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Journal of Chinese Integrative Medicine ›› 2008, Vol. 6 ›› Issue (1): 32-36.doi: 10.3736/jcim20080107

• Original Clinical Research • Previous Articles     Next Articles

Principal factor analysis of symptoms of rheumatoid arthritis and their correlations with efficacy of traditional Chinese medicine and Western medicine

Yi-ting He1, Qing-lin Zha2, Jian-ping Yu2, Yong Tan3,4, Cheng Lu4(), Ai-ping Lv4,5   

  1. 1. Second Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong Province 510120, China
    2. National Pharmaceutical Engineering Research Center, Jiangxi College of Traditional Chinese Medicine, Nanchang, Jiangxi Province 330006,China
    3. Traditional Chinese Medicine Institute, Capital Medical University, Beijing 100069, China
    4. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
    5. E-institute of Shanghai Education Committee, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
  • Received:2007-03-28 Online:2008-01-20 Published:2008-01-15
  • Contact: LU Cheng E-mail:lap64067611@126.com

Objective:To explore the correlations between symptom-based principal factors of rheumatoid arthritis (RA) and the effect of traditional Chinese medicine or Western medicine on RA after factor analysis of RA symptoms.

Methods:Four hundred and thirteen RA patients from 9 clinical centers were included in the clinical trial. They were randomly divided into Western medicine (WM) treated group with 204 cases and traditional Chinese medicine (CM) treated group with 209 cases. A complete physical examination and 18 common clinical manifestations were recorded before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included glucosidorum Tripterygll totorum tablet and Yishen Juanbi Tablet. The American College of Rheumatology 20 (ACR20) was used for efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. Eighteen symptoms in the RA patients were analyzed by factor analysis and the relationships between the factors and effects were analyzed with Chi-Square test.

Results:Four principal factors were obtained from the analysis results of the 18 symptoms. The factors could represent the symptoms related to joints, cold-syndrome, deficiency syndrome and heat-syndrome in traditional Chinese medicine (TCM),respectively. The effect of WM therapy was better than CM therapy. After 12 weeks of treatment, the effect of CM on patients without deficiency-syndrome was better than the patients with deficiency-syndrome. After 24 weeks of treatment, WM therapy showed better effect on patients with cold syndrome than patients without cold syndrome.

Conclusion:The results based on the factor analysis of RA symptoms are similar to the results of syndrome differentiation of TCM, and the factor-related different categories of symptoms are associated with the curative effect, thus further research on the symptoms is necessary.

Key words: rheumatoid arthritis, factor analysis, statistical, treatment effectiveness

CLC Number: 

  • R593.22

Table 1

Load coefficient of each common factor after factor analysis of RA symptoms"

Symptom Factor 1 Factor 2 Factor 3 Factor 4
Joint tenderness 0.738 - - -
Joint pain 0.704 - - -
Joint swelling 0.682 - - -
Joint stiffness 0.611 - - -
Heavy limbs 0.384 0.331 0.346 0.368
Afraid of cold - 0.646 0.242 -
Cold joints - 0.626 - -
Cold limbs - 0.586 - -
Soreness and weakness of the back and knees - 0.270 0.483 -
Dizziness - - 0.425 -
Fatigue 0.361 0.346 0.421 -
Limb numbness - - 0.369 -
Frequent urination at night - - 0.309 0.267
Hot joint 0.224 - - 0.525
Dysphoria - - 0.407 0.441
Thirsty - - 0.237 0.433
Fever - - - 0.343
Yellow and turbid urine - - - 0.337
Eigenvalue 2.375 1.685 1.341 1.215
Proportion (%) 35.01 24.85 19.77 17.92
Cumulation (%) 35.01 59.86 79.62 97.54
Implicative significance in traditional Chinese medicine Joint symptoms Cold syndrome Deficiency syndrome Heat syndrome

Table 2

Correlation between efficacy and cold syndrome related factors after 12 and 24 weeks of treatment [Cases (%)]"

Group n Effect after 12 weeks of treatment Effect after 24 weeks of treatment (%)
Chinese herbal medicine-treated
Non-cold syndrome 103 30 (29.1) 51 (49.5)
Cold syndrome 106 36 (34.0) 57 (53.8)
Western medicine-treated
Non-cold syndrome 106 35 (33.0) 59 (55.7)
Cold syndrome 98 37 (37.8) 68 (69.4)*

Table 3

Correlation between efficacy and deficiency syndrome related factor after 12 and 24 weeks of treatment [Cases (%)]"

