[1]何强,梅杰,孙欣△.膝骨关节炎发病及临床症状发展与中医体质类型相关性分析[J].中国中医骨伤科杂志,2023,31(10):23-28.[doi:10.20085/j.cnki.issn1005-0205.231005]
　HE Qiang,MEI Jie,SUN Xin.Analysis of the Correlation between the Development of Osteoarthritis of the Knee and Clinical Symptoms and the Type of TCM Constitution[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(10):23-28.[doi:10.20085/j.cnki.issn1005-0205.231005]
点击复制

膝骨关节炎发病及临床症状发展与中医体质类型相关性分析()
分享到：

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

卷:
第31卷
期数:
2023年10期
页码:
23-28
栏目:
临床研究
出版日期:
2023-10-15

文章信息/Info

Title:
Analysis of the Correlation between the Development of Osteoarthritis of the Knee and Clinical Symptoms and the Type of TCM Constitution
文章编号:
1005-0205(2023)10-0023-06
作者:
何强1; 2; 梅杰1; 2; 孙欣1△
1南京中医药大学附属南京中医院(南京,210023)
2山东中医药大学
Author(s):
HE Qiang1; 2; MEI Jie1; 2; SUN Xin1△
1Nanjing Hospital of Traditional Chinese Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China;
2Shandong University of Traditional Chinese Medicine,Jinan 250355,China.
关键词:
膝骨关节炎;  发生;  发展;  中医体质类型;  相关性
Keywords:
knee osteoarthritis;  occurrence;  development;  TCM body type;  correlation
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.231005
文献标志码:
A
摘要:
目的:探讨分析膝骨关节炎(KOA)的发病及临床症状发展与中医体质类型之间的相关性。方法:选取2020年5月至2022年12月收治的150例膝骨关节炎患者作为观察组,同时期收治的50例非膝骨关节炎患者作为对照组。分析两组患者中医体质类型分布情况,并应用二元Logistic回归分析膝骨关节炎发病与中医体质类型之间的相关性。将200例根据膝骨关节炎临床症状严重程度(WOMAC评分)进行亚组分析,并应用Spearman相关性分析膝骨关节炎临床症状发展与中医体质类型之间的相关性。结果:两组患者一般资料比较,差异无统计学意义(P>0.05),具有可比性。两组患者中医体质类型分布上,观察组占比前三位的为痰湿质(33.34%)>血瘀质(24.00%)>阳虚质(20.67%),对照组占比前三位的为平和质(36%)>气虚质(24%)>痰湿质(12%)。膝骨关节炎发生与中医体质类型二元Logistic回归分析结果提示:膝骨关节炎发生与阳虚质、痰湿质、血瘀质正相关(P<0.05),与平和质、气虚质负相关(P<0.05),与其余各项指标无相关性(P>0.05)。膝骨关节炎临床症状严重程度不同的四组患者中医体质类型分布上,无占比前三位的为平和质(36%)>气虚质(24%)>痰湿质(12%),轻度占比前三位的为阳虚质(28%)>痰湿质(18%)>平和质(16%),中度占比前三位的为痰湿质(34%)>血瘀质(24%)>阳虚质(24%),重度占比前三位的为痰湿质(48%)>血瘀质(36%)>阳虚质(10%)。膝骨关节炎发展与中医体质类型Spearman相关性分析结果提示:膝骨关节炎发展与痰湿质、血瘀质正相关(P<0.05),与平和质、气虚质、阳虚质均负相关(P<0.05),与其余各项指标无相关性(P>0.05)。结论:膝骨关节炎发病及临床症状发展与中医体质类型之间存在相关性,痰湿质和血瘀质人群更易患膝骨关节炎,且临床症状更重; 平和质人群不易患膝骨关节炎,即使患膝骨关节炎,其临床症状也较偏颇体质轻。
Abstract:
Objective:To explore and analyse the correlation between the onset and clinical symptom development of knee osteoarthritis(KOA)and the traditional Chinese medicine(TCM)body type.Methods:150 cases of KOA patients from May 2020 to December 2022 were selected as the observation group,and 50 non-KOA patients admitted during the same period as the control group.The distribution of TCM body type in the two groups was analyzed,and the correlation between the onset of KOA and TCM body type was analyzed by applying binary logistic regression.The 200 patients were subgrouped according to the severity of KOA clinical symptoms(WOMAC score)and Spearman correlation was applied to analyse the correlation between the development of KOA clinical symptoms and TCM body type.Results:There was no statistical difference between the two groups in terms of general information(P>0.05).In terms of the distribution of TCM constitution types between the two groups,the top three groups in the observation group were Phlegm-Damp(33.34%)> Blood Stasis(24.00%)> Yang deficiency(20.67%).In the control group,the top three groups were Pinghe(36%)> Qi deficiency(24%)> Phlegm-Damp(12%).Binary logistic regression analysis of the occurrence of KOA and TCM body type suggested that the occurrence of KOA was positively correlated with Yang deficiency,Phlegm-Damp and Blood Stasis(P<0.05),negatively correlated with Pinghe and Qi deficiency(P<0.05),and the remaining indicators were not correlated(P>0.05).The distribution of TCM constitution types among the four groups of patients with different severity of KOA clinical symptoms showed that the top three groups of patients with no clinical symptoms were Pinghe(36%)> Qixu(24%)> Phlegm-Damp(12%).The top three groups of patients with mild clinical symptoms were Yangxu(28%)> Phlegm-Damp(18%)> Pinghe(16%).The top three groups of patients with moderate clinical symptoms were Phlegm-Damp(34%)> Blood Stasis(24%)> Yangxu(24%).The top three percentages of severe were Phlegm-Damp(48%)> Blood Stasis(36%)> Yang deficiency(10%).Spearman's correlation analysis between KOA development and TCM body type suggested that KOA development was positively correlated with Phlegm-Damp and Blood Stasis(P<0.05),Pinghe,Qi-vacant and Yang-vacant were negatively correlated(P<0.05),and the remaining indicators were not correlated(P>0.05).Conclusion:There is a correlation between the occurrence and development of KOA and the type of TCM constitution.People with Phlegm-Damp and Blood-Stasis constitutions are more likely to suffer from KOA and have more severe clinical symptoms.People with calm and harmonious constitutions are less likely to suffer from KOA,and even if they do suffer from KOA their clinical symptoms are less severe than those of biased constitutions.

