Background:Chronic obstructive pulmonary disease (COPD) poses a significant global health burden, particularly in older adults. Pulmonary rehabilitation (PR) is a core management strategy, yet its implementation remains limited and imbalanced, especially within primary healthcare settings in China. The county medical community model aims to integrate healthcare resources, representing a potential platform for optimizing PR delivery. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding PR among older adults with COPD within a county medical community and to analyze the associated influencing factors. Methods:A convenience sampling approach was applied to select 150 older adults with COPD who visited medical community institutions between January 2024 and December 2024. Data were collected using a general information wquestionnaire and a pulmonary rehabilitation KAP questionnaire. Statistical analyses were conducted to evaluate KAP levels and to identify factors associated with pulmonary rehabilitation KAP. Results:The total pulmonary rehabilitation KAP score among the 150 older adults with COPD was 68.63 ± 19.23. Scores for the knowledge, attitude, and practice dimensions were 32.57 ± 11.79 (out of a possible 60), 15.77 ± 3.77 (out of a possible 20), and 20.28 ± 8.50 (out of a possible 50), respectively. Multiple linear regression analysis indicated that the type of hospital visited, age, the presence of a primary caregiver, and guidance from medical staff were significant influencing factors associated with pulmonary rehabilitation KAP among older adults with COPD (p < 0.05). Conclusion:Older adults with COPD in the medical community demonstrated a generally positive attitude toward pulmonary rehabilitation, whereas knowledge and practice levels remained relatively low. Strengthened and targeted professional guidance from medical staff for patients and their caregivers across different age groups is warranted. Enhanced coordination within medical communities and the development of innovative service models may facilitate more effective implementation of pulmonary rehabilitation, thereby improving quality of life and health management among older adults with COPD.

A clinical study used pregabalin as a control to test the effectiveness and safety of Ba-Duan-Jin for fibromyalgia (FM) and explore the relation with brain function. This was a 12-week, prospective, randomized, single-blind trial with 36-week follow-up. A total of 104 FM patients were randomly assigned to Ba-Duan-Jin or pregabalin group. The primary outcome was the pain visual analogue scale score, and the secondary outcome was a series of specialized assessment scales regarding other common FM symptoms. Functional magnetic resonance imaging (fMRI) data of patients before and after treatment were collected. After treatment, both groups showed significant improvements in pain, fatigue, sleep, depression and other aspects, achieving nearly identical results, except that sleep improvement in the Ba-Duan-Jin group was less than that in the pregabalin group at 4 weeks. Most of these improvements were maintained at the 12-week follow-up, with pain and quality of life improvements lasted until 36-week follow-up. The exploratory fMRI results showed elevated degree centrality (DC) values in the parahippocampal gyrus (PHG) of the brain in patients who responded adequately to the treatment with the Ba-Duan-Jin (P < 0.005), and the pre-treatment DC values of the PHG were positively correlated with the improvement in overall symptom severity and sleep quality (P < 0.05) in Ba-Duan-Jin group. In conclusion, aside from insomnia, both Ba-Duan-Jin and pregabalin demonstrated similar improvements in FM. Ba-Duan-Jin may brings new strategies for pain management in FM patients by targeting the PHG, and the DC of PHG may be associated with Ba-Duan-Jin's efficacy. PERSPECTIVE: The results of this study demonstrate that the Ba-Duan-Jin may provide additional option for the multidisciplinary management of fibromyalgia patients.

