膝骨关节炎发病及临床症状发展与中医体质类型相关性分析

Analysis of the Correlation between the Development of Osteoarthritis of the Knee and Clinical Symptoms and the Type of TCM Constitution

目的:探讨分析膝骨关节炎(KOA)的发病及临床症状发展与中医体质类型之间的相关性。方法:选取2020年5月至2022年12月收治的150例膝骨关节炎患者作为观察组,同时期收治的50例非膝骨关节炎患者作为对照组。分析两组患者中医体质类型分布情况,并应用二元Logistic回归分析膝骨关节炎发病与中医体质类型之间的相关性。将200例根据膝骨关节炎临床症状严重程度(WOMAC评分)进行亚组分析,并应用Spearman相关性分析膝骨关节炎临床症状发展与中医体质类型之间的相关性。结果:两组患者一般资料比较,差异无统计学意义(P>0.05),具有可比性。两组患者中医体质类型分布上,观察组占比前三位的为痰湿质(33.34%)>血瘀质(24.00%)>阳虚质(20.67%),对照组占比前三位的为平和质(36%)>气虚质(24%)>痰湿质(12%)。膝骨关节炎发生与中医体质类型二元Logistic回归分析结果提示:膝骨关节炎发生与阳虚质、痰湿质、血瘀质正相关(P<0.05),与平和质、气虚质负相关(P<0.05),与其余各项指标无相关性(P>0.05)。膝骨关节炎临床症状严重程度不同的四组患者中医体质类型分布上,无占比前三位的为平和质(36%)>气虚质(24%)>痰湿质(12%),轻度占比前三位的为阳虚质(28%)>痰湿质(18%)>平和质(16%),中度占比前三位的为痰湿质(34%)>血瘀质(24%)>阳虚质(24%),重度占比前三位的为痰湿质(48%)>血瘀质(36%)>阳虚质(10%)。膝骨关节炎发展与中医体质类型Spearman相关性分析结果提示:膝骨关节炎发展与痰湿质、血瘀质正相关(P<0.05),与平和质、气虚质、阳虚质均负相关(P<0.05),与其余各项指标无相关性(P>0.05)。结论:膝骨关节炎发病及临床症状发展与中医体质类型之间存在相关性,痰湿质和血瘀质人群更易患膝骨关节炎,且临床症状更重;平和质人群不易患膝骨关节炎,即使患膝骨关节炎,其临床症状也较偏颇体质轻。

Objective:To explore and analyse the correlation between the onset and clinical symptom development of knee osteoarthritis(KOA)and the traditional Chinese medicine(TCM)body type.Methods:150 cases of KOA patients from May 2020 to December 2022 were selected as the observation group,and 50 non-KOA patients admitted during the same period as the control group.The distribution of TCM body type in the two groups was analyzed,and the correlation between the onset of KOA and TCM body type was analyzed by applying binary logistic regression.The 200 patients were subgrouped according to the severity of KOA clinical symptoms(WOMAC score)and Spearman correlation was applied to analyse the correlation between the development of KOA clinical symptoms and TCM body type.Results:There was no statistical difference between the two groups in terms of general information(P>0.05).In terms of the distribution of TCM constitution types between the two groups,the top three groups in the observation group were Phlegm-Damp(33.34%)>Blood Stasis(24.00%)>Yang deficiency(20.67%).In the control group,the top three groups were Pinghe(36%)>Qi deficiency(24%)>Phlegm-Damp(12%).Binary logistic regression analysis of the occurrence of KOA and TCM body type suggested that the occurrence of KOA was positively correlated with Yang deficiency,Phlegm-Damp and Blood Stasis(P<0.05),negatively correlated with Pinghe and Qi deficiency(P<0.05),and the remaining indicators were not correlated(P>0.05).The distribution of TCM constitution types among the four groups of patients with different severity of KOA clinical symptoms showed that the top three groups of patients with no clinical symptoms were Pinghe(36%)>Qixu(24%)>Phlegm-Damp(12%).The top three groups of patients with mild clinical symptoms were Yangxu(28%)>Phlegm-Damp(18%)>Pinghe(16%).The top three groups of patients with moderate clinical symptoms were Phlegm-Damp(34%)>Blood Stasis(24%)>Yangxu(24%).The top three percentages of severe were Phlegm-Damp(48%)>Blood Stasis(36%)>Yang deficiency(10%).Spearman's correlation analysis between KOA development and TCM body type suggested that KOA development was positively correlated with Phlegm-Damp and Blood Stasis(P<0.05),Pinghe,Qi-vacant and Yang-vacant were negatively correlated(P<0.05),and the remaining indicators were not correlated(P>0.05).Conclusion:There is a correlation between the occurrence and development of KOA and the type of TCM constitution.People with Phlegm-Damp and Blood-Stasis constitutions are more likely to suffer from KOA and have more severe clinical symptoms.People with calm and harmonious constitutions are less likely to suffer from KOA,and even if they do suffer from KOA their clinical symptoms are less severe than those of biased constitutions.