类风湿性关节炎膝关节病变的超声改变与中医辨证分型的相关性研究

Correlation Study between Rheumatoid Arthritis Types Based on Syndrome Differentiation in TCM and Ultrasonic Changes in Knee Joints

目的探讨类风湿性关节炎(RA)膝关节病变的超声改变与中医辨证分型的相关性,为RA的中医辨证提供客观依据。方法选择中医辨证属寒证或热证的RA膝关节病变患者52例(104个膝关节),以彩色多普勒超声观察2种不同证型膝关节髌上囊积液、滑膜厚度和滑膜血流,并做相关性分析。结果热证与寒证患者在关节腔积液及滑膜增生的发生率方面没有明显差别,但热证患者的关节腔积液量较寒证患者显著增多(P<0.05),且热证患者增厚的滑膜内血流信号较寒证者显著增多(P<0.05)。结论 RA患者膝关节增厚的滑膜内血流信号及关节腔积液量与寒热辨证具有一定的相关性,应用超声观察RA患者的膝关节积液量和滑膜血流情况,可为中医寒热辨证提供参考依据。

Objective To study the relativity between rheumatoid arthritis types based on syndrome differentiation in TCM and ultrasonic changes in knee joints, in order to offer objective basis for syndrome differentiation in TCM. Method Fifty-two cases （104 knee joints） of rheumatoid arthritis with cold or hot syndrome based on TCM syndrome differentiation were observed with ultrasound. The relation between ultrasonic features including joint effution, synovium thickness, blood flowing signal and syndrome differentiation was analyzed. Results There was no difference in the incidence of joint effution and synovium thickness between two groups. While, joint effution in hot syndrome was more than that in cold syndrome （P〈0.05）. Blood flowing signal of knee joints in hot syndrome was higher than that in cold one （P〈0.05）. Conclusions Both blood flowing signal in synovium and knee joint effution are correlative with cold and hot syndromes in rheumatoid arthritis. Ultrasound features such as knee joint effution and blood flowing signal in synovium can provide references for cold and hot syndrome differentiation in TCM.