摘要: |
目的:运用肌骨超声对膝骨关节炎不同证型进行检查,探讨膝骨关节炎不同证型与肌骨超声的关系。方法:选取2019年1月至2020年1月来我院就诊的100例膝骨关节炎患者,共128例膝关节,根据中医辨证论治原理,分为风寒湿痹证组、湿热蕴结证组,肝肾亏虚证组,气滞血瘀证组,应用超声技术探测膝关节滑膜厚度,滑膜血流,骨赘,关节软骨及软骨下骨质破坏,关节积液,腘窝囊肿形成等情况,比较不同证型肌骨超声检查结果。结果:湿热蕴结证滑膜增生阳性率高于风寒湿痹证(X2=5.334,P=0.021)、气滞血瘀证(X2=9.246,P=0.002)、肝肾亏虚证(X2=3.966,P=0.046);湿热蕴结证血流阳性率高于风寒湿痹证(X2=7.125,P=0.008)、气滞血瘀证(X2=5.578,P=0.018)、肝肾亏虚证(X2=4.094,P=0.043);肝肾亏虚证软骨及软骨下骨质破坏阳性率高于风寒湿痹证(χ2=4.836, P=0.028)、湿热蕴结证(χ2=5.868, P=0.015)、气滞血瘀证(χ2=4.018, P=0.045);湿热蕴结证关节积液阳性率高于风寒湿痹证(χ 2 =12.157, P=0.000)、肝肾亏虚证(χ 2 =10.234, P=0.001);气滞血瘀证关节积液阳性率高于风寒湿痹(χ 2 =4.378, P=0.036)、肝肾亏虚证(χ 2 =5.145, P=0.023);气滞血瘀证腘窝囊肿阳性率高于风寒湿痹证(x2=6.615,p=0.010)、肝肾亏虚证(x2=6.300,p=0.012)。不同证型骨赘形成阳性率差异无统计学意义 (χ 2 =7.199, P=0.066) 。结论:KOA患者的关节肌骨超声变化与中医证型存在相关性, 肝肾亏虚证患者易出现软骨破坏;湿热蕴结证患者易产生滑膜增生,血流较丰富;气滞血瘀证患者易产生关节积液,形成腘窝囊肿,为KOA患者的辩证分型提供了客观依据。
关键词:膝骨关节炎;肌骨超声;中医辨证论治 |
关键词: 膝骨关节炎 肌骨超声 中医辨证论治 |
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Relationship between different syndromes of knee osteoarthritis and musculoskeletal ultrasonography |
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The first Affiliated Hospital of Guangxi University of Chinese Medicine
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Abstract: |
Objective: To investigate the relationship between different syndromes of knee osteoarthritis and musculoskeletal ultrasound by using musculoskeletal ultrasound.Selection methods: between January 2019 and January 2020 in our hospital 100 cases of patients with knee osteoarthritis, a total of 128 cases of knee joint, according to the principle of TCM treatment based on syndrome differentiation, into the wind cold dampness of group, damp and hot accumulate knot, kidney deficiency syndrome group, and qi stagnation and blood stasis syndrome group, the application of ultrasonic technology to detect knee joint synovial thickness, synovial blood flow, osteophyte, articular cartilage and subchondral bone damage, joint effusion, popliteal fossa cyst formation, etc., to compare different syndrome types musculoskeletal ultrasound examination results.Results: The positive rate of synovium hyperplasia with dampness and heat accumulation was higher than that of wind-cold and dampness bi (X =5.334, P=0.021), qi stagnation and blood stasis (X =9.246, P=0.002), and liver and kidney deficiency (X =3.966, P=0.046).The positive blood flow rate of damp-heat accumulation syndrome was higher than that of wind-cold and dampnessbi syndrome (X =7.125, P=0.008), qi stagnation and blood stasis syndrome (X =5.578, P=0.018), and liver-kidney deficiency syndrome (X =4.094, P=0.043).The positive rate of cartilage and subchondral bone destruction in liver-kidney deficiency syndrome was higher than that in wind-cold and dampness-bi syndrome (2=4.836, P=0.028), damp-heat accumulation syndrome (2=5.868, P=0.015), and Qi stagnation and blood stasis syndrome (2=4.018, P=0.045).The positive rate of joint efficency in damp-heat accumulation syndrome was higher than that in fenghanshibi syndrome (2 =12.157, P=0.000) and liver-kidney deficiency syndrome (2 =10.234, P=0.001).The positive rate of joint effusion in qi-stagnation and blood-stasis syndrome was higher than that in Fenghanshibi (2 =4.378, P=0.036) and liver-kidney deficiency syndrome (2 =5.145, P=0.023).The positive rate of popliteal cyst in qi stagnation and blood stasis syndrome was higher than that in wind-cold and dampnessbi syndrome (x =6.615, P =0.010) and liver-kidney deficiency syndrome (x =6.300, P =0.012).There was no significant difference in the positive rate of osteophyte formation among different syndromes (2 =7.199, P=0.066).Conclusion: Ultrasonic changes of articular musculoskeletal in KOA patients are correlated with TCM syndrome types, and patients with liver-kidney deficiency syndrome are prone to cartilage destruction.Patients with damp-heat accumulation syndrome tend to have synovial hyperplasia and rich blood flow.Patients with qi stagnation and blood stasis tend to produce joint effusion and form popliteal fossa cyst, which provides objective basis for the dialectical classification of KOA patients.S |
Key words: Knee osteoarthritis Musculoskeletal ultrasound TCM treatment based on syndrome differentiation |