ETHNOPHARMACOLOGICAL RELEVANCE:Qingrehuoxue (QRHX) granules, composed of 12 Chinese herbs, have been used for over 40 years to treat rheumatoid arthritis (RA) in China and show potential in protecting bone health. However, high-quality evidence on their effects is limited. AIM OF THE STUDY:To assess the effects of QRHX granules on bone marrow edema (BME) in active RA patients. MATERIALS AND METHODS:This multicenter, randomized, double-blind, placebo-controlled trial enrolled RA patients from 13 hospitals in China. Participants were randomly assigned in a 1:1 ratio to receive either QRHX granules (10 g, twice daily) plus methotrexate (MTX) or a placebo plus MTX for 24 weeks. The primary outcome was the change in MRI-assessed BME score at week 24. Secondary outcomes included changes in bone erosion scores, Disease Activity Score in 28 joints, and safety outcomes. RESULTS:A total of 204 patients (mean age, 48.77 years; SD, 11.96) were randomized to either the QRHX or placebo group. At week 24, the QRHX group showed a significantly greater reduction in BME scores compared to the placebo group (adjusted between-group difference, -2.50; 95 % CI, -4.76 to -0.25; P = 0.030). QRHX also significantly reduced bone erosion progression (adjusted between-group difference, -2.90; 95 % CI, -5.49 to -0.31; P = 0.030). Adverse events were rare and similar across both groups, with no deaths or life-threatening events. CONCLUSION:QRHX granules, combined with MTX, significantly reduced MRI-detected BME and slowed bone erosion in active RA, suggesting potential as a complementary treatment for bone protection in RA.

OBJECTIVES:To better investigate neurobiological heterogeneity in fibromyalgia for its symptom diversity and individual differences. METHODS:We collected structural MRI data and clinical characteristics of Chinese female fibromyalgia patients and healthy controls matched by age and educational level, then invited qualified patients to undergo either Ba-Duan-Jin or pregabalin intervention for 12 weeks randomly. Structural MRI was analyzed by CAT12 software, and the regional volume of gray matter (GMV) was calculated according to the Brainnetome atlas. Fibromyalgia patients were clustered using the HYDRA algorithm to detect disease subtypes. RESULTS:Two distinct neuroanatomical subtypes were found among 75 patients. Compared to 93 healthy controls, patients in subtype 1 (n = 38, 50.7%) showed widespread GMV increase, especially in some pain-related brain regions, while no structural changes were observed in subtype 2 (n = 37, 49.3%). At the baseline before treatment, patients in subtype 1 showed a younger age (p = 0.037), longer illness duration (p = 0.042), and a severer psychological stress state evaluated by the Perceived Stress Scale (p = 0.008). After standardized treatment, subtype 1 patients showed less improvement in pain VAS score (p = 0.027) than subtype 2 patients. In addition, GMV of the bilateral dorsal caudate had negative correlations with stress level (Left r = -0.335, p = 0.040; Right r = -0.341, p = 0.036), and GMV of the left rostral temporal thalamus (r = 0.781, p = 0.038) and lateral amygdala (r = 0.761, p = 0.047) were positively related to the improvement of pain severity after treatment in subtype 1 patients. CONCLUSIONS:These two neuroanatomical subtypes in fibromyalgia emphasize different underlying neuropathological processes and need future studies to optimize individualized treatment. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT03890133.

OBJECTIVE:To explore the effects of overweight and obesity (overweight/obesity) on symptom severity and quality of life in Chinese patients with fibromyalgia syndrome (FMS). METHODS:A cross-sectional survey was used to collect general data on height, weight, gender and age of 435 FMS patients who visited the rheumatology clinic of Guang 'anmen Hospital from October 2018 to December 2021. The numbers of tender points, widespread pain index and symptom severity scale were used as diagnostic indicators of the disease. The pain visual analogue scale, Beck depression inventory, perceived stress scale (PSS), Pittsburgh sleep quality index (PSQI) and multidimensional fatigue scale were used to assess the severity of pain and negative emotions, stress perception, sleep quality, and fatigue symptoms of this disease. The revised fibromyalgia impact questionnaire, fibromyalgia symptom scale (FS) and quality of life assessment scale (36 item short-form health survey, SF-36) were used to evaluate the overall condition and quality of life of the FMS patients. At the same time, 50 healthy volunteers matched in gender and age were recruited as the control group. Covariance analysis was used to explore the effects of overweight/obesity on the FMS patients after adjusting for age and gender. RESULTS:According to the Chinese body mass index (BMI) standard, there were 242 (59%) and 170 (41%) FMS patients in the normal weight group and overweight/obesity group, respectively, with average BMI of (21.66±1.42) kg/m2 and (26.25±1.83) kg/m2, respectively. Compared with the normal weight FMS patients, the overweight/obesity patients had higher PSS scores (P=0.010), PSQI sub-dimension sleep efficiency scores (P < 0.001) and FS scores (P=0.025), and lower SF-36 sub-dimension physical functioning scores (P=0.041). However, there were no statistical differences in the above indicators between normal weight and overweight/obesity patients in the healthy control group (P > 0.05). CONCLUSION:Compared with normal-weight FMS patients, overweight/obesity patients have higher levels of perceived stress, lower sleep efficiency, and more severe fibromyalgia symptoms, as well as a low quality of life characterized by decreased physiological function. It is important for overweight/obesity FMS patients to control BMI actively in order to improve sleep efficiency, psychological state, physical functioning, and the overall condition.

