股骨头坏死痛点分布与经筋理论相关性的临床研究

Clinical Study on the Correlation between the Tenderness Point and Muscle Region Theory in Osteonecrosis of the Femoral Head

目的:观察股骨头坏死患者髋周压痛点及结筋病灶点的分布规律,分析其与经筋理论的相关性,为针刀治疗本病提供理论依据。方法:对160例股骨头坏死患者进行髋周触诊检查,确定并统计压痛点及结筋病灶点。结果:160例患者,其中双侧患病142例,单侧患病18例,总计302髋。其中23髋压痛点不明显,279髋存在数量不等的压痛点(占92.38%)。股骨头坏死患者的压痛点主要分布于髋关节前侧,其次为髋关节后侧、外侧、内侧。足六经筋在髋部的结筋病灶点中,出现频率最高的为足太阴经筋,平均达到46.36%,其次为足阳明经筋,出现频率平均为37.58%,足少阳经筋平均为23.42%,足太阳经筋平均为14.94%,足厥阴经筋为11.92%,足少阴经筋平均为10.71%。结论:股骨头坏死患者髋周压痛点及结筋病灶点有明显的分布规律,此规律与足六经筋的生理功能和压痛点的解剖结构密切相关,对中医针刀治疗股骨头坏死有一定的指导作用,有助于进一步完善针刀疗法治疗股骨头坏死的治疗方案。

Objective:To study the distribution of the tenderness points and the positive reflexive points on patients with osteonecrosis of femoral head,so as to provide the theoretical basis for the treatment of the disease with acupotomy.Methods:160 cases of osteonecrosis of femoral head were palpated in order to determine and assessed the tenderness points and positive reflexive points.Results:Among 160 patients,142 were bilateral and 18 were unilateral with a total of 302 hips.Among them,23 hips pain points were not obvious,279 hips had different number of tenderness points(92.38%).The tenderness points of patients with osteonecrosis of the femoral head were mainly located in the front of the hip joint,next was the back side,the outboard and the inside of the hip joint.The highest frequency was the meridian of foot Taiyin(46.36%).The next was the Foot Yangming meridians with an average frequency of 37.58%.Foot Shaoyang meridians was 23.42%.Foot Taiyang meridians was 14.94%.Foot Jueyin meridians was 11.92%.Foot Shaoyin meridians was 10.71%.Conclusion:The tenderness points and positive reflexive points on patients with osteonecrosis of femoral head have obvious distribution rules.This rule is closely related to the physiological function of the six meridians of the foot and the anatomical structure of the pain points,which plays a guiding role in the treatment of osteonecrosis of femoral head by acupotomyand helps to further improve the treatment plan of acupotomy on patients with osteonecrosis of femoral head.