[1]王强 陈元川 庞坚△ 陈博 王辉昊 曹月龙 石瑛 詹红生 石印玉.膝骨关节炎证候分型与疼痛程度的相关性分析[J].中国中医骨伤科杂志,2016,24(05):9-13.
　WANG Qiang CHEN Yuanchuan PANG Jian CHEN Bo WANG Huihao CAO Yuelong SHI Ying ZHAN Hongsheng SHI Yinyu.Correlation Analysis between Syndrome Classification and Pain Degree of Knee Osteoarthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2016,24(05):9-13.
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膝骨关节炎证候分型与疼痛程度的相关性分析
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第24卷
期数:
2016年05期
页码:
9-13
栏目:
实验研究
出版日期:
2016-05-15

文章信息/Info

Title:
Correlation Analysis between Syndrome Classification and Pain Degree of Knee Osteoarthritis
文章编号:
1005-0205(2016)05-0009-05
作者:
王强1; 2 陈元川1 庞坚1△ 陈博1 王辉昊1 曹月龙1 石瑛1 詹红生1 石印玉1
1.上海中医药大学附属曙光医院石氏伤科医学中心(上海, 201203)
2.上海市光华中西医结合医院
△.通信作者 E-mail:lidazul@126.com
Author(s):
WANG Qiang1; 2 CHEN Yuanchuan1 PANG Jian1△ CHEN Bo1 WANG Huihao1 CAO Yuelong1 SHI Ying1 ZHAN Hongsheng1 SHI Yinyu1
1.Department of Shi' Traumatology Medical Center,Shuguang Hospital,Affiliated to Shanghai University of Traditional Chinese medicine,Shanghai 201203,China;
2.Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200052,China.
关键词:
骨关节炎; 膝关节;  证候;  疼痛;  相关分析
Keywords:
osteoarthritis;  knee joint;  pain;  syndrome;  correlation analysis
分类号:
R684.3
文献标志码:
A
摘要:
目的:探讨膝骨关节炎患者各证候分型与不同状态下膝关节疼痛程度的相关性。方法:收录膝骨关节炎患者602例,选用系统聚类分析法对KOA患者的症状进行聚类分析,评估患者证候分型情况; 采用国际公认的视觉模拟评分法(Visual Analogue Score,VAS)进行评分,评定患者膝关节的疼痛程度。对患者各种证候分型分别与不同状态下膝关节疼痛(静息疼痛、平地行走疼痛、上或下楼梯疼痛)VAS评分数值的相关性进行分析。结果:在静息状态下,单一证候中脾虚、阳虚、气虚、气滞、血瘀、寒湿、风与疼痛VAS评分相关(r=0.138,0.212,0.135,0.285,0.262,0.147,0.127),证候分型中气血亏虚型和肾虚寒凝型与疼痛VAS评分相关(r=-0.247,0.323); 在平地行走时,单一证候中气滞、血瘀、寒湿与疼痛VAS评分相关(r=0.193,0.215,0.145),证候分型中肾虚寒凝型与疼痛VAS评分相关(r=0.192); 在上下楼梯时,单一证候中气滞、血瘀、寒湿与疼痛VAS评分相关(r=0.179,0.184,0.150),证候分型中肾虚寒凝型与疼痛VAS评分相关(r=0.180)。结论:以单一证候血瘀为主的实证和以肾虚寒凝型为主的虚实夹杂症与疼痛程度相关性较高; 以气虚亏虚型为主的虚证的临床表现越明显,其疼痛的程度就越低或越不明显。
Abstract:
Objective:To investigate the correlation between different syndromes and pain degree of knee joint in patients with knee osteoarthritis.Methods:All 602 patients with knee osteoarthritis were chooses and analyzed.The system clustering analysis method was used to cluster analysis of the symptoms and evaluate of patients' syndrome classification.The visual analogue score(VAS)was used to evaluate of patients' pain.The correlation of VAS score of patients with various types of syndrome and the pain of the knee joint in different states(rest pain,pain in the ground,up or down stairs)was analyzed.Results:In the state of resting,a single syndrome of spleen deficiency,yang deficiency,qi deficiency,qi stagnation,blood stasis,cold dampness,and wind was correlation with knee VAS score(r=0.138,0.212,0.135,0.285,0.262,0.147,0.127 respectively).Syndrome classification of qi and blood deficiency type and kidney deficiency and cold coagulation type was correlation with knee VAS score(r=-0.247,0.323 respectively).In the state of walking on the ground,a single syndrome of qi stagnation,blood stasis,and cold dampness was correlation with knee VAS score(r=0.193,0.215,0.145 respectively).Syndrome classification of kidney deficiency and cold coagulation type was correlation with knee VAS score(r=0.192).In the state of up and down the stairs,a single syndrome of qi stagnation,blood stasis,and cold dampness was correlation with knee VAS score(r=0.179,0.184,0.150 respectively).Syndrome classification of kidney deficiency and cold coagulation type was correlation with knee VAS score(r=0.180).Conclusion:A single syndrome of blood stasis and syndrome classification of kidney deficiency and cold coagulation type are high correlation with pain degree.Syndrome classification of qi deficiency type,the clinical manifestation is more obvious,and the degree of pain is lower or less obvious.