OBJECTIVES:To investigate sleep quality in patients with fibromyalgia (FM) and to analyse the effect of sleep on FM symptoms and quality of life.METHODS:Patients with FM and healthy subjects were recruited to assess their sleep quality, and patients were further assessed for pain, fatigue, depression, psychological stress and quality of life. The patients were divided into a sleep disorder group as measured by the Pittsburgh Sleep Quality Index (PSQI score >7 points) and a group without sleep disorders (PSQI score ≤7 points). Linear regression analysis was used to explore the effect of sleep quality on FM pain controlling for sex and age, and the effect of sleep quality on FM fatigue, depression, psychological stress and quality of life controlling for sex, age and pain.RESULTS:A total of 450 patients and 50 healthy subjects participated in the study. The number of FM patients with sleep disorders was significantly higher than that of healthy subjects (90% vs. 14%, p≤0.001). In addition to the number of pain sites, the levels of pain, fatigue, depression, stress symptoms and quality of life were significantly impaired in FM patients with sleep disorders (p<0.05). In terms of the effects on quality of life assessed with the 36-item short-form health survey, the decrease in mental health was more substantial than the decrease in physical health (B=-12.10 vs. B=-5.40).CONCLUSIONS:Similar to FM patients in other countries and regions, a decrease in sleep quality is also the core symptom of FM patients in China and is significantly correlated with the severity of pain, fatigue, depression and stress symptoms and reduced quality of life, especially with regard to mental health, suggesting that the treatment of this disease should include sleep disorder interventions.

慢性疼痛是全球性的健康问题,纤维肌痛综合征(FMS)作为以慢性疼痛为核心症状的风湿病,其临床表现具有高度异质性,且发病机制复杂,迄今尚未彻底阐明.由于医学伦理及道德的约束,人体试验存在诸多局限,故FMS动物模型作为研究本病的有力工具,对于明确FMS发生发展和病理机制尤为重要.本文从造模方法、与FMS临床症状、病理生理学和治疗反应的相似度4个方面对FMS目前较成熟的动物模型进行综述,希望能为研究者选用和建立本病的实验动物模型提供参考.

目的 调查纤维肌痛综合征(FMS)中医证候分布情况及不同证候患者的人口学特点和病情轻重程度.方法 采用横断面调查研究方法,将中医证候分为寒湿痹阻证、肝郁气滞证、气滞血瘀证、肝胆湿热证、肝血亏虚证、肝肾不足证及复合证候(同时具有以上2种证候),制定"纤维肌痛综合征中医证候调查问卷".根据患者的应答进行数据分析,得到FMS中医证候分布情况,比较不同证候的人口学特点,并采用《视觉模拟评分法》《修订版纤维肌痛影响问卷》《匹兹堡睡眠质量指数》《多维疲劳量表》《贝克忧郁量表》《压力知觉量表》对患者病情进行评估.结果 共165例患者参与调查.单一证候97例,分别为肝肾不足证27例(16.4％)、肝郁气滞证25例(15.2％)、气滞血瘀证17例(10.3％)、肝胆湿热证14例(8.5％)、寒湿痹阻证7例(4.2％)和肝血亏虚证7例(4.2％),复合证候中肝郁气滞合肝血亏虚证最多,为34例(20.6％),其他复合证候共34例(20.6％).不同证候患者在性别、年龄、吸烟、教育程度、收入方面存在差异,肝血亏虚证患者病程较长,肝郁气滞证患者抑郁程度较高,寒湿痹阻证患者总体病情较轻.结论 在FMS证候分布以实证及虚实夹杂证为主,少数为虚证.邪实主要见于气滞、血瘀、寒湿,正虚主要见于血虚、阴虚,阳虚者较少,病变脏腑主要在肝.FMS证候可能与人口学特点和病情程度有关.

