Exploration of the Correlation Between Core Traditional Chinese Medicine Symptoms and Clinicopathological Indicators in Rheumatoid Arthritis:A Logistic Regression-Based Study

HAN Yuxin; WANG Zihan; LAN Meiqi; BIAN Yuting; QU Xiangke; XU Yuan; TAO Qingwen; WANG Jianming

Abstract：Objective This paper is designed to identify the core symptom set in patients with rheumatoid arthritis(RA)and investigate its correlation with biochemical markers and disease activity scores.Methods A total of 227 RA patients who visited the Department of Rheumatology of Traditional Chinese Medicine,China-Japan Friendship Hospital,from April 2021 to March 2023 were recruited.Cluster analysis was used to extract the core symptom set,while multivariate logistic regression,along with ROC curve analysis,was applied to assess the correlation between the core symptom set,biochemical markers,and disease activity scores.Results Under the guidance of traditional Chinese medicine theory,symptoms were categorized into three sets based on cluster analysis.The symptom with the highest frequency set(1082 occurrences,70.34%)was deemed the core symptom set,which included symptoms such as"joint pain,soreness and weakness of the waist and knees,cold in extremities,joint cold,aversion to cold"related to kidney Yang deficiency and cold syndrome.Lower age,lower white blood(WBC)cell counts,lower immunoglobulin IgA(P<0.01),and higher hemoglobin(Hb)(P<0.05)were statistically significant in the core symptom group compared to the non-core symptom group.Compared to the non-core symptom group,the core symptom group exhibited statistically significant differences in lower age,lower white blood cell counts,lower immunoglobulin IgA levels,and higher hemoglobin(Hb)levels(P<0.05).Multivariate logistic regression revealed a positive correlation between WBC,IgA,and the core symptom set(P<0.05).However,Hb displayed a non-significant negative correlation(P>0.05).The composite ROC curve formulated by the combination of WBC,IgA,and Hb demonstrated the largest area under the curve(AUC=0.672),signifying its capability to effectively discriminate whether a patient is in the core symptom set status.Conclusion The core symptoms observed in patients with RA are closely linked to kidney Yang deficiency and resulting cold syndrome.Additionally,the core symptom set of RA can be distinguished by measuring levels of WBC,IgA,and Hb.The combined analysis of core symptoms,biochemical markers,and disease activity scores aids in the objectification of TCM syndrome differentiation.