【摘要】 【目的】探讨膝骨关节炎经筋辨证与骨髓水肿、骨赘分布的相关性,为骨髓水肿、骨赘分布作为膝骨关节炎经筋辨证提供临床依据。【方法】选取膝骨关节炎患者78例(共108膝),对膝骨关节炎进行经筋辨证,分析其分布规律及与膝骨关节炎骨髓水肿、骨赘分布情况的关系。【结果】(1)经筋病变与骨髓水肿关系:经筋分型与骨髓水肿分级有关(χ2=14.959,P<0.01);单经筋病与两经筋、多经筋合病的骨髓水肿程度有明显差异(P<0.05),两经筋合病与多经筋合病之间的骨髓水肿程度差异不明显(P>0.05);秩和检验结果显示:随着经筋合病程度的不断加重,骨髓水肿分级的平均秩次逐渐加大(单经筋病变级为48.42,两经筋合病级为59.74,三经筋合病级为82.42)。(2)经筋病变与骨赘分布情况:足阳明经筋病变在髌股区出现骨赘的阳性率为78.6%,足三阴经筋病变在膝内侧区出现骨赘的阳性率为61.3%,足太阳经筋病变在膝后侧区出现骨赘的阳性率为76.7%,足少阳经筋病变在膝外侧区出现骨赘的阳性率为64.3%。【结论】膝骨关节炎经筋辨证分型与骨髓水肿、骨赘分布存在相关性,随着经筋合病程度的加重,骨髓水肿程度也相应地加重;经筋病变分型影响膝关节骨赘分布情况。X线检查及MRI检查可为膝骨关节炎经筋辨证分型提供客观证据。更多还原

【Abstract】 Objective To explore the correlation of musculature differentiation of knee osteoarthritis( KOA)patients with edema in bone marrow and the distribution of osteophyma, which will supply evidence for the musculature differentiation of bone marrow edema and osteophyma. Methods The study involved 108 affected knee joints of 78 KOA patients. The KOA patients were differentiated according to the traditional Chinese medical theory of musculature, and the correlation of musculature types with the distribution of bone marrow edema and osteophyma was analyzed. Results(1) The results of chi-square test showed that musculature types were correlated with the grading of bone marrow edema( χ2=14.959, P <0.01). The results of multiple comparison showed that the grading of bone marrow edema in patients with single musculature symstem affection differed from that in patients with two musculature symstems affection and mutiple musculature symstems affection(P<0.05), but the grading of bone marrow edema in patients with two musculature symstems affection and mutiple musculature symstems affection was similar(P﹥0.05). The results of rank sum test showed that the grading of bone marrow edema increased with the increase of complexity of musculature affection, and the mean rank was 48.42 in patients with single musculature symstem affection, 59.74 in patients with two musculature symstems affection and 82.42 in three musculature symstems affection.( 2) The incidence of osteophyma was 78.6% in patella and femur region of patients with musculature affection of foot yangming-stomach meridian, 61.3% in knee medial side of patients with musculature affection of foot triple-yin meridians,76.7% in knee posterior side of patients with musculature affection of foot taiyang-bladder meridian, and 64.3%in knee lateral side of patients with musculature affection of foot shaoyang-gallbladder meridian. Conclusion The musculature differentiation in KOA patients is correlated with edema in bone marrow and the distribuion of osteophyma. With the increase of complexity of musculature affection, the grading of bone marrow edema increases, and the distribution of osteophyma varies in different types of musculature affection. The results of Xray photography and MRI can supply objective evidence for the musculature differentiation in KOA patients.更多还原