痛风性膝关节炎中医证型与关节镜下组织结构病变的相关性研究  

Study on the Correlation of Traditional Chinese Medicine Syndrome Patterns of Knee Gouty Arthritis and Tissue Structure Lesion under Arthroscope

作　　者：邓丰承 谭挺生 何嘉健 

机构地区：[1]广东省中西医结合医院骨科,广东佛山528000

出　　处：《光明中医》2018年第4期451-453,共3页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：广东省佛山市科技局医学类科技攻关项目(No.2016AB001052)

摘　　要：目的探讨痛风性膝关节炎的不同中医证型与关节镜下组织结构病变的相关性。方法选取80例痛风性膝关节炎患者,由1名副主任医师对患者进行中医辨证分型。所有患者均行关节镜手术治疗,对不同中医证型患者的关节镜下痛风结晶、骨质增生、软骨、半月板及交叉韧带等组织病变程度进行比较,并对数据进行统计学分析处理。结果 80例患者关节镜下均可见关节腔内分布不同程度的痛风结晶,4种证型患者痛风结晶、骨质增生、软骨、半月板及交叉韧带等组织病变程度比较,痰瘀痹阻型、肝肾亏虚型均较湿热蕴结型、寒湿痹阻型严重,差异有统计学意义(P<0.05);痰瘀痹阻型与肝肾亏虚型比较,湿热蕴结型与寒湿痹阻型比较,均无显著性差异,无统计学意义(P>0.05)。结论关节镜下组织结构病变程度可作为评价痛风性膝关节炎严重性的一项重要指标,并可在一定程度上为中医辨证施治提供客观依据。Objective To investigate the correlation of traditional Chinese medical syndrome patterns of knee joint gouty arthritis and the tissue structure lesion under arthroscope. Methods Eighty knee joint gouty arthritis patients were enrolled into the study. The syndrome types were differentiated by an associate chief physician. All patients underwent arthroscopic operation therapy. The severity of tissue structure lesion of gout crystallization, bone hyperplasia, cartilage, meniscus and cruciate ligament under arthroscope in knee joint gouty arthritis patients with different syndrome types was classified, and then the data was statistically analyzed. Results 80 cases of patients under arthroscopy can be seen within the joint cavity distribution of varying degrees of gout crystallization. The comparison of histopathological changes in gout, bone hyperplasia, cartilage, meniscus and cruciate ligament in four syndromes was carried out, patients with blockage of phlegm and blood stasis, deficiency of liver and kidney both had severer changes than dampness-heat accumulation and cold- dampness blockage, and the difference was statistically significant （P 〈 0.05）. Comparison with blockage of phlegm and blood stasis, deficiency of liver and kidney was carried out, comparison with dampness-heat accumulation and cold-dampness blockage was carried out, both had no significant difference, and the differences were not statistically significant （ P 〉 0. 05 ）. Conclusion Tissue structure lesion under arthroscope can be used as an important diagnostic indicator for knee joint gouty arthritis severity evaluation, and the results will provide an objective basis for syndrome differentiation and treatment to some extent.

关 键 词：骨痹 痛风性膝关节炎 中医证型 组织结构病变 

分 类 号：R274.9[医药卫生—中西医结合]