中国骨伤2023，Vol.36Issue(12)：1130-1135,6.DOI:10.12200/j.issn.1003-0034.2023.12.005
基于膝骨关节炎患者中医体质分层探讨风寒湿外部因素对临床症状的影响特点
Influence of wind,cold and dampness on clinical manifestation of knee osteoarthritis patients based on the stratifica-tions of traditional Chinese medicine constitution
摘要
Abstract
Objective To explore influence of external factors of wind,cold and dampness on clinical symptoms in knee osteoarthritis(KOA)patients with different constitutions of traditional Chinese medicine.Methods A cross-sectional stratified study was performed to select 108 patients with Grade Ⅱ KOA in Kellgren & Lawrence(K-L)classification,including 22 males and 86 females,aged from 47 to 75 years old with an average of(60.7±6.0)years old;body mass index(BMI)ranged from 17.87 to 31.22 kg·m-2 with an average of(23.80±2.86)kg·m-2.According to Classification and Judgment of TCM Physique(ZYYXH/T157-2009),the types of TCM physique were determined and divided into 4 layers according to the deficiency and actual physique.Among them,there were 24 patients without biased physique,12 males and 12 females,aged from 51 to 73 years old with an average of(62.8±6.0)years old,BMI ranged from 17.87 to 31.14 kg·m-2 with an average of(24.32±3.25)kg·m-2;there were 46 patients with virtual bias constitution,including 7 males and 39 females,aged from 47 to 70 years old with an average of(60.0±5.8)years old,BMI ranged from 19.38 to 31.22 kg·m-2 with an average of(23.42±2.97)kg·m-2;There were 26 patients with solid bias constitution,including 2 males and 24 females,aged from 48 to 75 years old with an av-erage of(60.4±5.8)years old,BMI ranged from 21.16 to 30.76 kg·m-2 with an average of(24.15±2.33)kg·m-2;there were 9 patients with special constitution,1 male and 8 female,aged from 53 to 75 years old with an average of(59.8±7.5)years old,BMI ranged from 19.26 to 26.67 kg·m-2 with an average of(23.79±2.49)kg·m-2.Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)was used to evaluate severity of clinical symptoms.The wind-cold-dampness external factor score was calculated through the questionnaire of wind-cold-dampness syndrome scale to evaluate degree of influence of wind-cold-dampness external factor.Pearson correlation analysis and partial correlation analysis were used to calculate the correla-tion coefficient between severity of external factors affecting wind,cold and dampness and severity of clinical symptoms in pa-tients with different TCM constitution stratification.Results There was no statistical significance between total score of wind-cold-dampness and WOMAC score in patients with no biased constitution and special condition.Total wind-cold-dampness score of patients with virtual biased constitution was positively correlated with WOMAC stiffness score(r=0.327,P=0.032),and total wind-cold-dampness score of patients with solid biased constitution was positively correlated with WOMAC pain score(r=0.561,P=0.005)and WOMAC overall score(r=0.446,P=0.033).After further adjusting for the interaction of external fac-tors of wind-cold-dampness,there was no statistical significance between wind-cold-dampness scores and WOMAC scores in patients with solid biased constitution.The score of dampness and pathogenic factors was positively correlated with WOMAC stiffness score(r=0.414,P=0.007).Conclusion The external factors of wind-cold dampness have different effects on the clini-cal symptoms of KOA patients with different TCM constitutions.Compared with other constitutions,the rigid symptoms of pa-tients with asthenic biased constitutions are more susceptible to dampness pathogenic factors.关键词
膝骨关节炎/中医体质/风/寒/湿Key words
Knee osteoarthritis/Traditional Chinese Medicine constitution/Wind/Cold/Dampness分类
医药卫生引用本文复制引用
谭则成,蒋鼎,徐勤光,王林,王学宗,陈博,庞坚,詹红生,曹月龙..基于膝骨关节炎患者中医体质分层探讨风寒湿外部因素对临床症状的影响特点[J].中国骨伤,2023,36(12):1130-1135,6.基金项目
国家自然科学基金项目(编号:81973874,81373665) （编号:81973874,81373665）
上海市慢性筋骨病临床医学研究中心(编号:20MC1920600)National Natural Science Foundation of China(No.81973874,81373665) （编号:20MC1920600）
