膝骨性关节炎中医证型与其关节镜下表现关系的临床研究

Clinical Study of Correlation of Traditional Chinese Medical Syndrome Patterns with Pathological Changes Under Arthroscope in Knee Osteoarthritis Patients

【目的】通过分析肾虚髓亏、瘀血阻滞型膝骨性关节炎(knee osteoarthritis,KOA)与关节镜下病理改变之间的相关性,为中医临床诊治提供客观量化指标;观察和评价膝关节镜技术治疗膝骨关节病的有效性。【方法】将收集到的59例(65膝)患者给予膝关节镜技术治疗,观察其关节镜下病理表现并记录,主要运用聚类分析的方法,计数关节镜镜下表现在不同证型中的向量值,与中医证型进行相关性分析;通过膝关节综合评分及手术前后临床表现好转情况量化表,评价膝关节镜技术治疗膝骨关节病的有效性。【结果】肾虚髓亏、瘀血阻滞型KOA在关节镜下表现差异明显;膝关节镜技术对早、中期KOA患者治疗效果良好。【结论】膝骨性关节炎中医证型与其关节镜下表现有内在密切的联系;膝关节镜技术对膝关节软骨的评价及治疗上具有一定优越性。

Objective The correlation of traditional Chinese medical syndrome patterns with pathological changes under arthroscope in knee osteoarthfifis （KOA） patients was explored for providing standardized indexes for traditional Chinese medical diagnosis and treatment of KOA, and the effectiveness of knee arthroscopy was observed. Methods The enrolled KOA patients were differentiated into the syndromes of kidney deficiency and marrow insufficiency, and blood-stasis blockage. All of the patients received examination and surgery under arthroscope, and the knee pathological manifestations were recorded. Cluster analysis was used to investigate the correlation of syndrome patterns with different vectors showed by arthroscopy. Comprehensive scores of knee function and improvement of clinical manifestations were observed before and after treatment for the evaluation ofeffectiveness of treatment for KOA under arthroscope. Results The pathological manifestations under arthroscope in KOA patients with the syndromes of kidney deficiency and marrow insufficiency differed from those in the syndrome of blood-stasis blockage. Knee arthroscopy showed good effect for early and middle-stage KOA. Conclusion Syndrome patterns in KOA patients are closely related with the pathological manifestations under arthroscope, and knee arthroscopy has advantages for assessment of knee cartilage injury and for treatment of KOA