Group n Effect after 12 weeks of treatment Effect after 24 weeks of treatment
Chinese herbal medicine-treated
Non-deficiency syndrome 118 45 (38.1)* 65 (55.1)
Deficiency syndrome 91 21 (23.1) 43 (47.3)
Western medicine-treated
Non-deficiency syndrome 109 38 (34.9) 67 (61.5)
Deficiency syndrome 95 34 (35.8) 60 (63.2)

Table 4

Correlation between efficacy and heat syndrome related factor after 12 and 24 weeks of treatment [Cases (%)]"

Group n Effect after 12 weeks of treatment Effect after 24 weeks of treatment
Chinese herbal medicine-treated
Non-heat syndrome 118 35 (29.7) 64 (54.2)
Heat syndrome 91 31 (34.1) 44 (48.4)
Western medicine-treated
Non-heat syndrome 109 41 (37.6) 68 (62.4)
Heat syndrome 95 31 (32.6) 59 (62.1)
[1] Zha QL, Lin SQ, He YT , et al. Analysis on the mathematics logic of dialectical thoughts of traditional Chinese medicine from symptomatic factors —469 rheumatoid arthritis cases from a multi-center clinical trial. Jiangxi Zhong Yi Xue Yuan Xue Bao. 2005; 17(1):75-77. Chinese.
查青林, 林色奇, 何羿婷 , 等. 从主观症状因子分析的结果看中医辨证的数学逻辑一附469例RA多中心临床病例分析.江西中医学院学报. 2005; 17(1):75-77.
[2] He YT, Zha QL, Yan XP , et al. Analysis on symptomatic factors of rheumatoid arthritis and its correlation with therapeutic efficacy. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005; 25(12):1077-1081. Chinese with abstract in English.
doi: 10.7661/CJIM.2005.12.1077
何羿婷, 查青林, 闫小萍 , 等. 类风湿性关节炎症状因子分析及其与疗效的关系.中国中西医结合杂志. 2005; 25(12):1077-1081.
doi: 10.7661/CJIM.2005.12.1077
[3] Rheumatoid arthritis: the status and future of combination therapy . Proceedings of a meeting. Chatham, Massachusetts, USA,July 13-15,1995. J Rheumatol Suppl. 1996; 44:1-110.
[4] Ministry of Health of the People's Republic of China. Guiding principle of new drug clinical research of traditional Chinese medicine. Beijing: Medical Science Publishing House of China. 1993: 210-214. Chinese.
中华人民共和国卫生部. 中药新药临床研究指导原则. 北京: 中国医药科技出版社. 1993: 210-214.
[5] State Food and Drug Administration . Guiding principle of new drug clinical research of traditional Chinese medicine. Beijing: Medical Science Publishing House of China. 2002 : 115-119. Chinese.
国家食品药品监督管理局. 中药新药临床研究指导原贝!1.北京: 中国医药科技出版社. 2002: 115-119.
[6] State Administration of Traditional Chinese Medicine. Standard of the People's Republic of China specification: the criteria for diagnosis and therapeutic effect evaluation of diseases and syndromes in traditional Chinese medicine. Nanjing: Nanjing University Publishing House. 1994: 29-30. Chinese.
国家中医药管理局. 中华人民共和国中医药行业标准 .中医病证诊断疗效标准.南京: 南京大学出版社. 1994: 29-30.
[7] Wang ZM , Bai RX. Integrated medical diagnosis and treatment criteria for four rheumatoid diseases. Zhong Xi Yi Jie He Za Zhi. 1989; 9(1):52-53. Chinese.
王兆铭 , 白人骁风湿四病”的中西医结合诊疗标准. 中西医结合杂志. 1989; 9(1):52-53.
[8] American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines. Guidelines for the management of rheumatoid arthritis : 2002 Update. Arthritis Rheum. 2002; 46(2):328-346.
doi: 10.1007/BF03278953
[9] Lu AP, Zha QL , Zhang ZB. Methodological thoughts about research of standardized clinical protocols of traditional Chinese medicine. Zhong Xi Yi Jie He Xue Bao. 2006; 4(2):117-119. Chinese with abstract in English.
doi: 10.3969/j.issn.1672-5085.2010.17.294
吕爱平, 查青林, 张志斌 . 中医药规范化治疗方案研究的思路与方法.中西医结合学报. 2006; 4(2):117-119.
doi: 10.3969/j.issn.1672-5085.2010.17.294
[10] Lu AP , Wang YY. Methodological thoughts on clinical efficacy evaluation with multiple clinical trials. Zhongguo Zhong Yao Za Zhi. 2006; 31(16):1384-1385. Chinese with abstract in English.
吕爱平, 王永炎 . 基于多次临床试验的中医药疗效评价研究思路.中国中药杂志. 2006; 31(16):1384-1385.
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