膝骨关节炎足阳明经筋病变与X线影像学测量指标的关系  

Relationship Between Foot-yangming Meridian-Sinew Lesions and X-ray Imaging Findings in Knee Osteoarthritis

作　　者：李飞龙 黎金羽 罗臻 谢平金 柴生颋 LI Feilong;LI Jinyu;LUO Zhen;XIE Pingjin;CHAI Shengting(The Third Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378 Guangdong,China;Guangdong Institute of Traditional Chinese Medicine Orthopaedics,Guangzhou 510378 Guangdong,China;Gaozhou Hospital of Traditional Chinese Medicine,Maomin 525200 Guangdong,China;Shenzhen Luohu Hospital Group/Shenzhen Luohu Hospital of Traditional Chinese Medicine,Shenzhen 518021 Guangdong,China)

机构地区：[1]广州中医药大学第三临床医学院,广东广州510405 [2]广州中医药大学第三附属医院,广东广州510378 [3]广东省中医骨伤研究院,广东广州510378 [4]高州市中医院,广东茂名525200 [5]深圳市罗湖医院集团/深圳市罗湖区中医院,广东深圳518021

出　　处：《广州中医药大学学报》2025年第1期26-31,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20241258);广州中医药大学第三附属医院科研基金创新项目(编号:sy2018005)。

摘　　要：【目的】在经筋理论指导下探讨膝骨关节炎(KOA)足阳明经筋病变与X线股胫关节内外侧间隙及比值、股胫关节半脱位程度和Insll-Salvati指数之间的相关性。【方法】选取2019年1月至2021年11月在广州中医药大学第三附属医院诊断为KOA的66例患者为研究对象,根据是否为足阳明经筋循经部位病变分为足阳明经筋组与非足阳明经筋组;行膝关节负重正侧位X线拍摄,测量2组X线影像学指标,再对2组行疼痛程度视觉模拟量表(VAS)评分及西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分,比较2组X线影像学测量指标及相关量表评分之间的差异,分析2组经筋病变在X线相关测量指标上发生的改变及影响。【结果】(1)非足阳明经筋组在X线正位片上股胫关节内侧间隙、内外侧间隙比值低于足阳明经筋组,股胫关节半脱位程度高于足阳明经筋组(P <0.05或P <0.01);(2)足阳明经筋组在X线侧位片上的髌韧带长度∶髌骨长度(LT∶LP)值明显大于非足阳明经筋组(P <0.01);(3)非足阳明经筋组的疼痛程度VAS评分及WOMAC关节疼痛评分均明显高于足阳明经筋组(P <0.05),而2组患者的WOMAC关节僵硬、生理功能评分及总分比较,差异均无统计学意义(P> 0.05)。【结论】KOA足阳明经筋病变可能与X线侧位片上的髌骨相对高位密切相关;非足阳明经筋病变可能与X线正位片上的股胫关节内侧间隙变窄、内外侧间隙比值增大及半脱位严重程度之间存在密切关系。Objective Under the guidance of meridian-sinew(jingjin)theory,the correlation between foot-yangming jingjin lesions and X-ray imaging findings such as medial space and lateral space in femorotibial joint and their ratio,degree of subluxation of femorotibial joint,and the Insll-Salvati index in the patients with knee osteoarthritis(KOA).Methods From January 2019 to November 2021,a total of 66 patients diagnosed as KOA at the Third Affiliated Hospital of Guangzhou University of Chinese Medicine were selected as the study subjects.The patients were divided into the foot-yangming jingjin group and non-foot-yangming jingjin group according to the presence of foot-yangming jingjin lesions.The X-ray postero-anterior and lateral radiography of the knee joint under weight bearing was performed,and imaging parameters of the two groups were measured.Afterwards the pain Visual Analogue Scale(VAS)scores and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores in the two groups were evaluated,the differences between the two groups’X-ray imaging findings and scale scores were compared,and the various X-ray imaging findings in the two groups were analyzed.Results(1)Under X-ray postero-anterior radiography of the knee joint,the medial space and lateral space in femorotibial joint and their ratio in non-foot-yangming jingjin group were lower than those in foot-yangming jingjin group,and degree of subluxation of femoro-tibial joint was higher than that of foot-yangming jingjin group(P<0.05 or P<0.01).(2)The ratio of length of patellar tendon to length of patella(LT:LP)under X-ray lateral radiography in foot-yangming jingjin group was significantly greater than that of the non-foot-yangming jingjin group(P<0.01).(3)The scores of pain VAS and WOMAC in non-foot-yangming jingjin group were both significantly higher than those in foot-yangming jingjin group(P<0.05),while the differences of the scores of WOMAC items such as joint stiffness and physiologic function,and the total WOMAC scores between the two groups

关 键 词：膝骨关节炎 足阳明筋经 X线影像学指标 经筋病变 视觉模拟量表(VAS)评分 西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分 

分 类 号：R274.12[医药卫生—中医骨伤科学]