Abstract Background: Bone destruction is the key and difficult point in the treatment of RA. Studies have found that the use of traditional Chinese medicine Qingre Huoxue Decoction (QRHXD) can effectively reduce disease activity and delay bone destruction. Magnetic resonance imaging (MRI) is one of the effective ways to evaluate bone destruction in RA in real time, which is helpful to the early evaluation and discovery of synovitis and bone destruction. Therefore, we designed a multicenter, randomized, double-blinded, controlled clinical trial to assess the improvement of the bone destruction of QRHXD in treating RA using MRI. Methods: This study aimed to assess the definitive evidence that the traditional Chinese medicine QRHXD slows bone destruction in RA using MRI. A total of 204 adult participants with RA will be enrolled, with balanced treatment allocation (1:1). The experimental intervention will be QRHXD plus MTX and the control intervention will be QRHXD placebo plus MTX for 24 weeks. The primary outcome measure will be RA MRI score at screening period and 24 weeks. Secondary outcome measures will include the ACR20, ACR50 and ACR70, DAS28, patient report outcome(PRO), health assessment questionnaire(HAQ) and X-ray sharp score of both hands. In addition, the vital signs and adverse reactions of the subjects will be recorded. Discussion: The purpose of this study is to use MRI to confirm that QRHXD can effectively slow the imaging progress of active RA. To provide evidence for the efficacy of Chinese medicine in delaying bone destruction in RA, and help to carry out more clinical research on Chinese medicine prescriptions. Trial registration number Clinical Trials.gov ID: NCT04170504.

养生气功八段锦是中国古代著名的导引之术,是我国历史文化瑰宝,在阴阳、经络、脏腑等中医学理论的指导下,八段锦在祛病保健、康复治疗等方面发挥了重要作用,蕴含着中医学未病先防的理念.其动作简单,易学易练,经过千年的沉淀,一直深受广大群众的推崇,是当下群众养生健身常用的锻炼方式.文中对八段锦的产生、形成、发展、流派进行梳理,并进一步探讨八段锦所体现的中医理论及其疗效机制,以期为八段锦的后续研究提供一定的参考.

OBJECTIVE:The revised Fibromyalgia Impact Questionnaire (FIQR) was developed to measure the quality of life of patients with fibromyalgia in randomized controlled trials and routine care. The purpose of this study was to translate and adapt the FIQR from English to Chinese, and to examine the validity and reliability of the Chinese version of the FIQR (CFIQR).METHODS:Following the translation of the FIQR, fibromyalgia patients from 6 centers were recruited and completed the CFIQR, the validated Chinese version of the Medical Outcome Study Short Form 36 Health Survey (SF-36) and the Beck Depression Inventory (BDI). In this study, Cronbach's alpha coefficient, test-retest reliability and item total correlation were used for evaluating external and internal reliability; and criterion and structural validity were evaluated.RESULTS:A total of 200 fibromyalgia patients completed the study. The internal consistency was excellent (Cronbach's alpha .90, .88, .88 and .93 for function, overall impact, symptoms scales and total score, respectively; item-total correlations from .25 to .83.) Test-retest reliability levels of the CFIQR total and subscale scores were strong correlation (intraclass correlation coefficient >0.75). Furthermore, there were significant correlations between the 3 subscale and the total score of the CFIQR and the SF-36, as well as the CFIQR and the BDI, by criterion validity (P < .01). Confirmatory factor analysis gave an acceptable value for structural validity according to the 3-factor structures of function, overall impact and symptoms.CONCLUSIONS:The CFIQR is a valid and reliable instrument for both clinical practice and research purposes with Chinese speakers globally. [ClinicalTrials.gov: NCT03381131].

