不同中医证型痛风性关节炎的CT影像学表现分析  

Analysis of CT imaging manifestations of gouty arthritis of different TCM syndrome types

作　　者：张谦[1] 时光丽 韩萌 李怡萱 孟庆良[1] ZHANG Qian;SHI Guangli;HAN Meng;LI Yixuan;MENG Qingliang(Henan Hospital of Traditional Chinese Medicine,Zhengzhou,Henan 450002,China)

机构地区：[1]河南省中医院,河南郑州450002

出　　处：《中国地方病防治》2025年第1期83-86,共4页Chinese Journal of Control of Endemic Diseases

基　　金：国家自然科学基金委员会项目(81874456)。

摘　　要：目的分析不同中医证型痛风性关节炎的CT影像学表现。方法随机抽取河南省中医院2020年4月至2022年7月收治的97例痛风性关节炎患者为研究对象,对其临床资料进行回顾性分析,所有患者进行中医辩证分型,并总结所有患者CT检查结果。结果97例患者经CT检查均能够见到痛风石,骨质破坏69例,软组织肿胀65例,滑膜增厚17例,关节积液48例。97例患者中医证型中,湿热夹瘀23例、肝肾阴虚20例、痰浊阻滞22例、湿热蕴结32例。痰浊阻滞型骨质破坏发生率显著高于肝肾阴虚型、湿热夹瘀型、湿热蕴结型(P<0.05);痰浊阻滞型骨质破坏发生率、软组织肿胀发生率显著高于肝肾阴虚型、湿热夹瘀型、湿热蕴结型(P<0.05);湿热蕴结型滑膜增厚发生率、关节积液发生率显著高于肝肾阴虚型、痰浊阻滞型、湿热夹瘀型(P<0.05)。结论不同中医证型痛风性关节炎的CT影像学表现不同,可在痛风性关节炎中医分型辩证中纳入CT影像学表现,为其提供客观量化指标。Objective To analyze the CT imaging manifestations of gouty arthritis of different Traditional Chinese Medicine(TCM)syndrome types.Methods A total of 97 patients with gouty arthritis who were admitted to the hospital from April 2020 to July 2022 were randomly selected as the research objects,and their clinical data were retrospectively analyzed.All patients were classified according to TCM syndrome differentiation and the CT findings of all patients were summarized.Results All 97 patients could see tophi by CT examination,bone destruction in 69 cases,soft tissue swelling in 65 cases,synovial thickening in 17 cases,and joint effusion in 48 cases.Among the TCM syndrome types of 97 patients,23 were damp-heat with blood stasis,20 were liver and kidney yin deficiency,22 were phlegm-turbid stagnation,and 32 were damp-heat accumulation.The incidence of bone destruction in phlegm-turbidity stagnation type was significantly higher than that in liver-kidney yin deficiency type,damp-heat stasis type,and damp-heat accumulation type(P<0.05);the incidence of bone destruction and soft tissue swelling in phlegm-turbidity stagnation type was significantly higher than liver-kidney yin deficiency type,damp-heat stasis type,and damp-heat accumulation type(P<0.05);the incidence of damp-heat accumulation type synovial thickening and joint effusion were significantly higher than those of liver-kidney yin deficiency type and phlegm turbidity type,block type,damp heat folder stasis type(P<0.05).Conclusion The CT imaging manifestations of gouty arthritis of different TCM syndrome types are different,and CT imaging manifestations can be included in the TCM classification of gouty arthritis to provide objective quantitative indicators.

关 键 词：中医证型 痛风性关节炎 CT影像学 

分 类 号：R259[医药卫生—中西医结合]