膝骨关节炎关节镜下表现与中医证候相关性研究  

Study on the Relation Between Tissues Image by Surgical Arthroscopy and Traditional Chinese Medicine Syndromes in Knee Osteoarthritis

作　　者：朱光宇[1] 田向东[1] 薛志鹏[2] 谢国庆 王剑[1] 管垒 谭冶彤 杨晨[2] 杜冬峰 ZHU Guang-yu TIAN Xiang-dong XUE Zhi-peng XIE Guo-qing WANG Jian GUAN Lei TAN Ye-tong DU Dong-feng(Department of Minimal Invasive Joint, The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China Graduate school of Beijing University of Chinese Medicine, Beijing 100029, China Beijing Guangji hospital of Chinese Medicine, Beifing, 100029, China)

机构地区：[1]北京中医药大学第三附属医院微创关节科,北京100029 [2]北京中医药大学,北京100029 [3]北京广济中医医院,北京100011

出　　处：《中国中医基础医学杂志》2017年第6期826-829,共4页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：北京中医药大学2016年度基本科研业务费项目(2016-JYB-JSMS-073)-关节镜联合揿针治疗膝骨性关节炎的研究

摘　　要：目的:通过探讨膝骨关节炎关节镜下影像与中医辨证分型的相关性,为膝骨关节炎的诊治提供思路。方法:取自北京中医药大学第三附属医院2013年6月至2016年12月121例(126侧)接受关节镜手术的膝关节骨性关节炎病人,按中医膝痹辨证分为瘀血痹阻、阳虚寒凝、肾虚髓亏3组,每组随机抽取各30例,通过研究关节镜手术中镜下所见滑膜增生、软骨损伤、游离体、半月板损伤等病理表现分析统计数据,找出每组内相同特性及组间差别,总结膝骨关节炎关节镜下组织病理变化与中医证型的关系。结果:根据中医证型,滑膜增生多见于瘀血阻滞型,膝关节软骨轻度损伤见于阳虚寒凝型,软骨严重损伤见于肾虚髓亏型且差异有统计学意义。结论:对于膝骨关节炎不同辨证分型在关节镜下呈现不同的组织病理变化,且同一分型病例具有大体相同的特征。Objective： Integration of traditional Chinese medicine and modern medicine gives a good advantage in achieving the best diagnosis and treatment of knee osteoarthritis. Methods： 121 patients （126 knees）with knee osteoarthritis were selected from the department of minimal invasive joint of the third affiliated hospital of Beijing University of Chinese Medicine from June 2013 to June 2016. They were divided into 3 groups and with 30 cases randomly selected per group in accordance to the syndrome differentiation of traditional Chinese medicine. The patients underwent arthroscopic surgery, and we categorized the patients having the same characterization in each group, and those having distinct difference into the three groups. Based on the arthroscopic analysis, we performed analysis of statistical data in order to analyze the relation between knee osteoarthritis under arthroscope and traditional Chinese medicine syndromes. Results： There are three syndromes according to traditional Chinese medicine that can be categorized into various different groups. The synovial proliferation can be seen mostly in the syndrome of stagnation of blood stasis. The slight damage of knee joint cartilage can be seen in the syndrome of yang deficiency and cold stagnation, the severe one in the syndrome of kidney- marrow deficiency. We found that there are different pathological expressions with the various degree of the tissues damage at the knee and we categorized the knee according to their syndrome. Conclusion： For knee osteoarthritis, different syndromes of traditional Chinese medicine presents different tissues pathological changes at the knee joint under arthroscopy, which will provide objective basis for the diagnosis of this medical condition.

关 键 词：辨证分型 膝骨关节炎 关节镜手术 相关性 

分 类 号：R255.6[医药卫生—中医内科学]