参考文献/References:

[1] 陈欣,刘建军,董万涛,等.膝骨性关节炎合并骨质疏松症调节机制的研究进展[J].中国骨质疏松杂志,2022,28(4):607-612.
[2] 童培建,钟滢.重视膝骨关节炎的中西医结合规范诊疗 ——《膝骨关节炎中医诊疗指南(2020年版)》解读[J].中医正骨,2021,33(10):6-8.
[3] BROPHY R H,FILLINGHAM Y A.AAOS clinical practice guideline summary:management of osteoarthritis of the knee(nonarthroplasty),third edition[J].J Am Acad Orthop Surg,2022,30(9):721-729.
[4] 中华医学会骨科学分会关节外科学组.骨关节炎诊疗指南(2018年版)[J].中华骨科杂志,2018,38(12):705-715.
[5] 中国中医药研究促进会骨伤科分会.膝骨关节炎中医诊疗指南(2020年版)[J].中医正骨,2020,32(10):1-14.
[6] 陈平雁.临床试验中样本量确定的统计学考虑[J].中国卫生统计,2015,32(4):727-731.
[7] TOOTSI K,VILBA K,MÄRTSON A,et al.Metabolomic signature of amino acids,biogenic amines and lipids inblood serum of patients with severe osteoarthritis[J].Metabolites,2020,10(8):323.
[8] 周颖,冯磊.中医体质分类与判定标准出台[J].中医药管理杂志,2009,17(4):297.
[9] DAINESE P,WYNGAERT K V,DE MITS S,et al.Association between knee inflammation and knee pain in patients with knee osteoarthritis:a systematic review[J].Osteoarthritis Cartilage,2022,30(4):516-534.
[10] 李辉,李宁,谢兴文,等.中医药干预基质金属蛋白酶表达治疗膝骨性关节炎研究进展[J].中国骨质疏松杂志,2022,28(1):120-123.
[11] GHASEMY M,SIRAT M,ISABEL MARÍA ROSA-DÍA Z,et al.Causes and consequences of academics' emotionsin private higher education institutions:implications for policy and practice through the lens of affective events theory[J].Educational Research for Policy and Practice,2021,20:367-393.
[12] PARK J I,JUNG H H.Estimation of years lived with disability due to noncommunicable diseases and injuries using a population-representative survey[J].PLoS One,2017,12(2):e0172001.
[13] MIRANIAN D,SCHWARTZ A,JIANG C,et al.Emergency department utilization for adnexal torsion:an analysis of the nationwide emergency department sample from 2006 to 2018[J].J Minim Invasive Gynecol,2022,29(9):1068-1074.
[14] GBD 2019 INDONESIA SUBNATIONAL COLLABORATORS.The state of health in Indonesia's provinces,1990-2019:a systematic analysis for the global burden of disease study 2019[J].Lancet Glob Health,2022,10(11):1632-1645.
[15] NELSON A E,HU D,ARBEEVA L,et al.The prevalence of knee symptoms,radiographic,and symptomatic osteoarthritis at four time points:the johnston county osteoarthritis proj,1999-2018[J].ACR Open Rheumatology,2021,3(8):558-565.
[16] 陈龙娇,李芳莉,王琦,等.基于中医体质学说探讨主动健康[J].中华中医药杂志,2022,37(8):4315-4318.
[17] 王琦,盛增秀.中医体质学说[M].南京:江苏科学技术出版社,1982.
[18] 柳璇,王琦.《中医体质分类与判定》标准修改建议及分析[J].北京中医药大学学报,2013,36(5):300-304.
[19] 高山,王敬威,孙乾坤,等.膝骨关节炎中医辨证分型与中医体质类型关联性分析[J].中国民族民间医药,2020,29(2):91-95.
[20] 齐晓红.685例膝骨关节炎中医证型聚类分析及与中医体质的关联性[J].光明中医,2018,33(22):3282-3284.
[21] 何强,梅杰,孙欣,等.膝骨性关节炎临床症状与中医体质类型相关性分析[J].中国中医骨伤科杂志,2021,29(11):42-46.

备注/Memo

备注/Memo:
基金项目:江苏省科技厅社会发展面上项目(BE20211612)
△通信作者 E-mail:545543314@qq.com
更新日期/Last Update: 2023-10-01