步态分析技术在膝骨性关节炎经筋辨证中的应用研究  

Application study of gait analysis on different syndrome types based on musculature zones of the knee osteoarthritis

作　　者：王常海[1] 李峰[2] 张蓉[3] 施延昭 

机构地区：[1]河南中医学院基础医学院,郑州450008 [2]北京中医药大学基础医学院 [3]第二炮兵总医院 [4]RSscan中国实验室

出　　处：《中国针灸》2010年第3期183-187,共5页Chinese Acupuncture & Moxibustion

基　　金：国家科技部"973"项目:2005CB523307;教育部高等学校优秀青年教师教学科研奖励计划项目:0100108;教育部科技成果完成项目:360-09-10130493-03

摘　　要：目的:研究膝骨性关节炎不同经筋证型的步态特征,探讨现代生物力学技术在经筋辨证客观化研究中的应用。方法:选取不同经筋证型的19例膝骨性关节炎(KOA)患者共30个患膝,运用足底压力测量系统测试步角、足跟部冲量、旋内旋外值及地面最大垂直反力出现时间占支撑期总时间的百分比。结果:在步角和足跟部冲量上,足少阳经筋病变膝和足三阴经筋病变膝均大于正常(均P<0.05),足阳明经筋病变膝正常;足阳明经筋病变膝在支撑中期旋外均值大于正常(P<0.05),足少阳经筋病变膝在推离期旋内均值大于正常(P<0.05),而足三阴经筋病变膝在推离期旋外均值大于正常(P<0.05);足阳明经筋病变膝地面最大垂直反力出现时间显著推迟(P<0.05)。结论:KOA患者不同经筋证型在步角、足跟部冲量、旋内旋外值、地面最大垂直反力出现时间等步态指标上各有不同,可以作为KOA患者经筋辨证的客观依据,生物力学技术可以运用于KOA的经筋辨证。Objective To study the gait characteristics of different syndrome types based on musculature zones of the knee osteoarthritis （KOA） and to discuss the application of modern biomechanical technology in objective study on syndrome differentiation which is based on musculature zones. Methods Thirty knees out of 19 patients suffering from KOA with the different musculature zone syndrome types were measured the step angle, the heel impulse, the internal and external rotation figures and the percentage of the maximum vertical ground reaction time in the total time of the supporting period by using the Plantar Pressure Measurement System. Results In the knees with abnormal mus- culature zones, the figures of step angle and the heel impulse of Foot Shaoyang Meridian and three foot yin meridia- ns were significantly increased than normal （all P〈0.05）, while those figures of Foot Yangming Meridian were normal; in the knees of Foot Yangming Meridian with abnormal musculature zones, the external rotation mean figure in the midstance was significantly increased than normal （P〈0.05） ;in the knees of Foot Shaoyang Meridian with abnormal musculature zones, the internal rotation mean figure in the propulsion was significantly increased than normal （P〈0.05） ; in the knees of the three foot yin meridians with abnormal musculature zones, the mean external rotation figure in propulsion was significantly increased than normal （P〈0.05） ; in the knees of the Foot Yangming Meridian with abnormal musculature zones, the time of maximum vertical ground reaction was significantly delayed （P〈0.05）. Conclusion The figures of the gait index in KOA patients with different musculature zone types are different, including the step angle, heel impulse, the internal and external rotation figures, the time of the maximum vertical ground reaction and so on, which could be used as the objective basis of syndrome differentiation based on musculature zones for KOA patients. Therefore, biomechanical technology can be appli

关 键 词：骨关节炎 膝 步态 十二经筋 辨证 

分 类 号：R246.2[医药卫生—针灸推拿学]