膝骨性关节炎经筋病灶点触诊规律分析

Analysis of palpation laws of muscle meridian focus on knee osteoarthritis

目的:探寻膝骨性关节炎(KOA)患者常见结筋病灶点在膝关节近端与远端的分布规律。方法:选择516例KOA患者的765个患膝,以经筋理论为指导,采用触诊法,结合经筋病灶点的解剖特点,统计经筋病灶点在膝关节近端与远端出现的部位和频次。结果:共触诊KOA患者近端经筋病灶点11 835次,远端经筋病灶点9455次。足阳明经筋、足太阳经筋、足少阳经筋及足三阴经筋4种证型的结筋病灶点分别占膝关节近端经筋病灶点总数的37.1%(4388/11 835)、34.9%(4127/11 835)、9.5%(1129/11 835)及18.5%(2191/11 835);占远端经筋病灶点总数的24.7%(2333/9455)、25.2%(2380/9455)、28.5%(2700/9455)及21.6%(2042/9455)。结论:KOA患者近端和远端经筋病灶点与膝关节解剖学结构及其生物力学特性密切相关,此经筋病灶点分布规律的研究为临床各种针灸疗法选择有效治疗点提供依据。

Objective To explore the distribution regulars of proximal and distal focus of muscle meridian re gions in knee osteoarthritis patients. Methods Seven hundred and sixty five knees were selected in 516 cases of knee osteoarthritis. Under the guidance of muscle meridian theory, with the anatomical features of muscle meridian focus, the frequency and the location where the proximal and distal focus of muscle meridian regions appeared were calculated by palpation. Results Of ill lhe points, 11 835 points of proximal focus of muscle meridian regions were found out by palpation, and 9455 points of distal focus of muscle meridian regions were found out. The per-centages of the frequency that the focus of muscle meridian of Foot Yangming, Foot Taiyang, Foot-Shaoyang and three foot Yin meridians appeared at proximal points of knee were 37.1% （4388/11 835）, 34.9%（4127/11 835）, 9.5% （1129/11 835） and 18.5%（2191/11 835） respectively; and the percentage of the frequency that the focusof muscle meridian appeared at distal points of knee were 24.7‰（2333/9455） ,25.20% （2380/9455）, 28.5% （2700/9455） and 21.6%（2042/9455）. Conclusion The proximal and distal focus of muscle meridian in knee osteoarthritis pa- tients are closely related with anatomy structure and biomechanical characteristics; the distribution regulars of fo- cus of muscle meridians study provides evidence for the selection of effective treatment points from different clinical acupuncture therapies.