痛风性关节炎中医证型与肌骨超声表现的相关性研究  

Correlation Between Traditional Chinese Medicine Syndromes and Musculoskeletal Ultrasound Findings in Gouty Arthritis

作　　者：肖燕燕 李建宁[2] 陈慧君 颜纯淳[1] 贺红安 蒋雪梅[2] XIAO Yanyan;LI Jianning;CHEN Huijun;YAN Chunchun;HE Hongan;JIANG Xuemei(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]山东中医药大学附属医院,山东济南250014

出　　处：《山东中医杂志》2021年第4期356-361,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划项目(编号:2015-089)。

摘　　要：目的:探讨痛风性关节炎肌骨超声表现与中医证型的相关性,为临床诊治提供客观依据。方法:收集痛风性关节炎患者108例,按照中医辨证分为湿热蕴结型、瘀热阻滞型、痰浊阻滞型和肝肾阴虚型4个证型,分析肌骨超声表现与不同中医证型的关系。结果:4个证型中,湿热蕴结型占比最高,累及关节最多。痛风性关节炎湿热蕴结型关节表面软组织水肿阳性率最高,为19.7%,明显高于痰浊阻滞型(P=0.004)、肝肾阴虚型(P=0.001);瘀热阻滞型关节表面软组织水肿阳性率明显高于肝肾阴虚型(P=0.048)。湿热蕴结型滑膜增生阳性率明显高于痰浊阻滞型(P=0.001)。湿热蕴结型滑膜血流阳性率明显高于痰浊阻滞型(P=0.002)、肝肾阴虚型(P=0.023);其余项目不同证型间比较差异无统计学意义。各证型间半定量分级比较,湿热蕴结型滑膜增生级别高于痰浊阻滞型(P<0.01),其他各证型滑膜增生级别两两比较,差异均无统计学意义(P>0.05);湿热蕴结型滑膜血流级别明显高于痰浊阻滞型(P<0.01)、肝肾阴虚型(P<0.05),其他各证型滑膜血流两两比较,差异均无统计学意义(P>0.05);各中医证型关节积液、骨侵蚀的半定量级别差异无统计学意义。结论:痛风性关节炎肌骨超声表现与中医辨证分型具有一定相关性,肌骨超声能为痛风性关节炎中医辨证论治提供客观可靠的参考依据,可作为中医四诊的有效补充。Objective:To explore the correlation between musculoskeletal ultrasound findings of gouty arthritis and traditional Chinese medicine(TCM)syndrome,so as to provide an objective basis for clinical diagnosisand treatment.Methods:There were 108 patients with gouty arthritis divided into 4 syndrome types according to TCM syndrome differentiation:damp heat accumulation type,blood stasis and heat stagnation type,phlegm turbid stagnation type and liver kidney yin deficiency type,and the relationship between musculoskeletal ultrasound findings anddifferent TCM syndrome was analyzed.Results:Among the 4 syndromes,the prevalence rate of damp heat accumulation type was the highest and the joint involved the most.The positive rate of soft tissue edema at joint surface of gouty arthritis in damp heat accumulation type was 19.7%,and was higher than that in phlegm turbid stagnation type(P=0.004)and liver and kidney yin deficiency type(P=0.001).The positive rate of soft tissue edema at joint surface in blood stasis and heat stagnation type was significantly higher than that in liver and kidney yin deficiency type(P=0.048).The positive rate of synovial hyperplasia in damp heat accumulation type was significantly higher than that in phlegm turbid stagnation type(P=0.001).The positive rate of synovial blood flow in the damp heat accumulation type was significantly higher than that in the phlegm turbid stagnation type(P=0.002)and in the liver and kidney yin deficiency type(P=0.023);there was no statistically significant difference among the other types of syndromes.On comparing the semi-quantitative grading of the various syndrome types,the level of synovial hyperplasia in damp heat accumulation type was higher than that in phlegm turbid stagnation type(P<0.01).There is no statistically significant difference in the level of synovial hyperplasia between other syndrome types(P>0.05).The synovial blood flow level in the damp heat accumulation type was significantly higher than that in the phlegm turbid stagnation(P<0.01),and liver and k

关 键 词：痛风性关节炎 肌骨超声 中医证型 关节表面软组织水肿阳性率 滑膜增生阳性率 滑膜血流阳性率 

分 类 号：R259.897[医药卫生—中西医结合]