Patients with fibromyalgia syndrome (FMS) offen shows Gastrointestinal symptoms. The composition of gastrointestinal flora and the abundance of some flora always changes in FMS, and the metabolic activities of flora may be related to the symptoms of FMS. The treatment of FMS by regulating liver and spleen with Traditional Chinese Medicine and regulating qi movement with traditional exercises can achieve better efficacy, and its efficacy mechanism may be related to the improvement of intestinal flora metabolism.

目的:探讨类风湿关节炎(RA)湿热痹阻证与寒湿痹阻证两组证候之间的差异.方法:选取类风湿关节炎中医数据中心(CRDC-TCM)确诊为RA湿热痹阻证与寒湿痹阻证患者,比较两组证候的人口学特征与病情特点.结果:共纳入659例RA确诊患者,其中湿热痹阻证463例、寒湿痹阻证196例.两组RA患者性别、年龄、病程比较,差异均无统计学意义.湿热痹阻证RA患者血沉(ESR)、C-反应蛋白(CRP)总体水平显著高于寒湿痹阻证RA患者(P＜0.01),但在RF方面比较差异无统计学意义.湿热痹阻证RA患者关节肿胀数总体水平较寒湿痹阻证多(P＜0.05),但在关节压痛数方面比较差异无统计学意义;湿热痹阻证与寒湿痹阻证RA患者在DAS-28(CRP)等级分布上差异有统计学意义(P＜0.05),湿热痹阻证RA患者以高度活动较多、寒湿痹阻证RA患者以中度活动较多.结论:湿热痹阻证与寒湿痹阻证RA患者在人口学特征上差异不明显;病情特点方面,在RF、关节压痛数上差异不明显,在ESR、CRP、关节肿胀数与疾病活动度上有显著差异.

目的 调查类风湿关节炎(RA)患者睡眠障碍的临床意义.方法 回顾性分析类风湿关节炎中医数据中心(CRDC-TCM)中741例RA患者病例信息,基于患者对睡眠状况自评的结果分为睡眠障碍组和无睡眠障碍组,比较2组患者一般资料、临床表现、疾病活动度(DAS28)、实验室检查、疼痛视觉模拟评分(VAS)、健康评估问卷评分(HAQ)、中医证候、用药情况的差异.结果 ①一般资料:男134例(18.08％),女607例(82.02％),年龄(55.90±13.40)岁,病程(17.90±10.00)年,其中睡眠障碍组363例(48.99％),无睡眠障碍组378例(51.01％).②临床表现:睡眠障碍组多伴有关节疼痛、关节肿胀、眩晕头痛、神疲乏力、胃部不适等症状,与无睡眠障碍组相比差异有统计学意义(P＜0.05).③2组患者不同等级DAS28差异无统计学意义(P＞0.05).④实验室检查及VAS评分、HAQ评分:睡眠障碍组患者HAQ评分高于无睡眠障碍组,差异有统计学意义(P＜0.01);2组患者血小板(PLT)、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体、VAS评分差异无统计学意义(P＞0.05).⑤睡眠障碍组患者中医证候按照频数排序为:湿热痹组＞肝肾不足＞风湿痹阻＞寒湿痹阻＞痰瘀痹阻＞气血两虚;无睡眠障碍组患者中医证候按照频数排序为:湿热痹组＞肝肾不足＞寒湿痹阻＞风湿痹阻＞气血两虚＞痰瘀痹阻,2组中医证候比较差异无统计学意义(P＞0.05).(2组患者使用糖皮质激素、NSAIDs、DMARDs、中药和生物制剂的差异无统计学意义(P＞0.05).结论 存在睡眠障碍的RA患者更易出现关节疼痛、关节肿胀、神疲乏力、胃部不适等临床症状,RA患者出现睡眠障碍可能与躯体功能障碍、高疾病活动度相关.

