蔡美美+游玉权+陈长贤+刘联群

【摘 要】目的：探讨强直性脊柱炎患者的中医体质特点及相关影响因素。方法：选取强直性脊柱炎患者107例，采用中华中医药学会颁布实施的《中医体质分类与判定》标准对研究对象进行体质判定，采用Logistic回归模型分析中医体质类型与强直性脊柱炎患者之间的关系。结果：①107例强直性脊柱炎患者中，偏颇体质占绝大多数，其中阳虚质最多，其次是湿热质、气虚质，分别占32.71%、14.95%、12.15%。②影响体质的因素主要有病程、年龄、骶髂关节炎，其中病程与气虚质显著相关，年龄与瘀血质相关，骶髂关节炎与气郁质相关。结论：强直性脊柱炎患者中偏颇体质主要为阳虚质、气虚质、湿热质，推测阳虚质、气虚质可能是强直性脊柱炎发病的重要原因，认为阳气不足是强直性脊柱炎最基本的体质特征，湿热质是强直性脊柱炎发病过程的体质特点，而且病程的延长可能会加重气虚，加重病情，因此及时、积极治疗可以改善患者预后。

【关键词】 脊柱炎，强直性；阳虚；中医体质

Study on the Constitution Characteristics of Patients with Ankylosing Spondylitis in TCM

CAI Mei-mei，YOU Yu-quan，CHEN Chang-xian，LIU Lian-qun

【ABSTRACT】Objective：To investigate the constitution characteristics and related factors of ankylosing spondylitis in TCM.Methods：Constitution of one hundred and seven cases of ankylosing spondylitis was judged according to Classification and Determination of Constitution in TCM promulgated by China Association of Chinese Medicine.The Logistic regression models were used to analyze the relationship between TCM constitution types and patients with ankylosing spondylitis.Results：①Among the 107 patients with ankylosing spondylitis，a majority had the biased constitution，most of which had yang deficiency，followed by dampness heat and qi deficiency，which accounted for 32.71%，14.95% and 12.15% respectively.②The main factors influencing the constitution were the course of disease，age and sacroiliitis.The course of disease was significantly related to the deficiency of qi，and the age was related to the blood stasis，and the sacroiliac joint was related to the qi depression.Conclusion：The biased constitutions in patients with ankylosing spondylitis are yang deficiency，qi deficiency and dampness heat.It is speculated that the yang deficiency and qi deficiency may play a key role in the incidence of ankylosing spondylitis.It is believed that yang deficiency is the basic constitution characteristic of ankylosing spondylitis，and dampness heat is the physical characteristic of the incidence of ankylosing spondylitis，and the extension of the course of disease may aggravate qi deficiency and the disease，so timely and active treatment can improve the prognosis of patients.

【Keywords】 spondylitis，ankylosing；yang deficiency；constitution in TCM

強直性脊柱炎（ankylosing spondylitis，AS）是我国常见多发的风湿性疾病，其患病率约0.2%～0.4%[1]，平均患病年龄为26～29岁[2]。遗传和环境因素在本病的发病中发挥作用[3-4]。体质是受先后天因素影响形成的综合性、相对稳定的固有特质个体特性，包括身体素质和心理特性。与人类在生长、发育过程中的环境密切相关[5]。其贯穿于人类生命的整个过程，在生理状态下，表达为对外界刺激的反应及对环境变化的适应性；在病理状态下，则表达为对某些疾病的易患性以及疾病传变转归的某些倾向性。……