| 膝骨关节炎不同中医证型在X线表现上的
差异性研究 |
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Received:August 29, 2010
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| 作者 | Author | 单位 | Unit | E-Mail |
| 金立昆 |
JIN Li-kun |
丰盛中医骨伤专科医院骨科病房, 北京 100034 |
The Fengsheng Orthopaedics Hospital of Beijing, Beijing 100034, China |
jinlikun99@163.com |
| 张国忠 |
ZHANG Guo-zhong |
丰盛中医骨伤专科医院骨科病房, 北京 100034 |
The Fengsheng Orthopaedics Hospital of Beijing, Beijing 100034, China |
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| 唐可 |
TANG Ke |
丰盛中医骨伤专科医院骨科病房, 北京 100034 |
The Fengsheng Orthopaedics Hospital of Beijing, Beijing 100034, China |
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| 刘洋 |
LIU Yang |
丰盛中医骨伤专科医院骨科病房, 北京 100034 |
The Fengsheng Orthopaedics Hospital of Beijing, Beijing 100034, China |
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| 期刊信息：《中国骨伤》2010年23卷，第12期，第906-909页 |
| DOI：10.3969/j.issn.1003-0034.2010.12.007 |
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目的：探讨膝骨关节炎中医证型与X线表现的相关性，为临床诊疗提供依据。
方法：2007年6-12月，收集骨科门诊78例(108膝)膝骨关节炎患者，男13例(19膝),女65例(89膝);年龄41～77岁。中医辨证分型：一型，肝肾不足、筋脉瘀滞证，43膝；二型，脾肾两虚、湿注骨节证，26膝；三型，肝肾亏虚、痰瘀交阻证，39膝。摄负重站立位膝关节正侧位、髌股关节Skyline位X线片，分别观察评价关节间隙狭窄、骨赘生成、软骨下骨硬化、软骨下囊变，测量下肢力线角，并进行K-L分级。用多个独立样本非参数检验分析3种证型与各种X线表现之间相关性。
结果：3种证型在外侧髌骨骨赘、胫骨髁间骨赘以及K-L分级严重程度上差异有统计学意义(P<0.05),二型>一型>三型；外侧胫骨骨赘的差异比较，P=0.071;外侧滑车骨赘的差异比较，P=0.63;其他X线表现在3种证型之间的差异亦无统计学意义。
结论：膝骨关节炎中医证型与放射学表现有一定的相关性，在外侧髌骨骨赘、胫骨髁间骨赘方面，表现为本研究中医分型中的二型最严重，一型其次，三型最轻。可以推测中医辨证分型中的脾肾两虚、湿注骨节证的辨证依据中可以加入X线表现骨赘生成明显，而且此证型属于放射学诊断的较严重期。 |
| [关键词]:骨关节炎,膝 放射摄影术 辨证分型 诊断 |
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| Study on the correlation between syndrome differ classification of knee osteoarthritis and X-ray image |
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Abstract:
Objective: To study the correlation between syndrome differ classification of knee osteoarthritis and X-ray image,so as to provide evidence for clinical diagnosis and treatment.
Methods: From Jun. 2007 to Dec. 2007,78 patients (108 knees) with knee osteoarthritis were reviewed,including 65 females(89 knees) and 13 males(19 knees),ranging in age from 41 to 77 years. According to the standards for the differentiation of syndrome in the treatment of knee osteoarthritis defined in Principle of Clinical Research for New Traditional Herbs,the patients were divided into three types:TypeⅠ，insufficiency of the liver and kidney,with stagnation of tendons and muscles,43 knees;TypeⅡ，insufficiency of the spleen and kidney,with dampness infusion into bone and joints,26 knees;TypeⅢ，deficiency of the liver and kidney,with inter-obstruction of phlegm and stasis 39 knees. Normotopia and lateral plain film of knee joint of weigh loading and in erect position,and patellofemoral Skyline plain flim was taken. Joint space narrow,osteophyte generation,subchondral osteosclerosis and subchondral cystic degeneration were evaluated. All data were analyzed by K independent samples nonparametric test in order to find out the correlation between syndrome differ classification of knee osteoarthritis and X-ray image.
Results: It was shown that after K independent samples nonparametric test about syndrome differ classification of knee osteoarthritis and X-ray image:there were significant differences among three types about lateral patella osteophyte,condyles of tibia osteophyte and TypeⅡwas the most serious,TypeⅠwas secondary,TypeⅡwas the lightest. Other index had no obvious difference among the three groups.
Conclusion: There is certain correlation between syndrome differ classification of knee osteoarthritis and X-ray image. There are significant differences among three types about lateral patella osteophyte,condyles of tibia osteophyte,the TypeⅡis the most serious,TypeⅠis secondary,TypeⅡis the lightest. Consequently,it can be deduced that worse osteophyte is one of accordancese of TypeⅡ-insufficiency of the spleen and kidney, with dampness infusion into bone and joints. And,the TypeⅡis more serious stage in radiologic manifestation. |
| KEYWORDS:Osteoarthritis, knee Radiography Syndrome differ classification Diagnosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 金立昆,张国忠,唐可,刘洋.膝骨关节炎不同中医证型在X线表现上的
差异性研究[J].中国骨伤,2010,23(12):906~909 |
| 英文格式: | JIN Li-kun,ZHANG Guo-zhong,TANG Ke,LIU Yang.Study on the correlation between syndrome differ classification of knee osteoarthritis and X-ray image[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(12):906~909 |
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