586例膝骨关节炎中医证型聚类分析及与中医体质的关系

Cluster Analysis of Traditional Chinese Medicine Syndrome Types of 586 Patients of Knee Osteoarthropathy and Its Relationship with TCM Constitution

目的：探讨膝骨关节炎的中医辨证分型及与中医体质的关系。方法：采用临床流行病学调查的方法,对北京市三家医院586例50-74岁确诊为膝骨关节炎的女性患者进行前瞻性研究。收集其四诊信息,并采用SPSS11.5软件对其进行聚类分析。采用王琦九种中医体质量表对586例患者进行中医体质调查,分析九种中医体质与中医证型的关系。结果：（1）四诊信息经聚类分析后认为可以分为3个证型,即风寒湿痹型（141例）,肾气亏虚型（386例）和痰瘀互阻型（59例）。（2）九种中医体质分布：平和质59例（10.1%）,偏颇体质527例（89.9%）。偏颇体质中多见的体质为阳虚质160例（27.3%）,气虚质157例（26.8%）,阴虚质80例（13.7%）。（3）50~74岁女性膝骨关节炎风寒湿痹型与平和质、气虚质、阳虚质显著相关;肾气亏虚型与平和质、气虚质、阴虚质显著相关;痰瘀互阻型与气虚质、阳虚质、痰湿质、血瘀质显著相关。结论：50~74岁女性膝骨关节炎患者的中医证型分为3类比较符合临床实际。偏颇体质以阳虚质、气虚质多见。50~74岁女性膝骨关节炎患者的体质以偏颇体质为多,从不同体质与中医证型的关系来看,风寒湿痹型与平和质、气虚质、阳虚质显著相关;肾气亏虚型与平和质、气虚质、阴虚质显著相关;痰瘀互阻型与气虚质、阳虚质、痰湿质、血瘀质显著相关。

Objective：Investigate the traditional Chinese medicine syndrome types of knee osteoarthropathy and the relationship with TCM constitution. Methods ： According to the ways of clinical epidemiology, 586 female patients who were diagnosed to be osteoarthritis were studied prospectively between 50 to 74 years old from three hospitals in Beijing. Collect the four diagnostic information, which were analyzed for the clustering analysis by SPSS11.5 software. Investigate the nine constitutions of 586 patients with the nine constitutions in traditional Chinese medicine information scale written by WANG Qi. Results ： （ 1 ） Diagnostic information by clustering analysis can be divided into 3 patterns ：the type of wind cold clamp impediment （ 141 cases ）, the type of kidney deficiency （ 386 cases ）and the type of phlegm-blood stasis blocking （ 59 cases ）. （ 2 ） In the nine types of traditional Chinese Medicine constitution information, 59 people had normal constitution （ 10.1% ）,527 people had abnormal constitution （89.9%）. The common abnormal constitutions were Qi- deficiency constitution （ 26.8% ）, Yang-deficiency constitution （ 27.3% ）, Yin-deficiency constitution （ 13.7% ）. （ 3 ） The type of wind cold damp impediment was significant correlation with Qi-deficiency constitution, Yang- deficiency constitution and the normal constitution. The type of kidney deficiency was significant correlation with Qi-deficiency constitution, Yin-deficiency constitution and the normal constitution. The type of phlegm- blood stasis blocking was significant correlation with Qi-deficieney constitution, Yang-deficiency constitution, phlegm-dampness constitution and blood stasis constitution. Conclusion：The traditional Chinese medicine syndrome types of knee osteoarthropathy female patients between 50-74 years old were divided into 3 types in conformity with clinical practice. The common abnormal constitutions were Qi-deficiency constitution and Yang -deficiency constitution. Most constitutions were abnormal. The relationship between constitution and the traditional Chinese medicine syndrome types was that the type of wind cold damp impediment was significant correlation with Qi-deficiency constitution, Yang-deficiency constitution and the normal constitution. The type of kidney deficiency was significant correlation with Qi-deficiency constitution, Yin-deficicncy constitution and the normal constitution. The type of phlegm-blood stasis blocking was significant correlation with Qi- deficiency constitution, Yang-deficiency constitution, phlegm-dampness constitution and blood stasis