A Retrospective Clinical Study on the Correlation between the Theory of Five Movements and Six Climates， and Kidney Deficiency with Governor Vessel Cold Syndrome and Kidney Deficiency Damp-Heat Syndrome in Ankylosing Spondylitis / 中医杂志

ABSTRACT

ObjectiveTo explore the relationship between the kidney deficiency and governor vessel cold syndrome and the kidney deficiency damp-heat syndrome in ankylosing spondylitis （AS） patients and the five evolutive phases and six climatic factors of their birth and onset year based on the theory of five movements and six climates （FMSC）. MethodsTotally 1791 patients with AS who were admitted to China-Japan Friendship Hospital from September 2010 to September 2020 and met the diagnostic and inclusion criteria were selected in this study. The clinical data were classified into two types of syndromes， kidney deficiency and governor vessel cold syndrome and the kidney deficiency damp-heat syndrome based on the diagnostic criteria of traditional Chinese medicine syndromes. The date of birth and the year of disease onset were converted into FMSC symbols according to the perpetual almanac （《万年历》）， and the two could be converted into the terrestrial branch， year evolutive phase， host evolutive phase， guest evolutive phase， host climatic qi， guest climatic qi， celestial manager qi， guest climatic qi adding to fixed host qi， combined analysis of five evolutive phases and six climatic factors， solar terms， and season of the date of birth， as well as the terrestrial branch， year evolutive phase， and celestial manager qi of the year of disease onset. Univariate analyses were performed using the two independent samples t-test or the Mann Whitney U-test， the Pearson （Pearson） χ2 test， or one-way logistic regression analyses， and variables for which statistical significance existed in the one-way analyses were included in the multivariate logistic regression analyses. General conditions， clinical manifestations， physical signs， laboratory indicators ［including C reactive protein （CRP）， erythrocyte sedimentation rate （ESR）， and humans leukocyte antigen B27 （HLA-B27）］， measurement （including occipital wall distance， jaw peduncle distance， finger-to-ground distance， thoracic range of motion， and Schober experiment）， and distribution of FMSC of birth and disease onset between AS patients with kidney deficiency and governor vessel cold syndrome and with the kidney deficiency damp-heat syndrome were compared， and the association between FMSC and AS patients with kidney deficiency and governor vessel cold syndrome and the kidney deficiency damp-heat syndrome was studied. ResultsThe differences in ESR， CRP， chest mobility， occurrence of achilles tendon enthesitis， and peripheral arthritis between the two groups of patients were statistically significant （P＜0.05）. Single factor analysis found that taking kidney deficiency and governor vessel cold syndrome as control the following FMSC factors increases the risk of developing kidney deficiency damp-heat syndrome： excess of water in year evolutive phase at birth， excess of wood in host evolutive phase at birth， excess of wood in guest evolutive phase at birth， excess of wood in year evolutive phase of onset， deficiency of metal in year evolutive phase at birth （OR = 2.000， P = 0.004）， excess of metal in host evolutive phase at birth （OR = 1.745， P = 0.024） or excess of wood （OR = 1.781， P = 0.023）， deficiency of fire in guest evolutive phase at birth （OR = 1.689， P = 0.049） or deficiency of wood （OR = 1.901， P = 0.018） or excess of metal （OR = 2.163， P = 0.004）， excess of water in year evolutive phase at the disease onset （OR = 1.880 ， P = 0.013） or deficiency of wood （OR = 1.707， P = 0.022）. Multivariate logistic regression analysis found that the risk of developing kidney deficiency damp-heat syndrome in AS was increased by deficiency of metal in year evolutive phase at birth， excess of metal in host evolutive phase at birth， higher level of ESR， greater the chest mobility， incidence of concomitant Achilles tendon enthesitis and peripheral arthritis. ConclusionThe year evolutive phase and host evolutive phase at birth play a significant role in the development of kidney deficiency and governor vessel cold syndrome AS. Risk of developing kidney deficiency damp-heat syndrome can be increased by excess of water or deficiency of metal in year evolutive phase at birth， and excess of wood or excess of metal in host evolutive phase at birth and the kidney deficiency damp-heat syndrome in ankylosing spondylitis.