Objective To explore spinal structural damage characteristics in ankylosing spondylitis（ AS） with cold and heat syndromes and its relevance with patients’ general situation

symptoms

signs

laboratory examination and other factors. Methods Sixty patients with AS were divided into cold syndrome group and heat syndrome group through syndrome differentiation

with 30 cases in each group. The modified Stoke Ankylosing Spondylitis Spine Score（ m SASSS） was compared between the patients in two groups

and correlation between the patient’s m SASSS score and age

gender

course of disease

grade of sacroiliac joint X-ray

as well as the results of laboratory examination was analysed. Results The m SASSS score in the cold syndrome group was higher than that in the heat syndrome group（ P < 0. 05）. The m SASSS score in the cold syndrome group was positively correlated with age

course of disease

grade of sacroiliac joint X-ray

Bath ankylosing spondylitis functional index

occiput to wall distance

fingertip to ground distance

and mandible to manubrium distance（ P < 0. 05）

and negatively correlated with thoracic mobility and the Schober test（ P < 0. 05）. The m SASSS score in the heat syndrome group was positively correlated with blood sedimentation and C-reactive protein（ P < 0. 05）. Conclusion Spinal structure damage degree in the cold syndrome group was more serious than in the heat syndrome group. Spinal structure damage degree in the heat syndrome group may have a certain correlation with inflammation.