely to be associated with kidney deficiency and dampness heat syndrome. Kidney deficiency and dampness heat syndrome，HLA-B27 positivity and ESR level are risk factors for inflammation on SIJ with male AS.
关键词
男性强直性脊柱炎中医证型磁共振成像骨髓水肿
Keywords
Maleankylosing spondylitisTCM syndromemagnetic resonance imagingbone marrow edema
references
杜琳,高延征.强直性脊柱炎诊断及治疗新进展[J].中华实用诊断与治疗杂志,2019,33(7):629-631.
DOMINIQUE B,JOACHIM S,JÜRGEN B,et al.Secukinumab,an interleukin-17A inhibitor,in ankylosing spondylitis[J].Gland J Med,2015,373(26):2534-2548.
班超,葛丽红,牛广明,等.强直性脊柱炎骶髂关节病变磁共振成像定量研究进展[J].磁共振成像,2018,9(2):157-160.
苏金梅，张文，唐福林.强直性脊柱炎研究进展：2008年欧洲风湿病联盟年会纪要[J].中华临床免疫和变态反应杂志，2009，3(1):78-79.
陶庆文,徐愿,孔维萍,等.基于名老中医经验传承寒热辨治强直性脊柱炎的临床研究[J].世界中西医结合杂志,2013,8(7):730-733.
邱新萍,孙颂歌,孙莹,等.阎小萍老师治疗强直性脊柱炎“治未病”学术思想的临床应用[J].世界中医药,2021,16(17):2635-2639.
张皖东,曹云祥,葛瑶,等.强直性脊柱炎中医辨证分型与免疫炎症指标的相关性研究[J].中国中医基础医学杂志,2014,20(10):1384-1387.
孔维萍,阎小萍,张卫,等.强直性脊柱炎患者骨密度、骨代谢指标与中医辨证分型的关系[J].中国骨质疏松杂志,2011,17(4):328-332.
孔维萍,金玥,朱笑夏,等.强直性脊柱炎寒热证候的脊柱结构损伤特点[J].中医杂志,2015,56(12):1026-1029.
陈爱萍,路素言,邵培培,等.强直性脊柱炎入院患者寒热证候特点及其与脊柱损伤和疾病活动度关系研究[J].北京中医药,2018,37(5):440-442.
郝萱语,张宁.男女性强直性脊柱炎临床特征比较[J].中华临床免疫和变态反应杂志,2017,11(1):21-25.
VAN DEN BERG R,DE HOOGE M,BAKKER PA,et al.Metric properties of the SPARCC score of the sacroiliac joints - data from baseline, 3-month, and 12-month followup in the SPACE cohort[J].J Rheumatol,2015,42(7):1186-1193.
VAN DER LINDEN S,VALKENBURG HA,CATS A. Evaluation of diagnostic criteria for ankylosing spondylitis.A proposal for modification of the New York criteria[J].Arthritis Rheum,1984,27(4):361-368.
郑筱萸.中药新药临床研究指导原则（试行）[M].北京：中国医药科技出版社,2002:119-123.
国家中医药管理局医政司.22个专业95个病种中医诊疗方案(合订版)[M].北京:国家中医药管理局医政司,2010:264-265.
GARRETT S,JENKINSON T,KENNEDY LG,et al.A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index[J].J Rheumatol,1994,21(12):2286-2291.
CALIN A,GARRETT S,WHITELOCK H,et al.A new approach to defining functional ability in ankylosing spondylitis:the development of the Bath Ankylosing Spondylitis Functional Index[J].J Rheumatol,1994,21(12):2281-2285.
MAKSYMOWYCH WP,INMAN RD,SALONEN D,et al.Spondyloarthritis research consortium of Canada magnetic resonance imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis[J]. Arthritis Rheum,2005,53(5):703-709.
HAROON N.Ankylosis in ankylosing spondylitis：current concepts[J].Clin Rheumatol,2015,34(2):1003-1007.
石金杰,张华东,赵亚男,等.基于网络药理学探讨补肾强脊颗粒治疗强直性脊柱炎的机制[J].北京中医药,2021,40(4):431-435.
LUKAS C,BRAUN J,VAN DER HEIJDE D,et al.Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis:a multireader experiment[J].J Rheumatol,2007,34(4):862-870.
LANDEWÉ RBM，HERMANN KGA，VAN DER HEIJDE DMFM，et al.Scoring sacroiliac joints by magnetic resonance imaging.a multiple-reader reliability experiment[J].J Rheumatol,2005,32（10）：2050-2055.
VAN ONNA M,JURIK AG,VAN DER HEIJDE D,et al. HLA-B27 and gender independently determine the likelihood of a positive MRI of the sacroiliac joints in patients with early inflammatory back pain: a 2-year MRI follow-up study[J].Ann Rheum Dis,2011,70(11):1981-1985.
黄志坚，米存东，杜昱,等.骶髂关节磁共振炎症评分及骶髂关节结构损伤评分在活动期中轴型脊柱关节炎病情评估中的价值[J].中华风湿病学杂志,2019，23(9):612-616,插1.
李乐,王芳军,刘连生.强直性脊柱炎MRI表现与中医证型相关性研究[J].西部中医药,2017,30(3):77-79.
张金山,张方园,万磊,等.强直性脊柱炎的磁共振成像炎症分期与中医证型和临床特征关系[J].安徽中医药大学学报,2017,36(6):11-13.
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