高频肌肉骨骼超声与膝骨关节炎中医辨证分型的相关性研究

Correlation Research Between High-Frequency Musculoskeletal Ultrasound and TCM Differentiated Syndromes of Knee Osteoarthritis

目的:探讨高频肌肉骨骼超声与膝骨关节炎中医辨证分型的相关性,为中医临床提供客观依据。方法:98例膝骨关节炎患者按中医辨证分型分为3组,患膝经高频肌肉骨骼超声检查并测量关节腔积液、滑膜厚度、股骨内外髁软骨厚度、滑膜血流、半月板情况、关节间隙等指标。结果:经统计分析,脾肾两虚、湿注骨节证患者高频超声显示滑膜增生明显、滑膜血流丰富、关节积液较多,与其他两组相比差异显著(P<0.05)。肝肾亏虚、痰瘀交阻证患者的超声显示其软骨减少、半月板损伤、关节间隙明显变窄,与其他两组相比差异显著(P<0.05)。肝肾不足、筋脉瘀滞证患者则存在滑膜增生、关节积液、软骨变薄、关节间隙变窄的情况,但并不显著。结论:高频肌肉骨骼超声检查与膝骨关节炎中医辨证分型之间具有一定的对应性,可以提供客观的、准确的检查指标来支持中医辨证,指导中医分型和临床治疗。

Objective： To discuss the correlation between the high-frequency musculoskeletal ultrasound and TCM differentiated syndromes of knee osteoarthritis（ KOA） to provide objective evidence for the TCM clinical practice. Methods： Totally 98 cases with KOA were divided into three groups according to the TCM differentiated syndromes. Then the affected knees were conducted high-frequency musculoskeletal ultrasound test and the indicators of arthroedema,thickness of the synovium,thickness of the cartilage of the internal and external condyles of the thighbone,synovium blood flow,meniscus condition and joint spaces were determined. Results： With statistical analysis,it showed obvious synovial hyperplasia,rich blood flow of the synovium and much join hydrops in patients with syndrome of spleen and kidney and syndrome of dampness infusing the osteocomma after high-frequency musculoskeletal ultrasound test; compared with the other two groups,the difference was significant（ P 〈 0. 05）. The test of the patients with syndrome of liver and kidney deficiency and syndrome of intermingling of phlegm and blood stasis showed decrease of cartilage,meniscus injury and obvious narrowing of joint space; compared with the other two groups,the difference was significant（ P 〈 0. 05）. For patients with syndrome of liver and kidney deficiency and stagnation of tendons and meridians,there were conditions of synovial hyperplasia,joint hydrops,decreased thickness of the cartilage and narrowing of the joint spaces,but the difference was not significant. Conclusion： There are some correlations between the high-frequency musculoskeletal ultrasound and TCM differentiated syndromes of KOA,which can provide objective and accurate examination indicators to support the TCM syndrome differentiation and clinical treatment.