长沙市膝关节骨性关节炎中医证型分布调查研究  

Research of Traditional Chinese Medicine (TCM) Syndrome Type for Knee Osteoarthritis in Changsha

作　　者：刘志豪[1] 卢敏[2] 肖学锋[1] 戴致波[1] 贾琼[1] 

机构地区：[1]湖南中医药高等专科学校第一附属医院,湖南株洲412000 [2]湖南中医药大学第一附属医院骨伤科

出　　处：《中国中医骨伤科杂志》2010年第8期39-42,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:根据膝关节骨性关节炎中医病名、病因病机、证候特点,前瞻性研究长沙市膝关节骨关节炎患者的病状特点、中医证候类型及其诊断要点。方法:在长沙地区选择4家中医院,对确诊为膝关节骨关节炎的病例采用问卷调查方法,收集人口学、症候学资料建立SPSS数据库,以频数分析方法研究各症状的分布规律,用多维尺度分析方法探讨各辨证要素之间的相互关系,用聚类分析归纳出证候类型及其诊断要点。结果:调查膝关节骨性关节炎患者804例,该病的中医病因病机:肝肾亏虚,筋骨不强是其发病的病理基础,"寒"、"湿"、"瘀"、"虚"、"热"所致筋骨瘀滞是其基本病理,从病状归纳出肾阳虚、血瘀、寒湿、肾阴虚、肝阴虚、痰浊、湿热、风、脾虚等9种辨证要素,聚类分析出肝肾阴虚、气滞血瘀、阳虚寒凝、湿热郁结等几种主要中医证型。结论:膝关节骨性关节炎是一个多病因的疾病,"瘀"、"寒"、"湿"、"虚"、"热"是膝关节骨性关节炎的主要病因病机因子,其病因病机责之于肝肾之虚和寒、湿、瘀、热之实。肾阳虚、血瘀、寒湿、肾阴虚、肝阴虚、湿热是膝关节骨关节炎主要的辨证要素。肝肾阴虚证、阳虚寒凝证、气滞血瘀证、湿热郁结证是膝关节骨关节炎的常见中医证型。Objective：To study the symptomatic characteristics,traditional Chinese medicine （TCM） syndrome types and the diagnosis of knee osteoarthritis （KOA） in Changsha. Methods：We adopted frequency analysis to study the distribution of the various symptoms and multidimensional scaling analysis to explore the relationship between differential syndrome elements. Meanwhile,we used cluster to analyze and summarize syndrome types and their diagnosis. Results：A total of 804 patients were involved in the study. The pathogenic basis for KOA was liver-kidney deficiency and weakness of bones and muscles. Stagnation of bones and muscles due to cold,dampness,stasis,and heat was the basic pathology. Based on symptoms and syndromes,9 key points for syndrome differentiation were concluded as follows：the kidney-yang deficiency,blood stasis,cold dampness,kidney and liver-yin deficiency,phlegm,damp heat,wind,and spleen deficiency. Cluster analysis indicated several main TCM syndromes for KOA：Yin deficiency syndrome of liver and kidney,qi and blood stasis syndrome,Yang deficiency syndrome of kidney and cold stasis,heat stasis syndrome. Conclusion：Knee osteoarthritis is a multi-factor disease,among which stasis,cold,dampness,deficiency,and heat are the main causes. Etiology and pathogenesis are attributed to liver and kidney deficiency and the cold,dampness,blood stasis and heat. Kidney-yang deficiency,blood stasis,cold dampness,kidney and liver-yin deficiency,and damp heat are major elements for syndrome differentiation. The most common syndrome types are Yin deficiency syndrome of liver and kidney,Yang deficiency syndrome of kidney and cold stasis,qi and blood stasis syndrome,and heat stasis Syndrome.

关 键 词：膝关节骨关节炎 流行病学调查 中医证型 

分 类 号：R684.3[医药卫生—骨科学]