重庆地区膝骨关节炎中医证候分布规律

Distribution Law of TCM Syndromes of Knee Osteoarthritis in Chongqing Area

目的分析重庆地区膝骨关节炎的中医证候分布规律和辨证核心因子。方法制定膝骨关节炎流调表,以义诊的方式调查重庆10个区县的膝骨关节炎患者,采用问卷星建立数据库、SPSS 23.0软件进行统计分析,运用Logistic逐步回归分析提取辨证核心因子,归纳总结中医证候分布规律。结果共收集835例膝骨关节炎患者临床资料,证候分布以肝肾亏虚为主(692例,82.87%),依次为寒湿痹阻证(83例,9.94%)、痰瘀痹阻证(25例,3%)、湿热蕴结证(19例,2.28%)、其他证(16例,1.91%)。肝肾亏虚证中夹寒湿(522例,62.52%)、夹湿热(38例,4.55%)、夹血瘀(27例,3.23%)、偏阴虚(49例,5.87%)、无兼夹证(56例,6.70%)。肝肾亏虚证以腰膝酸软、头晕眼花为辨证核心因子,夹寒湿证以关节冷痛、喜温喜按,夹湿热证以关节灼痛、口干口苦,夹血瘀证以关节刺痛、肢体麻木,偏阴虚证以五心烦热、潮热盗汗为辨证核心因子。寒湿痹阻证以关节冷痛、喜温喜按为辨证核心因子,血瘀证、湿热蕴结证分别以关节刺痛,口干口苦为辨证核心因子。结论肝肾亏虚是重庆地区膝骨关节炎最常见证候,依次为寒湿痹阻证、痰瘀痹阻证、湿热蕴结证、其他证。以腰膝酸软、头晕眼花、关节冷痛、喜温喜按、关节灼痛、口干口苦、关节刺痛、肢体麻木、潮热盗汗为辨证核心因子。

Objective To analyze the distribution of TCM syndromes and core factors of syndrome differentiation of knee osteoarthritis in Chongqing area.Methods It formulated a flow chart for knee osteoarthritis,investigated knee osteoarthritis patients in 10 districts and counties in Chongqing by means of free diagnosis and used questionnaire star to establish a database.SPSS23.0 software was used for statistical analysis.Logistic stepwise regression analysis was used to extract the core factors of syndrome differentiation,and the distribution rules of TCM syndromes were summarized.Results:A total of 835 patients with knee osteoarthritis were collected.The distribution of syndromes was mainly liver and kidney deficiency(692 cases,82.87%),followed by cold-damp Bi syndrome(83 cases,9.94%),blood stasis syndrome(25 cases,3%),damp-heat accumulation syndrome(19 cases,2.28%),other syndromes(16 cases,1.91%).In the syndrome of liver and kidney deficiency,there was colddamp(522 cases,62.52%),damp-heat(38 cases,4.55%),blood stasis(27 cases,3.23%),partial Yin deficiency(49 cases,5.87%),no complicated sydnrome(56 cases,6.70%).The core factors liver and kidney deficiency syndrome included soreness of waist and knees and dizziness.The syndrome of cold-damp is characterized by joint cold and pain,having a desire for pressure and warmth,and the syndrome of damp-heat was characterized by joint burning,dry mouth and bitter mouth.Tingling,numbness of the limbs,and the core factors of partial Yin deficiency syndrome were dysphoria in chestpalms-soles,hot flushes and night sweats.The cold-damp Bi syndrome is based on joint cold pain and having a desire for pressure and warmth as the core factors of syndrome differentiation.Blood stasis syndrome and damp-heat accumulation syndrome used joint tingling,dry mouth and bitter mouth as the core factors of syndrome differentiation.Conclusion Deficiency of liver and kidney is the most common syndrome of knee osteoarthritis in Chongqing,followed by cold-damp syndrome,blood stasis syndrome,damp-heat accumulation syndrome and other syndromes.Weakness of waist and knees,dizziness,cold joints,having a desire for pressure and warmth,joint burning,dry mouth,joint tingling,numbness,hot flashes and night sweats are the core factors of syndrome differentiation.