摘要
目的:探讨髌骨软化症(chondromalacia patellae, CMP)中医证型的分布规律及危险因素。方法:收集2018年1月至2023年6月在天长市中医院收治的CMP患者的病例资料,提取中医证型、年龄、性别、体质量指数(body mass index, BMI)、饮食偏嗜、吸烟情况、饮酒情况、合并症等信息。按照中医证型不同将纳入的CMP患者分为肝肾亏虚组、痰湿痹阻组和气滞血瘀组。先对3组患者的相关信息进行单因素对比分析,然后将其中组间差异具有统计学意义的因素作为自变量,将CMP中医证型作为因变量,进行多因素Logistic回归分析。采用Hosmer-Lemeshow检验判断模型拟合优劣。结果:共纳入122例CMP患者,其中肝肾亏虚组60例、痰湿痹阻组45例、气滞血瘀组17例。3组患者年龄、吸烟情况、饮食偏嗜、体质量指数、是否合并腰椎病、是否合并甲状腺功能减退的组间差异均有统计学意义,其余各因素的组间差异均无统计学意义。多因素Logistic回归分析结果显示,以气滞血瘀证为对照,年龄>65岁、合并腰椎病、合并甲状腺功能减退是CMP肝肾亏虚证的危险因素(β=2.366,P=0.000,OR=20.544;β=3.479,P=0.003,OR=28.328;β=1.371,P=0.030,OR=3.936),饮食偏咸、BMI>28 kg·m^(-2)是CMP痰湿痹阻证的危险因素(β=2.234,P=0.000,OR=9.341;β=1.845,P=0.046,OR=6.896)。Hosmer-Lemeshow检验显示回归模型对数据拟合度较好(χ^(2)=2.372,P=0.726)。结论:肝肾亏虚证和痰湿痹阻证是CMP的主要中医证型;相对于气滞血瘀证,年龄>65岁、合并腰椎病、合并甲状腺功能减退是CMP肝肾亏虚证的危险因素,饮食偏咸、BMI>28 kg·m^(-2)是CMP痰湿痹阻证的危险因素。
Objective:To investigate the distribution rules and risk factors for traditional Chinese medicine(TCM)syndrome types in patients with chondromalacia patellae(CMP).Methods:The medical records of CMP patients who were diagnosed and treated in the Tianchang Hospital of Traditional Chinese Medicine from January 2018 to June 2023 were collected,and the information,including TCM syndrome type,age,gender,body mass index(BMI),dietary preferences,smoking,drinking and comorbidity,was extracted from the electronic medical record system(EMRS).According to the TCM syndrome type,the included CMP patients were divided into liver-kidney deficiency group,phlegm-dampness impediment group,qi-stagnation and blood-stasis group.Single-factor analysis was conducted on the information of patients in the 3 groups,followed by multi-factor logistic regression analysis by taking the factors with significant differences among the 3 groups as independent variable,and the TCM syndrome type of CMP patients as dependent variable,respectively.Furthermore,the goodness-of-fit(GOF)of the logistic regression model was assessed by using Hosmer-Lemeshow(HL)test.Results:One hundred and twenty-two patients were included in the final analysis,60 ones in liver-kidney deficiency group,45 ones in phlegm-dampness impediment group,and 17 ones in qi-stagnation and blood-stasis group.The differences were statistically significant in age,smoking,dietary preferences,BMI,whether combined with lumbar diseases,and whether combined with hypothyroidism among the 3 groups,while,were not statistically significant in the rest factors.The results of logistic regression analysis revealed that,with qi-stagnation and blood-stasis syndrome as a reference,age of>65 years,combined with lumbar disease and combined with hypothyroidism were the risk factors for liver-kidney deficiency syndrome(β=2.366,P=0.000,OR=20.544;β=3.479,P=0.003,OR=28.328;β=1.371,P=0.030,OR=3.936),and high-salt diets,a BMI of>28 kg/m(2)were the risk factors for phlegm-dampness impediment syndrome in CMP pa
作者
杨树明
潘赐明
丁家雯
YANG Shuming;PAN Ciming;DING Jiawen(Tianchang Hospital of Traditional Chinese Medicine,Tianchang 239300,Anhui,China;Kunming Chenggong Huixian Hospital of Traditional Chinese Medicine,Kunming 650500,Yunnan,China)
出处
《中医正骨》
2024年第6期32-36,共5页
The Journal of Traditional Chinese Orthopedics and Traumatology