Background: Osteoarthritis (OA) is imposing substantial burdens on individuals and society with the aging population. Cortex Daphnes patch is widely used for symptomatic knee OA in China with a satisfying clinical efficacy; however, there is scant clinical evidence supporting its use. To evaluate its efficacy, we conducted a multicenter, non-inferiority, randomized, parallel-group study comparing Cortex Daphnes patch with topical nonsteroidal anti-inflammatory drugs in patients with knee OA (NCT02770950).Methods: A total of 264 symptomatic knee OA patients were treated with Cortex Daphnes or indomethacin cataplasms applied to affected sites once daily for 2 weeks. The primary outcome was improvement in knee pain on walking as assessed using a visual analog scale (VAS). The non-inferiority margin based on the full analysis population was set as –5 mm on the pain VAS. The secondary outcomes were changes of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, WOMAC scores for pain, function and stiffness, the 36-item Short Form Health Survey (SF-36), and global assessment of knees by the patients. Responder rates for pain VAS, WOMAC total score, and WOMAC pain were also included in the secondary outcomes.Results: The Cortex Daphnes patch was non-inferior to indomethacin cataplasms for the primary outcome with a group difference (Cortex Daphnes patch–indomethacin cataplasm) of 2.1 mm (95% confidence interval: 2.1–6.4); similar results were found in the per-protocol population. For all other outcomes, no significant differences were found in the full analysis set or in the per-protocol analysis set, except the responder rates for WOMAC pain was higher in the Cortex Daphnes patch group than in the indomethacin cataplasm group (78.4 vs. 64.7%, p = 0.022) in the per-protocol analysis set. Overall, 28.8% patients in the Cortex Daphnes patch group and 9.8% in the indomethacin cataplasm group reported treatment-related adverse events, the vast majority of which were mild-to-moderate skin irritation, resulting in only 3.8 and 0.8% of patients dropping out, respectively.Conclusion: The Cortex Daphnes patch, which provides satisfactory analgesic efficacy and enhances the physical function of the knee, as well as improving quality of life, may be a promising alternative to knee OA.

目的:分析气象要素[海拔(气压)、温度、湿度]对类风湿关节炎(RA)中医证候分布的影响.方法:选取类风湿关节炎中医数据中心患者1 411例,分别比较地处不同温度带、湿度分区和海拔分区的中医证候分布情况.结果:①居住在暖温带的RA患者最多[606例(42.95％)],暖温带、中温带和亚热带的RA患者证候分布差异具有统计学意义(P＜0.05);②居住在半湿润区的RA患者最多[813例(57.62％)],半湿润区、湿润区和干旱区RA患者证候分布差异具有统计学意义(P＜0.05);③居住在低海拔区的RA患者最多[1 272例(90.15％)],低海拔区和中海拔区RA患者证候分布差异具有统计学意义(P＜0.05).结论:气温、气压和湿度等气象要素均能影响RA的证候分布.

Fibromyalgia is characterized by multi-focal pain and is associated with fatigue, unrefreshing sleep and psychological impairment. Pregabalin is one of the most frequently used agents in fibromyalgia treatment. However, it has failed to demonstrate benefit over placebo for reducing fatigue and psychological impairment, and may cause adverse effects (e.g. somnolence, dizziness). “Ba-Duan-Jin” (BDJ) is a common form of “Qigong” exercise for health promotion in China. Growing evidence suggests that BDJ may achieve satisfactory control of fibromyalgia-related symptoms in Chinese patients. Therefore, we wish to ascertain if BDJ could overcome the disadvantages of pregabalin. A single-blind randomized controlled trial has been designed which will recruit 104 patients with fibromyalgia (age 18–70 years) with a visual analog scale (VAS) pain score of ≥ 40 mm These patients will be randomly assigned to one of two groups: (1) BDJ group (to undertake guided BDJ exercise and take a placebo capsule) or (2) pregabalin group (to take a pregabalin capsule and receive wellness education and guided muscle-relaxation exercises). The primary endpoint will be changes in the VAS score for pain. The secondary endpoints will be changes in the score for the Revised Fibromyalgia Impact Questionnaire, Multidimensional Fatigue Inventory-20, Pittsburgh Sleep Quality Index, Beck II Depression Inventory, Perceived Stress Scale and Short Form-36 Health Survey Questionnaire. These parameters will be assessed at 0, 4, 8, 12 and 24 weeks of follow-up. Our results are expected to provide more clinical evidence for the beneficial effects of BDJ in treating fibromyalgia. NCT03797560.

