摘要
目的：探讨压痛值、软组织位移值及香蕉面积比值等疼痛客观化指标在膝骨关节炎患者患膝关节功能和疼痛评价中的作用，为膝骨关节炎的临床诊治提供依据。方法：2011年3月至2012年8月，利用人体压痛力学定量测试仪和软组织张力仪对120例膝骨关节炎患者进行检查，男23例，女97例；年龄40～70岁，中位数58．5岁；左侧62例，右侧58例；病程3个月至2年，中位数11．5个月。记录患膝的压痛值、软组织位移值及香蕉面积比值，分别采用美国特种外科医院膝关节功能评分标准和疼痛视觉模拟评分标准对患膝关节功能和疼痛进行评分，分析疼痛客观化指标对患膝功能评分和疼痛评分的影响。结果：本组120例，压痛值x，为（7．02±0．48）kPa，软组织位移值x，为（3．19±0．25）mm，香蕉面积比值墨为（74．15±6．01）％，疼痛视觉模拟评分Kvas为（5．20±0．67）分，膝关节功能评分yHhss为（88．83±3．06）分。对自变量进行筛选后回归方程分别为Yhss=-0．343X24-114．299（F=99．236，P=0．000），Yhss=-0．666—0．394X24-0．096X3（F=654．165，P=0．000）；即压痛值和香蕉面积比值对患膝关节功能评分没有影响；但软组织位移值增加1mm，患膝关节功能评分就减少0．343分（R2=0．457）；压痛值对患膝疼痛视觉模拟评分无影响；但在香蕉面积比值不变的前提下，软组织位移值增加lmm，疼痛视觉模拟评分下降0．394分；在软组织位移值保持不变的情况下，香蕉面积比值增加1％，疼痛视觉模拟评分增加0．096分（R2=0．918）。结论：测量膝骨关节炎患者患膝局部压痛点的软组织位移值，对评价其膝关节功能有一定的意义，而测量局部压痛点的软组织位移值和香蕉面积比值可用于患膝疼痛的客观评估。
Objective：To study the role of objective detection indicators of pain in assessing knee function and knee pain in patients with knee osteoarthritis,including tenderness values, soft tissue displacement values,banana area ratio and so on, so as to provide the basis for the diagnosis and treatment of knee osteoarthritis in clinic. Methods：From March 2011 to August 2012,120 patients with knee osteoar- thritis ,23 males and 97 females ,62 cases in the left knee and 58 cases in the right knee ,were examined by using the quantitative tester of human tenderness and the soft tissue tensiometer. The mean age of patients was 58.5 years（ range ft＇om 40 to 70 years） and the mean course of disease was 11.5 months（ range from 3 months to 2 years）. Tenderness values, soft tissue displacement values and banana area ratio were recorded;and knee function and knee pain were measured respectively by using American Hospital for Special Surgery knee performance score and visual analogue scale;and then the impact of pain objective detection indicators on knee function and knee pain were analyzed. Results ： For 120 patients, the tenderness values （ Xt ） was 7.02 ＋/- 0.48 kPa, the soft tissue displacement values （ X： ） was 3.19 ＋/- 0.25 mm,the banana area ratio（X3 ）was 74.15 ＋/-6.01%, the visual analogue scale （ YVAS ） was 5. 20 ＋/--0. 67 points, and the knee function score（ YHss ） was 88.83 ＋/- 3.06 points. After screening the independent variables, the regression equation were obtained（ YHss = - 0. 343X2 ＋ 114. 299 （ F = 99. 236, P = 0. 000 ） , YVAS = -- 0. 666 -- 0. 394X2 ＋ 0. 096X3 （ F = 654. 165, P = 0. 000 ） ）. As the regression equation showed, the tenderness values and banana area ratio had no impact on knee function scores, however, the knee function scores decreased by 0. 343 points（R2 =0. 457）while the soft tissue displacement values increased 1 ram. The tenderness values had no impact on visual ana- logue scale, however, the visual analogue scales decreased
出处
《中医正骨》
2013年第9期22-24,共3页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
骨关节炎
膝
关节痛
关节功能
疼痛测定
Osteoarthritis, knee
Arthralgia
Joint function
Pain measurement
