【目的】研究中医体质与强直性脊柱炎（ankylosing spondylitis，AS）患者发病因素的相关性。【方法】选取2019年8月至 2020年9月就诊于西安市第五医院（即陕西省中西医结合医院）的100例强直性脊柱炎患者及其家系成员作为研究对象。采用 中华中医药学会颁布的《中医体质分类与判定》中的准则对研究对象进行体质判定，通过问卷调查和临床调查的方式收集 强直性脊柱炎患者及其家系成员的社会人口学、生活习惯、临床症状、中医体质等情况，调查强直性脊柱炎患者的疾病诱 发因素；采用二进制逻辑回归模型，分析强直性脊柱炎患者中医体质类型与发病因素的相关性。【结果】（1）100例强直性脊 柱炎患者中，以偏颇体质居多，其分布频率由高到低依次为阳虚质、气虚质、湿热质，分别占33.00%、14.00%、18.00%。 （2）强直性脊柱炎患者的Ⅰ、Ⅱ、Ⅲ级亲属的患病率分别为56.25%、40.00%、25.00%；在人类白细胞抗原B27（HLA-B27）阳 性率方面，强直性脊柱炎患者的HLA-B27均为阳性，而其Ⅰ、Ⅱ、Ⅲ级亲属的HLA-B27阳性率分别为44.31%、30.67%、 15.63%。（3）回归分析结果显示，强直性脊柱炎患者的病程与气虚质、骶髂关节炎级别与气郁质、年龄与血瘀质呈显著相关 性（P＜0.05或P＜0.01）。表明强直性脊柱炎患者的病程和年龄是影响体质的重要因素，其中病程与气虚关系密切，年龄与 血瘀关系密切。【结论】强直性脊柱炎为高度遗传的自身免疫性疾病，其发病与HLA-B27相关；阳气亏欠是强直性脊柱炎最 基本的体质特点，而湿热质是强直性脊柱炎疾病进展过程（尤其是疾病活动期）的主要体质类型，且随病程的延长会加剧病 情和气虚表现。

Abstract： Objective To study the correlation between traditional Chinese medicine（TCM） constitution and pathogenic factors in patients with ankylosing spondylitis（AS）. Methods One hundred patients of AS and their family members who had medical consultation in the Fifth Hospital of Xi’an（i.e.，Shaanxi Hospital of Integrated Traditional Chinese and Western Medicine） in August 2019 and September 2020 were selected as the study subjects. The guidelines of Classification and Determination of Traditional Chinese Medicine Constitution issued by the China Association of Chinese Medicine were adopted to determine the traditional Chinese medicine（TCM） constitution types of the study subjects. The sociodemographic information，living habits，clinical symptoms，and TCM constitution types of the AS patients and their family members were collected by means of questionnaires and clinical investigations， and then the pathogenic factors of the patients with AS were investigated. The binomial 广州中医药大学学报 Journal of Guangzhou University of Traditional Chinese Medicine 2024年3月第41卷第3期 March 2024，Vol. 41，No. 3 545 Logistic regression model was used to analyze the correlation between TCM constitution types and pathogenic factors in patients with AS. Results （1）Among the 100 AS patients， the majority of them had the biased constitutions，and the biased constitutions with the occurrence frequency in descending order were yang deficiency constitution， qi deficiency constitution， and damp-heat constitution， which accounted for 33.00%， 14.00%， and 18.00%，respectively.（2）The prevalence rates of AS in the first-，second-，and third-degree relatives of AS patients were 56.25%，40.00% and 25.00%，respectively. For the positive rates of human leukocyte antigen B27（HLA-B27）in AS patients and their family members，HLA-B27 in AS patients was all positive，while the positive rates of HLA-B27 in the first-， second-， and third-degree relatives of AS patients were 44.31%， 30.67% and 15.63%，respectively.（3）The results of regression analysis showed that the disease duration of AS patients was significantly correlated with qi deficiency constitution， the grading of sacroiliac arthritis was correlated with qi stagnation constitution，and age was correlated with blood stasis constitution（P＜0.05 or P＜ 0.01）. The results indicated that disease duration and age were the important factors affecting the constitution types of AS patients， and disease duration was closely related to qi deficiency while age was closely related to blood stasis. Conclusion AS is a highly hereditary autoimmune disease，and its onset is associated with HLA-B27. Yang deficiency is the basic constitution type of AS，and damp-heat constitution is the main constitution type in the progression of AS（especially in the active stage of the disease）. The prolongation of the disease will exacerbate the illness condition of AS and then the manifestations of qi deficiency will be more obvious

R259.323

陕西省中医药管理局中西医结合临床协作创新项目（编号：2020-ZXY-006）；西安市第五医院院内科研项目（编号：20201c01）