207例膝骨关节炎患者中医证型与炎症指标及高频超声影像改变的关系  

The Correlation between Traditional Chinese Medicine Syndrome Types,Inflammatory Indicators,and High-Frequency Ultrasound Changes in 207 Patients with Knee Osteoarthritis

作　　者：高阳鹭 叶敏兰 唐晓颇[1] 王建[1] GAO Yanglu;YE Minlan;TANG Xiaopo;WANG Jian(Guang'anmen Hospital of China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中国中医骨伤科杂志》2024年第4期34-38,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：中国中医科学院科技创新工程项目(CI2021A01511)。

摘　　要：目的:探讨膝骨关节炎(KOA)患者不同中医证型与炎症指标及高频超声影像改变的关系。方法:采用回顾性、横断面调查研究方法,依据中医辨证分型标准将膝骨关节炎患者辨证分为肝肾亏虚证、寒湿痹阻证、湿热痹阻证、痰瘀痹阻证、气血虚弱证5个证型,分析不同中医证型与炎症指标红细胞沉降率(ESR)、C反应蛋白(CRP)、超敏C反应蛋白(hs-CRP)以及高频超声影像改变之间的相关性。结果:最终纳入207例膝骨关节炎患者,其中湿热痹阻证71例,肝肾亏虚证60例,寒湿痹阻证31例,痰瘀痹阻证28例,气血虚弱证17例。湿热痹阻证的红细胞沉降率和C反应蛋白表达水平高于其他4种证型,差异有统计学意义(P<0.05)。湿热痹阻证的红细胞沉降率和超敏C反应蛋白的表达水平高于其他4种证型,差异有统计学意义(P<0.05)。湿热痹阻证较肝肾亏虚证滑膜血流信号阳性率更高,差异有统计学意义(P<0.05)。湿热痹阻证滑膜增生评分较其他4个证型高(P<0.05)。寒湿痹阻证和湿热痹阻证患者较肝肾亏虚证和气血亏虚证患者关节积液阳性率及超声影像改变更多。结论:膝骨关节炎患者以湿热痹阻证和肝肾亏虚证为主要证型,且炎症指标水平和高频超声下表现与中医证型有一定的关系。炎症指标结合高频超声影像改变可为膝骨关节炎中医辨证分型提供参考。Objective:To investigate the relationship between different TCM syndrome types and inflammation index and high-frequency ultrasound changes in patients with knee osteoarthritis(KOA).Methods:Retrospective and cross-section investigation was conducted to classify KOA patients into five types according to TCM syndrome differentiation criteria:deficiency of liver and kidney,cold-dampness obstruction,damp-heat obstruction,phlegm-stasis obstruction and Qi-blood weakness.The correlation between different TCM syndrome types and inflammatory indicators erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),hypersensitive C-reactive protein(hs-CRP)and changes under high-frequency ultrasound was analyzed.Results:207 KOA patients were included in the study,including 71 cases of damp-heat obstruction,60 cases of liver and kidney deficiency,31 cases of cold-dampness obstruction,28 cases of phlegm-stasis obstruction,and 17 cases of Qi-blood weakness.The expression levels of ESR and CRP in damp-heat impediment syndrome were higher than those in other 4 syndrome types(P<0.05).The expression levels of ESR and hs-CRP in damp-heat impediment syndrome were higher than those in other 4 syndrome types(P<0.05).The positive rate of synovial blood flow signal was higher in damp-heat Bi syndrome than in liver and kidney deficiency syndrome(P<0.05).The synovial hyperplasia score of damp-heat obstruction syndrome was higher than that of the other 4 syndrome types(P<0.05).Conclusion:The main syndromes of patients with KOA are dampness-heat obstruction syndrome,liver and kidney deficiency syndrome,and the level of inflammation indicators and the manifestations of high-frequency ultrasound have a certain relationship with TCM syndromes.Inflammation index combined with high-frequency ultrasound can provide a certain objective basis for TCM syndrome differentiation and classification of KOA.

关 键 词：膝骨关节炎 证型 炎症指标 关节超声 

分 类 号：R684.3[医药卫生—骨科学]