膝关节骨关节炎患者证候特点分析——附624例分析

AN ANALYSIS ON THE SYMPTOMATIC CHARACTERISTICS OF 624 CASES OF KNEE OSTEOARTHRITIS

为探讨膝关节骨关节炎患者证候类型及其诊断要点,收集6 2 4例确认为膝关节骨关节炎患者的四诊资料,采用症状计量辨证法辨析基本证候,聚类分析法归纳证候类型,二值多元Logistic回归分析法确定各证候的辨证要点。结果显示6 2 4例膝关节炎患者的基本证候分别为:肾阳虚证5 0 8例(81.4 % ) ,血瘀证4 6 4例(74 .4 % ) ,寒湿证340例(5 4 .4 % ) ,肝阴虚证2 92例(46 .8% ) ,脾虚证2 12例(34.0 % ) ,肾阴虚证12 0例(19.2 % ) ,痰证4 8例(7.7% ) ,湿热证4 0例(6 .4 % ) ,风证4例(0 .6 % )。证候类型的聚类分析结果为肾阳虚血瘀寒湿证2 76例(44 .2 % ) ,肝阴虚肾阳虚血瘀证15 6例(2 5 .0 % ) ,肝脾肾虚血瘀证10 4例(16 .7% ) ,肝肾阴虚血瘀证88例(14 .1% ) ,并归纳出各证型的辨证要点。表明肾阳虚证、血瘀证、寒湿证、肝阴虚证、脾虚证、肾阴虚证、痰证、湿热证、风证等是膝关节骨关节炎的基本证候单位,肾虚寒湿瘀滞证、肝肾亏虚血瘀证、肝脾两虚肾虚血瘀证、肝肾阴虚血瘀证等是膝关节骨关节炎的常见中医证候类型。

The objective of the paper is to study the syndrome types and the main diagnostic points of knee osteoarthritis (KO). The diagnostic materials of 624 cases of diagnosed KO were collected, the basic syndromes were differentiated and analyzed by syndromemetry syndromes -differentiating method, the syndrome types were summed up by cluster analysis, and the main diagnostic points of each syndrome were determined by binary multivariate Logistic regression analysis. The results showed that the basic syndromes of 624 KO cases included: kidney-Yang-deficiency syndrome in 508 cases (81.4%), blood-stasis syndrome in 464 (74.4%), cold-damp syndrome in 340 (54.5%), liver-Yin-deficiency syndrome in 292 (46.8%), spleen-deficiency syndrome in 212 (34.0%), kidney-Yin-deficiency syndrome in 120 (19.2%), phlegm syndrome in 48 (7.7%), damp-heat syndrome in 40 (6.4%) and wind syndrome in 4 (0.6%); the cluster analysis results of syndrome types included: kidney-Yang-deficiency, blood-stasis and cold-damp syndrome in 276 cases (44.2%), liver-Yin-deficiency, kidney-Yang-deficiency and blood-stasis syndrome in 156 (25.0%), liver-spleen-kidney-deficiency and blood-stasis syndrome in 104 (16.7%), liver-kidney-Yin-deficiency and blood-stasis syndrome in 88 (14.1%); the main syndromes-differentiating points were summed up for each syndrome type, suggesting that the basic syndrome units of KO included: kidney-Yang-deficiency syndrome, blood-stasis syndrome, cold-damp syndrome, liver-Yin-deficiency syndrome, spleen-deficiency syndrome, kidney-Yin-deficiency syndrome, phlegm syndrome, damp-heat syndrome, wind syndrome, etc; the common TCM syndromes of KO included: kidney-deficiency, cold-dampness-stasis-stagnation syndrome, liver-kidney-deficiency and blood-stasis syndrome and liver-kidney-Yin-deficiency and blood-stasis syndrome, etc.