Objective

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To explore the literature on dampness syndrome in rheumatoid arthritis， determine the core types of dampness syndrome， and construct corresponding evidence for syndrome differentiation.

Methods

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Through systematic literature review， the dampness syndrome diagnosis and four diagnostic methods information was extracted and standardized from the included literature. The frequency of dampness syndrome diagnosis was analyzed to identify the types of core dampness syndrome of rheumatoid arthritis. Combined with frequency analysis and Apriori association rules， the information rules of the four diagnostic methods related to the core wet syndrome were mined， and the syndrome differentiation participation and correlation of the four diagnostic methods information were discussed. By identifying high-frequency and strongly associated items， key diagnostic evidence was determined， and their importance levels were assigned using a weighting method.

Results

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There were 41 types of dampness syndromes in rheumatoid arthritis. According to the descending order of frequency， the top three syndromes were cold dampness obstruction syndrome， damp heat obstruction syndrome， and wind-cold-dampness impediment syndrome， with frequencies of 26.71%， 24.78%， and 16.89%， respectively. Among these， cold dampness obstruction syndrome and damp heat obstruction syndrome were the core types of dampness syndromes. There were 17 key evidence items for syndrome differentiation of cold dampness obstruction syndrome， with a weight range of 3~10 and a median of 4. These evidence items include arthralgia， exacerbated by exposure to cold， joint swelling， motion difficulty in joints， cold pain in joints， pale tongue， stringy and tight pulse， morning joint stiffness， white fur， exacerbated by rainy weather， body trapped， lack of thirst， aversion to wind， aversion to cold， bland taste in the mouth， joint deformity and greasy white fur. There were 16 key evidence items for syndrome differentiation of damp heat obstruction syndrome， with a weight range of 3~10 and a median of 6. These evidence items include arthralgia， joint swelling， red tongue， slippery and rapid pulse， greasy yellow fur， fever， heat sensation upon touching painful joints， redness of the skin over painful joints， deep-colored urine， morning joint stiffness， motion difficulty in joints， thirst， heat and depression in the heart， hot pain in joints， dry stool， and reluctance to drink due to thirst.

Conclusions

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The core dampness syndromes of rheumatoid arthritis are cold dampness obstruction syndrome and damp heat obstruction syndrome. The syndrome differentiation evidence includes joint symptoms， other symptoms， and tongue-pulse manifestations. In the syndrome differentiation of cold dampness obstruction syndrome， emphasis is placed on joint symptoms while evaluating tongue and pulse manifestations. Conversely， in the syndrome differentiation of damp heat obstruction syndrome， emphasis is placed on tongue and pulse manifestations while evaluating joint symptoms.