[1]陈元川 庞坚 石印玉△ 詹红生 曹月龙 高宁阳 李志强.膝骨关节炎膝痛分布及其与影像学特征的关系研究[J].中国中医骨伤科杂志,2018,26(05):39-43，48.
　CHEN Yuanchuan PANG Jian SHI Yinyu ZHAN Hongsheng CAO Yuelong GAO Ningyang LI Zhiqiang.Clinical Study on Knee Pain Location and Its Association with Imaging[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(05):39-43，48.
点击复制

膝骨关节炎膝痛分布及其与影像学特征的关系研究()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第26卷
期数:
2018年05期
页码:
39-43，48
栏目:
临床论著
出版日期:
2018-05-02

文章信息/Info

Title:
Clinical Study on Knee Pain Location and Its Association with Imaging
文章编号:
1005-0205(2018)05-0039-05
作者:
陈元川1; 2 庞坚1; 2 石印玉1; 2△ 詹红生1; 2 曹月龙1; 2 高宁阳1; 2 李志强1; 2
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上海市中医药研究院骨伤科研究所
Author(s):
CHEN Yuanchuan1; 2 PANG Jian1; 2 SHI Yinyu1; 2△ ZHAN Hongsheng1; 2 CAO Yuelong1; 2 GAO Ningyang1; 2 LI Zhiqiang1; 2
1Shi's Center of Orthopedics and Traumatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China; 2Institute of Traumatology & Orthopedics,Shanghai Academy of Traditional Chinese Medicine,Shanghai 201203,China.
关键词:
疼痛;  膝骨关节炎;  膝痛图谱;  从筋论治;  中医药
Keywords:
Keywords: pain;  knee osteoarthritis;  knee pain map;  prevention and treatment based on Jin theory;  traditional Chinese medicine
分类号:
R684.3
文献标志码:
A
摘要:
目的:疼痛是人类的第五大生命体征,膝痛是膝骨关节炎患者到医院就诊的主要原因和主诉。而对于膝痛的直接描述尚不完善,本研究提出了一种新方法CKPM(Chinese Knee Pain Map),以期能够更直接有效的描述膝痛。方法:通过对300例患膝的研究,观察KPM疼痛类型和经筋病证类型的特点,并结合X线K-L分级、MRI半定量评估(WORMS法)以及WOMAC的临床症情描述法分析两者与这些指标间的相关性以及两者间的相关性,验证CKPM的有效性和可靠性的同时提出常见的KPM疼痛以及经筋分布类型。结果:膝痛KPM疼痛类型出现频率依次为混合性疼痛,占38.44%; 复合性疼痛,占34.01%; 单关节痛,占27.55%.经筋病证类型依次为两经筋病变124例,占42.18%、多经筋病变110例,占37.41%和单经筋病变60例,占20.41%、KPM疼痛类型与经筋病证类型呈一致性,与K-L分级、MRI半定量评估(WORMS法)以及WOMAC临床症情改变情况呈正相关。结论:在膝骨关节炎中CKPM疼痛类型较复杂的或者说疼痛范围较大的其临床表现(包括临床症状和影像学表现)相对较重。CKPM可以作为膝骨关节炎诊疗评估的有效的、可靠的一种手段。
Abstract:
Abstract Objective:Pain is called the fifth vital signs.And knee pain is the main reason and the most frequent complain for patients to go to hospitals.In order to assess the severity of knee osteoarthritis directly and completely,this research raised a method,called Chinese Knee Pain Map,CKPM.Method:300 knees were observed though knee pain map combined with Jingjin patterns,named CKPM.The correlation between KPM and the Jingjin patterns was analyzed.Then,CKPM was compared with X-ray K-L scores,MRI based semiquantitative scores(WORMS),and clinical symptoms(WOMAC scores)by correlation analysis.We conclude the common patterns of KPM(knee pain map)and Jingjin,meanwhile,the reliability and validity of the CKPM were verified in this part.Results:The most frequent appeared KPM patterns are mixed ones(38.44%),combined ones(34.01%)and single(27.55%)joint ones.The Multiple Jingjin patterns occupied 37.41 percent with 110 knees,the percentages of the dual Jingjin patterns is 42.18% with 124 knees and that of single Jingjin is 20.41% with 60 knees.CKPM has a positive correlation with K-L scores,MRI based semiquantitative scores(WORMS)and WOMAC scores.Conclusion:In knee osteoarthritis patients,CKPM pain patterns have a positive correlation with X-ray K-L scores; MRI based semiquantitative scores,WORMS,and WOMAC scores.More complicated patterns means more severity of the disease.CKPM could be a reliable and valuable method to assess knee osteoarthritis.

