强直性脊柱炎中医证型与综合影像学表现的相关性研究  

Correlation Study on Chinese Medicine Syndrome Type of Ankylosing Spondylitis and Comprehensive Imaging Manifestations

作　　者：叶亮[1] 简润强[1] 黄勇[1] YE Liang;JIAN Runqiang;HUANG Yong

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《新中医》2018年第11期122-125,共4页New Chinese Medicine

基　　金：广东省中医药局科研项目(20152118)

摘　　要：目的:分析强直性脊柱炎(AS) 3种不同中医证型患者的影像学改变。方法:收集231例AS患者,辨证分为湿热证、寒湿证、肝肾不足证3组,并做综合的影像学检查。结果:肝肾不足证组的骶髂关节分级情况与寒湿证组、湿热证组比较,差异均有统计学意义(P <0.05),寒湿证组与湿热证组之间不存在统计学差异(P> 0.05)。肝肾不足证组骶髂关节损害程度偏高,Ⅲ级和Ⅳ级所占百分比超过85%,而寒湿证组、湿热证组的骶髂损害情况以Ⅰ级、Ⅱ级居多。肝肾不足证组腰椎、髋关节受累的发生率最高,与寒湿证组、湿热证组比较,差异均有统计学意义(P <0.05)。寒湿证组与湿热证组的腰椎受累阳性率、髋关节受累阳性率比较,差异均无统计学意义(P> 0.05)。结论:影像学表现可作为一种参考的手段辅助AS的中医辨证,但在实际临床应用上不能单纯地依赖影像学检查,仍需结合望、闻、问、切四诊进行综合的辨证。Objective： To analyze the imaging changes of patients with ankylosing spondylitis （AS） of three different types of Chinese medicine syndrome. Methods： Selected 231 cases of patients with AS, and divided them into three groups of damp-heat syndrome, cold-dampness syndrome and liver-kidney deficiency syndrome based on syndrome differentiation. Conducted comprehensive imaging examination. Results： Comparing the grading of sacroiliac joint in the group of liver-kidney deficiency syndrome with that in the groups of damp-heat syndrome and cold-dampness syndrome, differences being significant （P 〈 0.05）, and there was no significant difference being found in the comparison between the groups of damp-heat syndrome and cold-dampness syndrome （P 〉 0.05）. The damage degree of sacroiliac joint in the group of liver-kidney deficiency syndrome was relatively high, among which the grade III and IV accounted for over 85%, while the grade I and II appeared more in the groups of damp-heat syndrome and cold-dampness syndrome. Incidence of involvement of lumbar vertebrae and sacroiliac joint in the group of liver-kidney deficiency syndrome was the highest; when comparing with the groups of damp-heat syndrome and cold-dampness syndrome, there were significant differences being found （P 〈 0.05）. Comparing the positive rate of involvement of lumbar vertebrae and sacroiliac joint in the group of damp-heat syndrome with those in the group of cold-dampness syndrome, there were no significant differences being found （P 〉 0.05）. Conclusion： Imaging manifestations can serve as a reference means for assisting Chinese medicine syndrome typing of AS, but in the practical clinical application, imaging examination can＇t be simply depended on without the combination of comprehensive syndrome differentiation of inspection, listening and smelling, inquirinu and palpation.

关 键 词：强直性脊柱炎(AS) 湿热证 寒湿证 肝肾不足证 影像学 

分 类 号：R593.23[医药卫生—内科学]