参考文献/References:

[1] 胥少汀,葛宝丰,徐印坎.实用骨科学(精)[M].3版.北京:人民军医出版社,2009.
[2] 王强,苟海昕,曹月龙,等.膝骨关节炎X线分级与疼痛程度的相关性分析[J].中国中医骨伤科杂志,2015,23(6):18-21.
[3] 向珍蛹,茅建春,徐先国,等.膝骨关节炎中医证型分布的流行病学研究[J].上海中医药杂志,2012,46(12):5-8.
[4] 赵万良,高文香.血瘀型膝骨关节炎的中医药治疗概况[J].中国中医药现代远程教育,2015,13(1):147-149.
[5] 邱贵兴.骨关节炎诊治指南[J].中华关节外科杂志,2007,1(4):281-285.
[6] Woodforde JM,Merskey H.Some relationships between subjective measures of pain[J].J Psychosom Res,1972,16(3):173-178.
[7] 沈自尹.肾阳虚证的定位研究[J].中国中西医结合杂志,1997,17(1):50-52.
[8] 朱文锋,何清湖.现代中医临床诊断学[M].北京:人民卫生出版社,2003:49-74.
[9] 杨锦华,曹惠英,冯仲锴,等.原发性膝关节骨关节炎中医证候流行病学调查[J].中医正骨,2005,17(7):19-22.
[10] 石印玉,徐荣善.养血软坚方治疗膝骨关节炎的临床报告[J].中国中医骨伤科杂志,1994,2(4):33-36.
[11] 庞坚,石印玉,曹月龙,等.膝骨关节炎中医观的再认识[J].上海中医药大学学报,2011,25(1):26-28.
[12] 冯欢欢,王培民,范竞,等.膝骨关节炎X线表现与膝关节疼痛程度的相关性分析[J].中医正骨,2013,25(6):29-30,33.
[13] 王成.膝骨关节炎疼痛原因及其与中医证候的相关性研究[D].北京:北京中医药大学,2008.
[14] 袁普卫,刘德玉,郝阳泉,等.辨病、辨证与辨位“三位一体”诊疗模式在膝痹病诊断中的意义[J].中国中医骨伤科杂志,2012,20(5):63-64.
[15] Marks R.Perceived Health Status of Women with Knee Osteoarthritis:A Cross-Sectional Study of the Relationships of Age,Body Mass,Pain and Walking Limitations[J].The Open Orthopaedics Journal,2014,8(1):255-263.
[16] 中国中医药研究促进会骨科专业委员会; 中国中西医结合学会骨伤科专业委员会关节工作委员会.膝骨关节炎中医诊疗专家共识(2015年版)[J].中医正骨,2015,27(7):4-5.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81102603,81173277)
上海市“海派中医流派传承研究基地”项目(ZY3- CCCX-1-1003)
上海市科学技术委员会科研计划项目(13401902502, 13411850500)
上海市中医药事业发展三年行动计划项目(ZYSNX D-CC-ZDYJ047)
卫生部重大新药创制国家科技重大专项(2015ZX09 101021)
更新日期/Last Update: 2016-05-15