膝骨关节炎中医证型与关节软骨损伤相关性分析

Analysis on TCM Syndrome of Knee Osteoarthritis and Its Relativity with Expression of Articular Cartilage Injury

目的:探讨膝骨关节炎(KOA)的不同中医证型与关节镜下关节软骨损伤表现的相关性。方法:选取80例膝骨关节炎患者,由2名高级职称医师对患者进行中医辨证分型。所有患者均行关节镜手术治疗,对不同中医证型膝骨关节炎的关节镜下关节软骨损伤程度进行Outerbridge分级,并对数据进行统计学分析处理。结果:4种证型间软骨损伤分级比较用非参数秩和检验,差异有统计学意义(P<0.05);用LSD多重比较检验发现,气滞血瘀型的软骨损伤分级较肝肾阴虚型、脾肾阳虚型、风寒湿痹型均高,且差异有统计学意义(均P<0.05)。结论:关节镜下软骨损伤Outerbridge分级作为诊断膝骨关节炎的一项重要指标,可在一定程度上为膝骨关节炎的辨证施治提供客观依据。

Objective：To investigate the correlation between different TCM syndromes of knee osteoarthritis and expression of articular cartilage injury under arthroscope. Methods：Select 80 patients with knee osteoarthritis and differentiate them according to TCM syndrome types by two doctors with senior title. All patients underwent arthroscopic operation therapy. Classified the severity of articular cartilage injury of different TCM syndromes of knee osteoarthritis under arthroscope with Outerbridge classification method. The data is statistically analyzed. Results：The difference of articular cartilage injury classification of 4 kinds of syndromes is statistically significant（P〈0.05）with non-parametric Wilcoxon test. Articular cartilage injury of patients with qi stagnation and blood stasis type is generally more severe than the other 3 kinds of syndromes-liver and kidney yin deficiency type,spleen and kidney yang deficiency type and wind-cold-dampness arthralgia type,and the difference is statistically significant（P〈0.05）with LSD multiple comparison test. Conclusion：Outerbridge classification method of articular cartilage injury under arthroscope as a important diagnostic indicator of knee osteoarthritis,can provide an objective basis for TCM syndrome differentiation and clinical treatment of knee osteoarthritis to some extent.