| 基于膝骨关节炎患者中医体质分层探讨风寒湿外部因素对临床症状的影响特点 |
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投稿时间：2023-01-09
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| 作者 | Author | 单位 | Address | E-Mail |
| 谭则成 |
TAN Ze-cheng |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Traumatology & Orthopaedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China |
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| 蒋鼎 |
JIANG Ding |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Traumatology & Orthopaedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China |
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| 徐勤光 |
XU Qin-guang |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Traumatology & Orthopaedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China |
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| 王林 |
WANG Lin |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Traumatology & Orthopaedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China |
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| 王学宗 |
WANG Xue-zong |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Traumatology & Orthopaedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China |
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| 陈博 |
CHEN Bo |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Traumatology & Orthopaedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China |
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| 庞坚 |
PANG Jian |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Traumatology & Orthopaedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China |
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| 詹红生 |
ZHAN Hong-sheng |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Traumatology & Orthopaedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China |
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| 曹月龙 |
CAO Yue-long |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Traumatology & Orthopaedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China |
ningtcm@126.com |
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| 期刊信息：《中国骨伤》2023年，第36卷，第12期，第1130-1135页 |
| DOI：10.12200/j.issn.1003-0034.2023.12.005 |
| 基金项目:国家自然科学基金项目(编号:81973874,81373665);上海市慢性筋骨病临床医学研究中心(编号:20MC1920600) |
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中文摘要:
目的:探讨不同中医体质膝骨关节炎(knee osteoarthritis,KOA)患者中风寒湿外部因素对临床症状的影响特点。
方法:采用横断面分层研究方法,选取108例Kellgren & Lawrence(K-L)分级Ⅱ级的KOA患者,其中男22例,女86例;年龄47~75(60.7±6.0)岁;身体质量指数(body mass index,BMI)17.87~31.22(23.80±2.86) kg·m-2。其中3例主要体质为倾向体质,其余105例参照《中医体质分类与判定(ZYYXH/T157-2009)》判断中医体质类型,并根据体质虚实分为4层,其中无偏颇体质24例,男12例,女12例,年龄51~73(62.8±6.0)岁,BMI 17.87~31.14(24.32±3.25) kg·m-2;虚性偏颇体质46例,男7例,女39例,年龄47~70(60.0±5.8)岁,BMI 19.38~31.22(23.42±2.97) kg·m-2;实性偏颇体质26例,男2例,女24例,年龄48~75(60.4±5.8)岁,BMI 21.16~30.76(24.15±2.33) kg·m-2;特禀质9例,男1例,女8例,年龄53~75(59.8±7.5)岁,BMI 19.26~26.67(23.79±2.49) kg·m-2。采用Western Ontario and McMaster大学骨关节炎指数(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)评价患者临床症状严重程度;通过风寒湿痹证量表的问卷调查形式计算风寒湿外部因素积分,评价风寒湿外部因素影响的程度。采用Pearson相关分析和偏相关分析计算不同中医体质分层患者的风寒湿外部因素影响严重程度与临床症状严重程度的相关系数。
结果:无偏颇体质、特禀质患者风寒湿总积分与WOMAC评分无相关性(P＞0.05);虚性偏颇体质患者风寒湿总积分与WOMAC僵硬评分呈正相关(r=0.327,P=0.032),实性偏颇体质患者风寒湿总积分与WOMAC疼痛评分(r=0.561,P=0.005)、WOMAC总分(r=0.446,P=0.033)呈正相关。进一步校正风寒湿外部因素的相互影响后,实性偏颇体质风寒湿各项评分与WOMAC评分的相关性无统计学意义;虚性偏颇体质湿邪评分与WOMAC僵硬评分(r=0.414,P=0.007)呈正相关。
结论:风寒湿外部因素对不同中医体质KOA患者临床症状的影响程度不一,相较于其他体质状态,虚性偏颇体质患者的僵硬症状更易受到湿邪的影响。 |
| 【关键词】膝骨关节炎 中医体质 风 寒 湿 |
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| Influence of wind,cold and dampness on clinical manifestation of knee osteoarthritis patients based on the stratifications of traditional Chinese medicine constitution |
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ABSTRACT
Objective To explore influence of external factors of wind,cold and dampness on clinical symptoms in knee osteoarthritis (KOA) patients with different constitutions of traditional Chinese medicine.
