肾虚血瘀证与膝骨性关节炎的关系研究

Correlation between kidney deficiency and blood stasis syndrome and knee osteoarthritis

目的研究肾虚血瘀证与膝骨性关节炎的关系,探讨膝骨性关节炎的中医治则。方法 100例膝骨性关节炎患者,按照中医辨证分型不同分为风寒湿痹证组(22例)、风湿热痹证组(20例)、瘀血痹阻证组(28例)、肾虚证组(30例)。对比四组患者的膝关节疼痛、活动范围、稳定性、屈曲畸形、伸直迟滞、内外翻畸形、行走、阶梯和支撑情况等指标评分,并观察对比各组X光片的差异,分析肾虚血瘀证与膝骨性关节炎的内在联系。结果瘀血痹阻组、肾虚证组患者的膝关节总评分分别为(110.5±12.6)、(110.2±11.6)分,均低于风湿热痹组的(121.6±15.5)分、风寒湿痹组的(121.5±14.6)分,差异均具有统计学意义(P<0.05)。瘀血痹阻组与肾虚证组之间、风湿热痹组与风寒湿痹组之间膝关节、活动范围、稳定性、屈曲畸形、伸直迟滞、内外翻畸形、行走、阶梯、支撑评分以及总评分比较,差异均无统计学意义(P>0.05)。各组患者总评分由高到低为:风湿热痹组>风寒湿痹组>瘀血痹阻组>肾虚证组。结论中医的肾虚血瘀证与膝骨性关节炎相关,可为临床应用中医补肾活血法提供依据。

Objective To study the correlation between kidney deficiency and blood stasis syndrome and knee osteoarthritis and discuss the traditional Chinese medicine treatment principle of knee osteoarthritis. Methods A total of 100 patients with knee osteoarthritis were divided into wind-cold-dampness arthralgia group(22 cases), rheumatism-heat arthralgia group(20 cases), blood stasis arthralgia syndrome group(28 cases), and kidney deficiency group(30 cases) according to different types of syndrome differentiation of traditional Chinese medicine. The knee joint pain, range of motion, stability, flexion deformity, extension retardation, varus deformity, walking, ladder and support of the four groups were compared, and the differences of X-ray films of each group were observed and compared, and the internal relationship between kidney deficiency and blood stasis syndrome and knee osteoarthritis was analyzed. Results The total knee score of blood stasis arthralgia syndrome group and kidney deficiency group were(110.5±12.6) and(110.2±11.6) points, which were lower than(121.6±15.5) and(121.5±14.6) points of wind-cold-dampness arthralgia group and rheumatismheat arthralgia group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in knee joint pain, range of motion, stability, flexion deformity, extension retardation, varus deformity, walking, ladder and support score between blood stasis arthralgia syndrome group, kidney deficiency group and wind-cold-dampness arthralgia group, rheumatism-heat arthralgia group(P>0.05). The total scores of the patients in each group from high to low were rheumatism-heat arthralgia group>wind-cold-dampness arthralgia group>blood stasis arthralgia syndrome group>kidney deficiency group. Conclusion The syndrome of kidney deficiency and blood stasis in traditional Chinese medicine is related to knee osteoarthritis, which can provide a basis for clinical application of traditional Chinese medicine method of invigorating the kidney and promoting blood circulation.