基于双能X线骨密度测量法对骨质疏松症的诊断及骨密度值与中医证型的相关性研究  

Study of relationship between osteoporosis and TCM syndrome types by DXA bone mineral density measurement

作　　者：李小圳 刘奕辰 宋志超 杨印辉[1] 哈春云 张书芹 鲁春磊 康庆[1] 郑新[3] 赵天佐[1] 陈正光[1] LI Xiaozhen;LIU Yichen;SONG Zhichao;YANG Yinhui;HA Chunyun;ZHANG Shuqin;LU Chunlei;KANG Qing;ZHENG Xin;ZHAO Tianz uo;CHEN Zhe ngguang(Department of Radiology,Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing,100700,China.)

机构地区：[1]北京中医药大学东直门医院放射科,北京100700 [2]北京中医医院延庆医院内科,北京102100 [3]首都医科大学附属北京中医医院放射科,北京100700

出　　处：《中国中西医结合影像学杂志》2018年第4期335-337,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：北京中医药大学青年教师项目(2017-JYB-JS-066)

摘　　要：目的 :基于双能X线骨密度测量法,对比分析骨质疏松症患者不同中医辨证分型的骨密度值,初步探索骨密度值、骨质疏松症与中医症候三者之间的关联。方法:选取241例骨质疏松症患者,根据中医辨证分型分为肝肾阴虚型、脾肾阳虚型、气滞血瘀型及肾阳虚衰型4组。应用双能X线骨密度测量法测量患者腰椎(L1~4)和左右侧股骨近端3个部位的骨密度值。对比分析4组上述3个部位骨密度的平均值T。结果:241例中肝肾阴虚型56例,脾肾阳虚型50例,气滞血瘀型81例,肾阳虚衰型54例,其中气滞血瘀型骨密度平均值T最低(-3.03)。对比组间骨密度平均值T,发现肝肾阴虚型与脾肾阳虚型,肝肾阴虚型与肾阳虚衰型,气滞血瘀型与脾肾阳虚型,气滞血瘀型与肾阳虚衰型组间差异均有统计学意义(均P<0.05);而肝肾阴虚型与气滞血瘀型、脾肾阳虚型与肾阳虚衰型组间差异均无统计学意义(均P>0.05)。结论:骨质疏松症患者气滞血瘀型较多见,符合骨质疏松症的中医病机"多虚多瘀"的特点。同时,不同证型间的骨密度差异,可初步反向证实中医辨证的精确性,同时使量化骨质疏松症中医证型成为可能。Objective：Comparing the bone mineral density（BMD） among osteoporosis patients with different traditional Chinese medicine（TCM） syndrome types to investigate the relationship of BMD,osteoporosis and TCM syndrome types. Methods：241 patients with osteoporosis were divided into four groups based on TCM syndrome types,including liver and kidney Yin deficiency,spleen and kidney Yang deficiency,qi stagnation and blood stasis and kidney Yang deficiency failure type. The BMD of the lumbar spine（L_（1~4））,right and left proximal of femur were measured using Dual-energy X-ray absorptiometry（DXA） for each patient. The differences of the value T of mean BMD between every two groups were compared. Results：There were 56 cases of liver and kidney Yin deficiency,50 of spleen kidney Yang deficiency,81 of qi stagnation and blood stasis and 54 of kidney Yang deficiency failure. Among four groups,the qi stagnation and blood stasis type showed the lowest T value（-3.03）. The statistical significant differences were found between group of liver and kidney Yin deficiency and spleen and kidney Yang deficiency,liver and kidney Yin deficiency and kidney Yang deficiency failure,qi stangnation and blood stasis and spleen and kidney Yang deficiency,qi stangnation and blood stasis and kidney Yang deficiency failure（all P〈0.05）. There were no significant differences between liver and kidney Yin deficiency and qi stagnation and blood stasis and between spleen and kidney Yang deficiency and kidney Yang deficiency failure. Conclusions：The qi stagnation and blood stasis type is relative more than other types. It is consistent with ＂multiple deficiency and stasis＂,which is the characterister of TCM theory of osteoporosis. Meanwhile,the statistical significant difference of BMD between groups indicates the accurate of diagnosis of TCM syndrome types on osteoporosis. Furthermore,the BMD could be as a measurement for TCM syndrome types on osteoporosis in the future.

关 键 词：骨质疏松 骨密度 中医证型 

分 类 号：R259[医药卫生—中西医结合]