参考文献/References:

[1] Thompson LR,Boudreau R,Newman AB,et al.The association of osteoarthritis risk factors with localized,regional and diffuse knee pain[J].Osteoarthritis Cartilage,2010,18(10):1244-1249.
[2] 陈元川,庞坚,石印玉,等.“石氏伤科膝骨关节炎特色诊疗方案”的临床优效性研究[J].中国中医骨伤科杂志,2016,24(6):9-12.
[3] Thompson LR,Boudreau R,Hannon MJ,et al.The knee pain map:Reliability of a method to identify knee pain location and pattern[J].Arthritis Rheum,2009,61(6):725-731.
[4] NIH.Mapping knee pain is a reliable way to identify pain location and pattern[J].Bethesda:NIH,2009,9.
[5] 高珊.膝骨性关节炎常见痛点与经筋理论相关性研究[D].昆明:云南中医学院,2012,5.
[6] 冯学烽.膝骨关节炎经筋辨证分型与骨髓水肿相关性研究[D].广州:广州中医药大学,2013,5.
[7] 陈永韶,冯学烽,邹伟民,等.膝骨关节炎经筋与影像学的相关性探讨[J].广州中医药大学学报,2014,31(4):526-529.
[8] 张书剑,张小卿,韩煜等.膝骨性关节炎经筋病灶点触诊规律分析[J].中国针灸,2012,32(3):267-271.
[9] Guermazi A,Roemer FW,Haugen IK,et al.MRI-based semiquantitative scoring of joint pathology in osteoarthritis[J].Nat Rev Rheumatol,2013,9(4),236-251.
[10] 中华医学会骨科学分会.膝关节炎诊治指南(2007年版)[J].中国矫形外科杂志,2014,22(3):287-288.
[11] 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.
[12] Peterfy CG,Guermazi A,Zaim S,et al.Whole-Organ Magnetic Resonance Imaging Score(WORMS)of the knee in osteoarthritis[J].Osteoarthritis Cartilage,2004,12(3):177-190.
[13] Farrokhi S,Chen YF,Piva SR,et al.The influence of knee pain location on symptoms,functional status and knee-related quality of life in older adults with chronic knee pain:data from the osteoarthritis initiative[J].Clin J Pain,2016,32(6):463-470.
[14] Daniel LR.Knee pain patterns and associations with pain and function in persons with or at risk for symptomatic radiographic osteoarthritis:a cross sectional analysis[J].J Rheumatol,2015,42(12):2398-2403.
[15] Van Ginckel A,Bennell KL,Campbell PK,et al.Location of knee pain in medial knee osteoarthritis:patterns and associations with self-reported clinical symptoms[J].Osteoarthritis and Cartilage,2016,24(7):1135-1142.
[16] Kaukinen P,Podlipska J,Guermazi A,et al.Association between MRI-defined structural pathology and generalized and localized knee pain-the Oulu knee osteoarthritis study[J].Osteoarthritis and Cartilage,2016,24(9):1565-1576.
[17] 陈宇,吴煊,李正.膝骨关节炎经筋辨证的临床特征研究分析[J].新中医,2016,48(7):109-111.
[18] 冯学烽.膝骨关节炎经筋辨证分型与骨髓水肿相关性研究[D].广州:广州中医药大学,2013.
[19] 王强,陈元川,庞坚,等.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(5):9-13.
[20] Luyten FP,Denti M,Filardo G,et al.Definition and classification of early osteoarthritis of the knee[J].Knee Surg Sports Traumatol Arthrosc,2011,20(3):401-406.

备注/Memo

备注/Memo:
基金项目:“中医骨伤科学”国家重点学科(100508) 上海领军人才项目(041) 国家自然科学基金面上项目(81674003) 上海市卫生和计划生育委员会中医药科研专项 (2016LZ001) △通信作者 E-mail:shiyinyu@126.com
更新日期/Last Update: 2018-05-02