Methods A cross-sectional stratified study was performed to select 108 patients with GradeⅡKOA in Kellgren & Lawrence (K-L) classification,including 22 males and 86 females,aged from 47 to 75 years old with an average of (60.7±6.0) years old;body mass index(BMI) ranged from 17.87 to 31.22 kg·m-2 with an average of (23.80±2.86) kg·m-2. According to Classification and Judgment of TCM Physique (ZYYXH/T157-2009),the types of TCM physique were determined and divided into 4 layers according to the deficiency and actual physique. Among them,there were 24 patients without biased physique,12 males and 12 females,aged from 51 to 73 years old with an average of(62.8±6.0) years old,BMI ranged from 17.87 to 31.14 kg·m-2 with an average of (24.32±3.25) kg·m-2;there were 46 patients with virtual bias constitution,including 7 males and 39 females,aged from 47 to 70 years old with an average of (60.0±5.8) years old,BMI ranged from 19.38 to 31.22 kg·m-2 with an average of(23.42±2.97) kg·m-2;There were 26 patients with solid bias constitution,including 2 males and 24 females,aged from 48 to 75 years old with an average of (60.4±5.8) years old,BMI ranged from 21.16 to 30.76 kg·m-2 with an average of (24.15±2.33) kg·m-2;there were 9 patients with special constitution,1 male and 8 female,aged from 53 to 75 years old with an average of (59.8±7.5) years old,BMI ranged from 19.26 to 26.67 kg·m-2 with an average of (23.79±2.49) kg·m-2. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to evaluate severity of clinical symptoms. The wind-cold-dampness external factor score was calculated through the questionnaire of wind-cold-dampness syndrome scale to evaluate degree of influence of wind-cold-dampness external factor. Pearson correlation analysis and partial correlation analysis were used to calculate the correlation coefficient between severity of external factors affecting wind,cold and dampness and severity of clinical symptoms in patients with different TCM constitution stratification.
Results There was no statistical significance between total score of wind-cold-dampness and WOMAC score in patients with no biased constitution and special condition. Total wind-cold-dampness score of patients with virtual biased constitution was positively correlated with WOMAC stiffness score (r=0.327,P=0.032),and total wind-cold-dampness score of patients with solid biased constitution was positively correlated with WOMAC pain score (r=0.561,P=0.005) and WOMAC overall score (r=0.446,P=0.033). After further adjusting for the interaction of external factors of wind-cold-dampness,there was no statistical significance between wind-cold-dampness scores and WOMAC scores in patients with solid biased constitution. The score of dampness and pathogenic factors was positively correlated with WOMAC stiffness score (r=0.414,P=0.007).
Conclusion The external factors of wind-cold dampness have different effects on the clinical symptoms of KOA patients with different TCM constitutions. Compared with other constitutions,the rigid symptoms of patients with asthenic biased constitutions are more susceptible to dampness pathogenic factors. |
| KEY WORDS Knee osteoarthritis Traditional Chinese Medicine constitution Wind Cold Dampness |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 谭则成,蒋鼎,徐勤光,王林,王学宗,陈博,庞坚,詹红生,曹月龙.基于膝骨关节炎患者中医体质分层探讨风寒湿外部因素对临床症状的影响特点[J].中国骨伤,2023,36(12):1130~1135 |
| 英文格式: | TAN Ze-cheng,JIANG Ding,XU Qin-guang,WANG Lin,WANG Xue-zong,CHEN Bo,PANG Jian,ZHAN Hong-sheng,CAO Yue-long.Influence of wind,cold and dampness on clinical manifestation of knee osteoarthritis patients based on the stratifications of traditional Chinese medicine constitution[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(12):1130~1135 |
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