基于红外热成像的膝骨关节炎不同中医证候热力学分布特征研究

Infrared thermography based study on thermodynamic distribution of different traditional Chinese medicine syndromes of knee osteoarthritis

目的对膝骨关节炎患者体表各区域不同热力学分布特征和中医证候的相关性进行研究,为膝骨关节炎的中医证候诊断提供新的客观方法。方法将患者辨证后分为风寒湿痹证组、风湿热痹证组、瘀血闭阻证组,每组20例;另选20名健康平和体质志愿者作为对照组。通过采集各入选对象的各脏腑投影区域的红外热像图及温度,比较各观察组与对照组间的温度和热凉偏离的差异。结果(1)风寒湿痹组在胃脘、左腰、右腰的体表温度与对照组比较,差异有统计学意义(P<0.05),明显更低,出现凉偏离;风湿热痹组在小腹、左少腹、右少腹的体表温度与对照组比较,差异有统计学意义(P<0.05),明显更高,出现热偏离;瘀血闭阻组在虚里、左肋、右肋的体表温度与对照组比较,差异有统计学意义(P<0.05),虚里明显更低、出现凉偏离,左肋、右肋明显更高、出现热偏离。(2)从温度变化的高低定性分析,与风湿热痹组比较,风寒湿痹组胃脘、大腹、左少腹、右少腹、左腰、右腰的温度明显更低;与瘀血痹阻组比较,风寒湿痹组虚里温度明显更高,左肋、右肋、胃脘、左腰、右腰温度明显更低;与瘀血痹阻组比较,风湿热痹组虚里、小腹、左少腹、右少腹温度明显更高,左肋、右肋温度明显更低。结论与健康平和质人群比较,风寒湿痹证、风湿热痹证、瘀血闭阻证的膝骨关节炎患者的热力学特征具有明显差异,可以通过红外热成像做出客观化评估诊断,该技术可为膝骨关节炎的中医证候客观化诊断提供新的方法与参考。

Objective The correlation between different thermodynamic distribution characteristics in various regions of the body surface of patients and traditional Chinese medicine(TCM)syndromes of knee osteoarthritis was investigated to provide an innovative and objective method for the diagnosis of TCM syndromes of knee osteoarthritis.Methods Patients were divided into wind-cold-damp Bi syndrome group,wind-damp-heat Bi syndrome group and static blood blockage syndrome group after syndrome differentiation,with 20 cases in each group.Another 20 healthy volunteers were selected as the control group.By collecting the infrared thermograms and temperatures of each organ's projection area of enrolled subjects,the differences in temperature and heat-cool deviation between the observation groups and the control group were compared.Results①Compared with the condition in the control group,the body surface temperatures of the stomach and epigastrium,left lower back and right lower back were significantly lower with a cool deviation in the wind-cold-damp Bi syndrome group,and the differences were statistically significant(P<0.05);The body surface temperatures of the lower abdomen,left and right lateral lower abdomen were significantly higher with a heat deviation in the wind-damp-heat Bi syndrome group,and the differences were statistically significant(P<0.05);The body surface temperature of Xuli(apex of heart)was significantly lower with a cool deviation,and the body surface temperatures of the left hypochondrium and right hypochondrium were significantly higher with a heat deviation,and the differences were statistically significant differences(P<0.05).②Based on qualitative analysis of the temperature changes,the body surface temperatures of the stomach and epigastrium,upper abdomen,left lower abdomen,right lower abdomen,left lower back and right lower back in the wind-cold-damp Bi syndrome group were significantly lower than those in the wind-damp-heat Bi syndrome group;the body surface temperature of Xuli in the wind-cold-damp Bi syndrome group was significantly higher than that in the static blood blockage syndrome group and the body surface temperatures of the left hypochondrium,right hypochondrium,stomach and epigastrium,left lower back and right lower back were significantly lower than those in the static blood blockage syndrome group;Compared with the condition in the static blood blockage syndrome group,the body surface temperatures of Xuli,the lower abdomen,left lateral lower abdomen and right lateral lower abdomen were significantly higher while the body surface temperature of the left hypochondrium and right hypochondrium were significantly lower in the wind-damp-heat Bi syndrome group.Conclusion Compared with those of healthy people,the thermodynamic characteristics of knee osteoarthritis patients with wind-cold-damp Bi syndrome,wind-damp-heat Bi syndrome,and static blood blockage syndrome are significantly different and these differences can be objectively assessed by infrared thermography,which can provide an innovative method and reference for objectified diagnosis of TCM syndromes of knee osteoarthritis.