【摘要】 目的了解骨质疏松症患者骨密度变化与中医定位辨证之间的相关性。方法观察湖南邵阳地区汉族人群原发性骨质疏松症464例,采用双能X线骨密度仪测定其骨密度,中医证候定位辨证标准判定其病位。结果同一患者可出现多个脏腑证候,主要脏腑定位:女性定位属肾脏178例(频率为62.68%),属肝57例(频率为20.07%);男性定位属肾脏117例(频率为65.00%),属肝35例(频率为19.44%),主要以肾为主,涉及肝、脾。组合脏腑定位主要在肝肾(195例)、脾肾(132例),经聚类分析,肾、肝肾、脾肾聚为1类。提示骨质疏松症的中医脏腑定位以肾为主,涉及肝、脾;骨质疏松症患者在同一部位不同脏腑间骨密度、骨矿盐水平比较,差异无统计学意义(P>0.05)。结论骨质疏松症的中医病位主要在肾,涉及肝、脾;但骨密度、骨矿盐水平的变化与脏腑定位之间没有明显相关性,中医辨证必须坚持中医思维方法。更多还原

【Abstract】 Objective To understand the correlation between bone density and localization differentiation in Chinese medicine in the patients with osteoporosis.Methods 464 cases of primary osteoporosis were observed among the people of Han nationality in Shaoyang,Hunan.Dual-functional X-ray bone density apparatus was used to measure bone density.The standard of pattern/syndrome localization differentiation in Chinese medicine was adopted to localize the disorder.Results The patterns/syndromes of multi-zangfu organs presented in the same patient.The main zangfu localization:for females,178 cases pertained to kidney disorder(62.68% in frequency)and 57 cases to liver disorder(20.07% in frequency);for males,117 cases pertained to kidney disorder(65.00% in frequency)and 35 cases to liver disorder(19.44% in frequency).Of the cases,the disease focused on kidney dysfunction,with the liver and spleen involved.The compound localization of zangfu included the liver plus kidney(195 cases)and the spleen plus kidney(132 cases).The cluster analysis indicated that the kidney,the liver plus kidney,as well as the spleen plus kidney were in the cluster No.1.It was suggested that osteoporosis was localized in the kidney chiefly,with the liver and spleen involved according to zangfu localization in Chinese medicine.There were no statistical significant differences in bone density and mineral among different zangfu organs in the same site for the patients with osteoporosis(P>0.05).Conclusion Osteoporosis is localized in the kidney,with the liver and spleen involved according to the theory of Chinese medicine.But,there are no obvious correlation of the changes in bone density and mineral with zangfu localization.Pattern/syndrome differentiation in Chinese medicine must insist on the thinking of Chinese medicine.更多还原