The Values of Clinical Laboratory Indicators in the Differential Diagnosis of TCM Syndrome Types for Patients with Rheumatoid Arthritis
Objective To evaluate the value of clinical laboratory indicators in the differential diagnosis of traditional Chinese medical syndrome types for patients with rheumatoid arthritis.Methods A total of 182 patients with rheumatoid arthritis who were hospitalized in the Department of Rheumatology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from January,2023 to December,2023 were selected as the study subjects.Among these subjects,30 patients were phlegm syndrome,80 cases were damp-heat syndrome,19 cases were syndrome of combined with cold and heat,and 53 cases were deficency syndrome.Levels of rheumatoid factor(RF),C-reactive protein(CRP),white blood cell(WBC),red blood cell(RBC),hemoglobin(Hb),platelet(PLT),total cholesterol(CHO),triglyceride(TG),and low-density lipoprotein cholesterol(LDL-C)in patients with different syndrome types were compared,and the receiver operating characteristic curve(ROC)was then drawn to evaluate the diagnostic value of the indicators for different syndrome types.Results Levels of CRP in damp-heat syndrome were significantly higher than those in phlegm syndrome,while levels of CRP in deficency syndrome was significantly lower than those in damp-heat syndrome(P＜0.05).When Hb,CHO,CRP,PLT were used as single indicators,they all showed certain differential diagnostic values for TCM syndromes of rheumatoid arthritis.The sensitivity of CHO in the differential diagnosis of phlegm syndrome from deficency syndrome was 73.33％,while the differential diagnosis specificity of Hb to damp-heat syndrome and syndrome of combined with cold and heat was 78.95％,and the area under the curve(AUC)was 0.703 when Hb was used as a single indicator in the differential diagnosis of phlegm syndrome from syndrome of combined with cold and heat.The sensitivity of CRP combined with LDL in differential diagnosis of phlegm syndrome and damp-heat syndrome was 93.33％,while the specificity of combined detection of CHO and Hb in the differential diagnosis of damp-heat syndrome and syndrome of combined with cold and heat was 94.74％,and the differential diagnosis area under the ROC of combined detection of CHO and Hb of phlegm syndrome and syndrome of combined with cold and heat was 0.747.Conclusion Hb,CHO,CRP,and PLT can provide theoretical basis and medication reference for syndrome differentiation,treatment and prognosis of rheumatoid arthritis.In particular,the combined detection of CHO and Hb is of high value in the diagnosis of phlegm syndrome and syndrome of combined with cold and heat in rheumatoid arthritis.
Traditional Chinese medical syndrome typeRheumatoid arthritisClinical laboratory index
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