基于中医证型变化探究膝骨关节炎与肌骨超声表现的相关性分析

Study on the Correlation Between Knee Osteoarthritis and Muscle Bone Ultrasonic Performance Based on the Changes of TCM Syndrome Types

目的基于中医证型变化探究膝骨关节炎与肌骨超声表现的相关性。方法选取我院2019年1月至2021年1月收治的100例膝骨关节炎患者(130膝),根据中医辨证论治原理将其分为肝肾亏虚证组(32例,40膝)、湿热蕴结证组(30例,34膝)、气滞血瘀证组(18例,34膝)、风寒湿痹证组(20例,22膝)。比较各中医证型患者病情程度分级和各中医证型超声下滑膜增生、滑膜血流、关节腔积液、骨侵蚀范围。结果肝肾亏虚组、风寒湿痹组重度患者数量多于其余三组(P<0.05),湿热蕴结组重度患者多于气滞血瘀组(P<0.05),湿热蕴结组中度患者多于其余三组(P<0.05),气滞血瘀组轻度患者多于其余三组(P<0.05),其中湿热蕴结组中轻度患者多于肝肾亏虚组和风寒湿痹组(P<0.05);四种中医证型之间的滑膜增生程度、骨侵蚀范围差异无统计学意义(P>0.05);肝肾亏虚组Ⅲ级血流信号占比少于湿热蕴结组和风寒湿痹组,无血流信号和Ⅰ级血流信号占比高于湿热蕴结组和风寒湿痹组(P<0.05);肝肾亏虚组和风寒湿痹组无关节腔积液占比高于湿热蕴结组和气滞血瘀组(P<0.05),湿热蕴结组Ⅰ级积液占比高于肝肾亏虚组(P<0.05)。结论膝骨关节炎肌骨超声表现与中医辨证分型有关,肌骨超声可为膝骨关节炎的中医辨证论治提供参考依据。

Objective Study on the correlation between knee osteoarthritis and muscle bone ultrasonic performance based on the changes of TCM Syndrome Types.Methods 100 patients(130 knees)with knee osteoarthritis treated in our hospital from January 2019 to January 2021 were divided into liver and kidney deficiency syndrome group(32 cases,40 knees),dampness heat accumulation syndrome group(30 cases,34 knees),qi stagnation and blood stasis syndrome group(18 cases,34 knees),wind cold dampness syndrome group(20 cases,22 knees)according to the principle of syndrome differentiation and treatment of traditional Chinese medicine.The degree of illness of patients with different TCM Syndrome Types and the range of synovial hyperplasia,synovial blood flow,joint cavity effusion and bone erosion were compared.Result The number of severe patients in the liver kidney deficiency group and the wind cold dampness arthralgia group was more than the other three groups(P<0.05),the number of severe patients in the damp heat accumulation group was more than that in the qi stagnation and blood stasis group(P<0.05),the number of moderate patients in the damp heat accumulation group was more than that in the other three groups(P<0.05),and the number of mild patients in the qi stagnation and blood stasis group was more than that in the liver kidney deficiency group and the wind cold dampness arthralgia group(P<0.05);There was no significant difference in synovial hyperplasia and bone erosion between the four TCM syndrome types(P>0.05);The proportion of grade III blood flow signal in the liver kidney deficiency group was less than that in the damp heat accumulation group and the wind cold dampness arthralgia group,and the proportion of no blood flow signal and grade I blood flow signal was higher than that in the damp heat accumulation group and the wind cold dampness arthralgia group(P<0.05);The proportion of no joint cavity effusion in the liver kidney deficiency group and the wind cold dampness arthralgia group was higher than that in the damp heat accumulation group and the qi stagnation and blood stasis group(P<0.05),and the proportion of grade I effusion in the damp heat accumulation group was higher than that in the liver kidney deficiency group(P<0.05).Conclusion The ultrasonic manifestation of knee osteoarthritis muscle bone is related to the syndrome differentiation of traditional Chinese medicine.Muscle bone ultrasound can provide a reference basis for the syndrome differentiation and treatment of knee osteoarthritis.