目的:探讨类风湿关节炎(RA)湿热痹阻证、寒湿痹阻证两组证候之间在血小板(PLT)、健康评估问卷(HAQ)评分、双手X线的差异.方法:选取类风湿关节炎中医数据中心(CRDC-TCM)确诊为RA湿热痹阻证与寒湿痹阻证患者,比较两组证候的人口学特征(性别、年龄、病程)与PLT指标、HAQ评分以及影像学(双手X线分期)特征.结果:共纳入625例RA确诊患者,其中湿热痹阻证RA患者420例,寒湿痹阻证RA患者205例.两组RA患者在性别分布、年龄与病程长短上比较,差异均无统计学意义.湿热痹阻证RA患者PLT、HAQ评分总体水平显著高于寒湿痹阻证RA患者(P＜0.05).两组RA患者在总体双手X线分期比较,差异无统计学意义,均以Ⅰ、Ⅱ期多见;两证之间比较,寒湿痹阻证Ⅲ、Ⅳ期RA患者占比较多.结论:两组证候在人口学特征上无明显差异;湿热痹阻证RA患者在PLT、HAQ评分总体上较寒湿痹阻证高;两组证候在双手X线分期差异无统计学意义,两证之间寒湿痹阻证Ⅲ、Ⅳ期RA患者占比较多.

路志正,著名中医学家,首届国医大师.路老非常重视八段锦的作用,每天坚持锻炼,在长期习练八段锦功法基础上,结合自己的学术思想和养生理念,将导引与养生、肢体锻炼与调理脏腑经络功能融为一体,逐渐改编、形成了一套独具特色的路氏八段锦功法.路老曾提出"持中央,运四旁,怡情志,调升降,顾润燥,纳化常"18字决作为学术思想的浓缩和精华,这18字决以调升降为根本.路氏八段锦注重调整脏腑功能,调节任督二脉和阴阳跷脉的经络经气;注重激发经脉之经气;注重增强习练者的肌肉耐力和关节灵活性.路氏八段锦非常有利于当今社会各类人群的养生保健,尤其是锻炼时间不足、工作压力较大、情绪不畅、睡眠质量下降、关节肌肉不适的人群,以及身体虚弱的慢性病患者和老年人.

目的 了解接受中医药治疗的类风湿关节炎(RA)患者就医及治疗现状.方法 收集类风湿关节炎中医数据中心(CRDC-TCM)中多家中医院和部分西医院采用中医药治疗的RA患者病例信息,采用描述统计方法分析患者的疾病活动度(DAS28)[分别以血沉(ESR)、C-反应蛋白(CRP)计算]、病程、系统性受累和用药情况. 结果 共纳入RA患者1247例,其中男性205例(16.4％),女性1042例(83.6％).患者平均疾病活动度DAS28-ESR (5.50±1.45)分,中、高疾病活动度患者1175例(96.4％);患者平均疾病活动度DAS28-CRP (4.80±1.40)分,中、高疾病活动度患者1096例(92.9％).患者中位病程为6 (2,12)年,其中病程1＜病程≤5年的患者最多,共578例(46.4％).无系统受累者956例(76.7％),有系统受累者291例(23.3％),消化系统受累最常见,共186例(14.9％),其次为血液系统受累88例(7.1％)、呼吸系统受累82例(6.6％).患者双手X线分期以Ⅱ、Ⅲ期居多,分别为199例(37.1％),154例(28.7％).895例(71.8％)患者服用过或正在服用非甾体类消炎药(NSAIDs),835例(67.0％)患者服用过或正在服用抗风湿药物(DMARDs),679例(54.5％)患者服用过或正在服用中成药和中药提取制剂,674例(54.0％)患者服用过或正在服用汤剂,256例(20.5％)患者使用过或正在使用中药外用药. 结论 采用中医药治疗的RA患者病情以中、重度较多,部分存在系统损害.在治疗方面,DMARDs、NSAIDs是主要选择用药,中药汤剂、中成药及中药提取制剂均发挥着重要的作用.