中国中西医结合杂志2026，Vol.46Issue(8)：932-937,6.DOI:10.7661/j.cjim.20251223.313
基于"遗传—环境—免疫"类风湿关节炎高风险人群筛查及中医证型分析
An Integrated Genetics-Environment-Immunity Approach to Screening High-Risk Populations for Rheumatoid Arthritis and Characterizing Chinese Medicine Patterns
摘要
Abstract
Objective To improve preclinical rheumatoid arthritis(pre-RA)screening methods by developing a secondary screening strategy based on a"genetic-environment-immune"framework,to enhance identification accuracy of high-risk populations,and to analyze Chinese Medicine(CM)syndrome distribution.Methods Identify high-risk populations for rheumatoid arthritis(RA)through primary screening.Secondary screening confirms pre-RA patients.CM syndrome analyses were performed in high-risk groups,the distribution law and characteristics of CM syndromes were discussed.Results Out of 7 195 individuals screened,314 were identified as high-risk,and 80 were confirmed as pre-RA patients.These individuals showed abnormally elevated erythrocyte sedimentation rate(ESR,32.50±23.75 mm/h),rheumatoid factor(RF,52.63±88.17 IU/mL)anti-cyclic citrullinated antibody(Anti-CCP,52.60±88.20 U/mL).Common CM syndromes were sequenced as wind-dampness obstruction(27.7％),cold-dampness obstruction(16.9％),Gan-Shen deficiency syndrome(16.2％),Pi deficiency with dampness obstruction syndrome(13.4％),damp-heat obstruction syndrome(9.2％),blood stasis obstructing the collaterals syndrome(7.6％),phlegm-blood stasis obstruction syndrome(5.1％),and qi-blood deficiency syndrome(3.8％).The proportion of damp-heat obstruction syndrome was significantly higher in males than in females(23.0％vs.5.9％;x2=15.019,P＜0.01).The majority of CM syndromes were concentrated in the 41～60 years old groups(63.4％),followed by the≤40 years group(20.1％),while individuals aged＞60 years accounted for a smaller proportion(16.6％).Phlegm-blood stasis obstruction syndrome was mainly distributed in the 41～60 years old and＞60 years old groups(both 37.5％),with significant differences among age groups(x2=6.142,P＜0.05).Conclusions The strategy effectively identified pre-RA individuals in high-risk RA patients.Bi(obstruction)syndromes predominated inRA high-risk groups,manifesting differences in gender and age.关键词
类风湿关节炎/高风险人群/临床前期类风湿关节炎/遗传—环境—免疫/中医证型/风险评估Key words
rheumatoid arthritis/high-risk populations/preclinical rheumatoid arthritis/genetics-environment-immunity/Chinese medicine syndrome pattern/risk assessment引用本文复制引用
温宇,李莎,沈志浩,沈正东,刘禹全,张鹏,吴晓东,高恺昕,温泽淮,黄闰月,梁伟东,杨圣钦,彭剑虹,姚血明,李楠,张伟铮,储永良,吕新亮..基于"遗传—环境—免疫"类风湿关节炎高风险人群筛查及中医证型分析[J].中国中西医结合杂志,2026,46(8):932-937,6.基金项目
国家自然科学基金项目(No.82274421,No.U23A6012) （No.82274421,No.U23A6012）
青年岐黄学者培育项目[No.国中医药人教函(2022)256号] （2022）
广东省自然科学基金项目(No.2024A1515012464) （No.2024A1515012464）
广东省中医证候临床研究重点实验室项目(No.2023B1212060063) （No.2023B1212060063）
