股骨头坏死髋周经筋辨证分型规律的临床研究

Clinical study on differentiation and classification in osteonecrosis of the femoral head around hip meridian

[目的]分析股骨头坏死患者髋周经筋辨证分型的规律,初步形成股骨头坏死的经筋辨证体系,为其经筋疗法提供理论依据。[方法]对190例股骨头坏死患者循髋周足六经筋进行触诊,统计各结筋病灶点出现的频次以及所属的经筋,分析各经筋证型的分布特征。[结果]190例患者(双侧患病169例,单侧患病21例),总计359髋,其中27髋因结筋病灶点不明显(占7.52%)无法判定经筋证型;332髋存在数量不等的结筋病灶点(占92.48%)。单一经筋证型(47.08%)与复合经筋证型(45.40%)的出现频率基本相当。最常见的单一经筋证型为足阳明经筋型(16.99%),其次依次为足三阴经筋型(15.04%)、足太阳经筋型(8.64%)和足少阳经筋型(6.41%)。在两经筋复合证型中,足阳明经筋的总出现率为21.45%,足三阴经筋的总出现率为20.34%,足太阳经筋的总出现率为17.55%,足少阳经筋的总出现率为15.88%。少见3经筋以上的复合证型(5.29%)。[结论]股骨头坏死患者髋周经筋病变存在多种证型,该证型分布有着明显规律,该规律与髋周经筋的生理功能密切相关,对临床运用经筋理论指导股骨头坏死的保髋治疗具有重要意义。

[Objective]To analyze the regularity of syndrome differentiation and classification of femoral head necrosis patients around the hip,and initially form the meridian tendon syndrome differentiation system of femoral head necrosis,so as to provide theoretical basis for the treatment of this disease.[Methods]The 190 cases of osteonecrosis of the femoral head were palpated along the six meridians of the foot around the hip.The frequency of the lesions and the corresponding meridians were counted,and the distribution characteristics of the syndrome types were analyzed.[Results]There were 190 patients(169 bilateral and 21 unilateral)with a total of 359 hips,27 hips were not obvious(7.52%)and could not determine the type of tendon syndrome,332 hips had different number of tendon lesions(92.48%).The frequency of single meridian pattern(47.08%)was similar to that of compound meridian pattern(45.40%).The most common single meridian tendon syndrome types were foot yangming meridian tendon type(16.99%)and foot three yin meridian tendon type(15.04%),followed by foot taiyang meridian tendon type(8.64%)and foot shaoyang meridian tendon type(6.41%).In the compound syndrome of two meridians and tendons,the total occurrence rate of tendons of foot yangming,foot three yin,foot taiyang and foot shaoyang was 21.45%,20.34%,17.55%and 15.88%,respectively.There were few complex syndrome types(5.29%).[Conclusion]There were many types of syndrome in patients with osteonecrosis of the femoral head,and the distribution of the syndrome types had obvious regularity,which was closely related to the physiological function of the tendons around the hip,which was of great significance for the clinical application of the theory of tendon in the treatment of femoral head necrosis.