Search JIM Advanced Search

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

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.
[1] Ju-Yeon Park, Young-Won Kwon, Sun-Ah Kim, Sun-Dong Park, Chang-Hyun Kim, Jin-Hee Kim, Ju-Hee Lee. Polyherbal formula SC-E3 inhibits rheumatoid arthritis activity in a mouse model of type-II collagen-induced arthritis. Journal of Integrative Medicine, 2021, 19(3): 265-273.
[2] Susana Seca, Sebastian Kirch, António S.Cabrita, Henry J.Greten. Evaluation of the effect of acupuncture on hand pain, functional deficits and health-related quality of life in patients with rheumatoid arthritis—A study protocol for a multicenter, double-blind, randomized clinical trial. Journal of Integrative Medicine, 2016, 14(3): 219-227.
[3] Jian Liu, Chuan-bing Huang, Yuan Wang, Gui-qin Xu, Yuan-yuan Cheng, Yun-xia Feng, Lei Liu, Ya-jun Qi. Chinese herbal medicine Xinfeng Capsule in treatment of rheumatoid arthritis: Study protocol of a multicenter randomized controlled trial. Journal of Chinese Integrative Medicine, 2013, 11(6): 428-434.
[4] Liang-ping Hu, Xiao-lei Bao, Chen-long Lv. Two-factor designs unable to examine the interactions (Part 2). Journal of Chinese Integrative Medicine, 2012, 10(9): 966-969.
[5] Liang-ping Hu, Xiao-lei Bao, Chen-yi Guo . Two-factor designs unable to examine the interactions (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(8): 853-857.
[6] Liang-ping Hu , Xiao-lei Bao, Chen-long Lü . How to choose an appropriate experimental design type (Part 2). Journal of Chinese Integrative Medicine, 2012, 10(7): 738-742.
[7] Liang-ping Hu, Xiao-lei Bao. How to choose an appropriate experimental design type (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(6): 615-618.
[8] Gui-lin Ouyang, Xiao-hui Feng, Lian-bo Xiao, Zheng Huang, Qing Xia, Da-peng Han, Fei Zhu . Effects of Chinese herbal medicine Qianggu Capsule on patients with rheumatoid arthritis-induced osteoporosis: a report of 82 cases. Journal of Chinese Integrative Medicine, 2012, 10(12): 1394-1399.
[9] Xiao-lei Bao, Liang-ping Hu. Multifactor designs able to examine the interactions. Journal of Chinese Integrative Medicine, 2012, 10(12): 1371-1374.
[10] Liang-ping Hu, Xiao-lei Bao. Three-factor designs unable to examine the interactions (Part 2). Journal of Chinese Integrative Medicine, 2012, 10(11): 1229-1232.
[11] Liang-ping Hu, Xiao-lei Bao. Three-factor designs unable to examine the interactions (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(10): 1088-1091.
[12] Yan Wang, Hong-yan Zhao, Mei-jie Liu, Cheng Xiao, Cheng Lü, Yong Tan, Qing-lin Zha, Yan Li, Hong Liu, Ai-ping Lü, Da-hong Ju. Establishment of a rat model of rheumatoid arthritis with kidney deficiency syndrome. Journal of Chinese Integrative Medicine, 2011, 9(9): 973-982.
[13] Qian Zhao, Rui Jin, Bing Zhang, Sen-mao Liu, Min Li, Xin Liu, Lian-zhen Li, Qian Zhang . Ridit analysis of experimental data from animal models of yang deficiency induced by different doses of hydrocortisone. Journal of Chinese Integrative Medicine, 2011, 9(9): 941-947.
[14] Zhi-ming Huang, Gui-ling Ouyang, Lian-bao Xiao, Ning-li Li, Hua-li Gao, Yong He, Zheng Huang, Xin-xing Huang. Effects of Drynaria total flavonoids on apoptosis of osteoblasts mediated by tumor necrosis factor-α. Journal of Chinese Integrative Medicine, 2011, 9(2): 173-178.
[15] Jin-xin Xu, Yu Zhang, Xue-zeng Zhang, Ying-ying Ma. Anti-angiogenic effects of genistein on synovium in a rat model of type Ⅱ collagen-induced arthritis. Journal of Chinese Integrative Medicine, 2011, 9(2): 186-193.
Full text



[1] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[2] Hao Li, Ming-jiang Yao, Wen-ming Zhao, Jie Guan, Lin-lin Cai, Ling Cui. A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment. Journal of Chinese Integrative Medicine, 2008, 6(1): 25-31
[3] Zhi-chun Jin. Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 5-8
[4] SUN Ming-yu, ZUO Jian, DUAN Ji-feng, HAN Jun, FAN Shi-ming, ZHANG Wei, ZHU Li-fang, YAO Ming-hui. Antitumor activities of kushen flavonoids in vivo and in vitro. Journal of Chinese Integrative Medicine, 2008, 6(1): 51-59
[5] Min Cheng, Qiong Feng, Shu-wen Qian, Hui Gao, Cui-qing Zhu. Preliminary assay of p-amyloid binding elements in heart-beneficial recipe. Journal of Chinese Integrative Medicine, 2008, 6(1): 68-72
[6] Ning-qun Wang, Liang-duo Jiang, Zong-xing Li. Research progress in asthma-related quality of life. Journal of Chinese Integrative Medicine, 2008, 6(1): 93-97
[7] Jing-yuan Mao, Chang-xiao Liu, Heng-he Wang, Guang-li Wei , Zhen-peng Zhang, Jie Xing, Wang Xian liang , Ying-fei Bi . Effects of Shenmai Injection on serum concentration and pharmacokinetics of digoxin in dogs with heart failure. Journal of Chinese Integrative Medicine, 2010, 8(11): 1070-1074
[8] Zhi-mei Wang, Bin Zhang. A study on translation of ellipses in Huangdi Neijing from perspective of hermeneutic theory. Journal of Chinese Integrative Medicine, 2010, 8(11): 1097-1100
[9] Gui Yu, Jie Wang. Thinking on building the network cardiovasology of Chinese medicine. Journal of Chinese Integrative Medicine, 2012, 10(11): 1206-1210
[10] Pedro Saganha João, Doenitz Christoph, Greten Tobias, Efferth Thomas, J. Greten Henry. Qigong therapy for physiotherapists suffering from burnout: a preliminary study. Journal of Chinese Integrative Medicine, 2012, 10(11): 1233-1239