摘要
目的:探究不同中医辨证分型老年膝骨性关节炎(KOA)的肌肉骨骼超声特征及X线分期情况、血清指标水平、疼痛程度差异。方法:选取佛山市中医院三水医院自2021年1月~2022年1月收治的147例60岁以上KOA患者为研究对象,将患者进行中医辨证分型归类,并比较不同中医辨证分型KOA患者血清指标、X线分期情况、肌肉骨骼超声特征及疼痛程度的差异。结果:147例60岁以上KOA患者中肝肾亏虚型占比最高,达40.14%,其次分别为风寒湿痹型和气滞血瘀型,对应占比为34.01%和25.85%。不同证型KOA患者X线分期、视觉模拟(VAS)评分、血清指标及肌肉骨骼超声特征比较,有统计学意义(P<0.05)。肝肾亏虚型KOA患者病程最长,X线分期、不同状态下VAS评分及白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)水平最高,其次分别为风寒湿痹型和气滞血瘀型。在肌肉骨骼超声特征中,风寒湿痹型患者积液高度最高,肝肾亏虚型患者滑膜厚度和滑膜血流分级最高,而关节间隙、股骨内外髁软骨厚度最低,且气滞血瘀型滑膜血流分级高于风寒湿痹型,有统计学意义(P<0.05)。结论:肌肉骨骼超声特征、X线分期、血清指标及疼痛程度均与老年膝骨关节炎不同中医辨证分型有一定相关性,可为中医辨证施治提供客观的指导。
Objective To explore the differences in musculoskeletal ultrasound characteristics,X-ray staging,serum index levels,and pain degrees of elderly knee osteoarthritis(KOA)with different TCM syndrome types.Methods A total of 147KOA patients over 6Oyears old who were admitted to the Sanshui Hospital of Foshan Hospital of traditional Chinese Medicine from Janu-ary 2021to January 2022were selected as the research objects,and the patients were classified by TCM syndrome differentiation,and the serum indexes,X Dfferences in line staging,musculoskeletal ultrasound features,and pain severity.Results Among the 147KOA patients over 60years old,the liver-kidney deficiency and phlegm accounted for the highest proportion,reaching 40.14%,followed by wind-cold-dampness type and qi stagnation and blood stasis type accounted for the accounting for 34.01%and 25.85%respectively.The comparison of X-ray staging,visual analogue score(VAS),serum indexes and musculoskeletal ultrasound characteristics of KOA patients with different syndromes was statistically significant(P<0.05).The KOA patients with liver-kidney deficiency had the longest disease course,X-ray staging,VAS score under different conditions,interleukin-1(IL-1),tumor necrosis factor-α(TNF-α),transforming growth The level of factor-β1(TGF-β1)was the highest,followed by wind-cold-dampness type and qi stagnation and blood stasis type.Among the musculoskeletal ultrasound features,the patients with wind-cold-dampness type had the highest effusion height,the highest synovial thickness and synovial blood flow classification was found in the liver-kidney deficiency type,while the lowest joint space and cartilage thickness of the internal and external femoral condyles were found in the qi stagnation and blood stasis type,and the synovial blood flow classification was higher than that of the wind-cold and damp paralysis type,which was statistically significant(P<0.05).Conclusion Musculoskeletal ultrasound features,X-ray staging,serum indexes,and pain levels are all correlated with di
作者
梁泳聪
祝家盛
欧晓丹
梁淑筠
张雪莲
LIANG Yongcong;ZHU Jiasheng;OU Xiaodan(Department of Orthopedics,Sanshui Hospital of Foshan Hospi-tal of traditional Chinese Medicine,Foshan Guangdong 528100,China)
出处
《四川中医》
2023年第6期68-71,共4页
Journal of Sichuan of Traditional Chinese Medicine
基金
广东省中医药管理局科研项目:正骨十四法治疗旋后外旋Ⅱ度踝关节骨折的疗效及相关因素分析(编号:20211378)。
关键词
中医辨证分型
肌肉骨骼超声特征
X线分期
血清指标
疼痛程度
TCM syndrome differentiation
Musculoskeletal ultrasound features
X-ray staging
Serum indexes
Pain de-gree
