膝骨性关节炎(骨痹)患者中医体质与临床证型的调查研究

Survey on TCM Constitutions and Clinical Syndromes in Patients with Knee Osteoarthritis

目的:对膝骨性关节炎(Knee Osteoarthritis,KOA)患者的中医体质与临床证型进行调查分析,并探讨2者之间的关系。方法:选取2013年6月至2016年6月于河南省信阳市中医院骨科门诊及住院收治的KOA患者1 591例,调查并统计所有患者的中医体质及临床证型分布情况,并对2者之间的关系进行分析。结果:1 591例KOA患者平和质461例(男/女=198/263);偏颇体质1 130例(男/女=130/1 000);平和质和偏颇体质患者的男女性别比,差异有统计学意义(P<0.01)。1 130例偏颇体质KOA患者中单纯偏颇体质患者625例(55.31%),兼夹偏颇体质患者505例(44.69%),均以为阳虚质、阴虚质及气虚质为主要体质类型。1 591例KOA患者中风寒湿痹型410例(25.77%),肝肾亏虚型1 042例(65.49%),痰瘀互阻型139例(8.74%),肝肾亏虚型明显高于风寒湿痹型及痰瘀互阻型,差异有统计学意义(P<0.01),风寒湿痹型明显高于痰瘀互阻型,差异有统计学意义(P<0.01)。肝肾亏虚型以平和质、阳虚质、阴虚质及气虚质为主要体质类型,风寒湿痹型以平和质、阳虚质及气虚质为主要体质类型,痰瘀互阻型以气虚质、痰湿质、阳虚质、血瘀质为主要体质类型。结论:KOA患者中男性以平和质为主,女性以偏颇体质为主,中医体质与临床证型具有一定的相关性。

Objective： To investigate and analyze the TCM constitutions and clinical syndromes of knee osteoarthritis（ KOA） and explore the relationship between TCM constitutions and clinical syndromes. Methods： A total of 1 591 patients with KOA admitted in orthopedics department in our hospital from Jun. 2013 to Jun. 2016 were selected to investigate and analyze the distribution of TCM constitution and clinical syndrome,and explore the relationship between TCM constitution and clinical syndrome. Results： In the total of 1 591 patients,461 cases are mild constitution（ male/female： 198/263） and 1 130 cases are biased constitution（ male/female： 130/1 000）,showing that there was significant difference in gender ratio between men and women in patients with mild constitution and biased constitution（ P〈0. 01）. Among 1 130 KOA patients with biased constitution,625 patients（ 55. 31%） were single biased constitution and 505 cases（ 44. 69%） has compound constitution,mainly with yang deficiency constitution,yin deficiency constitution and qi deficiency constitution. Among the 1 591 cases of KOA patients,there were 410 cases（ 25. 77%） with wind cold damp impediment type,1042 cases（ 65. 49%） with liver and kidney deficiency type,139 cases（ 8. 74%） with phlegm-blood stasis blocking type. Liver and kidney deficiency type was significantly higher than the cold damp impediment type and phlegm-blood stasis blocking type（ P〈0. 01）. The cold damp impediment type was significantly higher than phlegm-blood stasis blocking type（ P〈0. 01）. Yang deficiency,yin deficiency,qi deficiency and mild constitution were the main constitutions in liver and kidney deficiency type. Yang deficiency,yin deficiency and qi deficiency constitution were the main ones in cold damp impediment type. Qi deficiency,phlegm dampness,Yang deficiency and blood stasis constitution were the main ones in phlegm-blood stasis blocking type. Conclusion： In the KOA patients,mild constitution is common in male patients but biased constitution in women and TCM constitutions have a certain correlation with the clinical syndromes.