摘要
目的:探讨膝骨关节炎(knee osteoarthritis,KOA)风寒湿痹证素评分与膝骨关节炎病情严重程度的关系。方法:从课题组前期风寒湿痹证队列研究中筛选患者,从病例资料中提取患者的性别、年龄、体质量指数、中医证候、西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)评分和膝骨关节炎全器官磁共振成像评分(whole-organ magnetic resonance imaging score,WORMS)。拟定包含25个证候条目的KOA风寒湿痹证素评分量表,并对入选患者进行证素评分。分析KOA风寒湿痹证素评分与WOMAC评分、WORMS的关系。结果:①一般情况。共纳入102例KOA患者,男22例、女80例;年龄47~73岁,中位数61岁;体质量指数17.87~31.14 kg·m^(-2),中位数23.43 kg·m^(-2);KOA风寒湿痹证素评分0~21分,中位数7分;WOMAC评分0~159.4分,中位数39.7分;WORMS 6~60分,中位数18.75分。②相关性分析结果。KOA风寒湿痹证素评分与WOMAC评分、WORMS均呈正相关(r=0.495,P=0.000;r=0.243,P=0.014);排除年龄、性别、体质量指数的影响后,KOA风寒湿痹证素评分与WOMAC评分呈正相关(r=0.419,P=0.000),与WORMS不存在相关性(r=0.163,P=0.108)。③回归分析结果。KOA风寒湿痹证素评分≥12分对WOMAC评分、WORMS均具有正向影响(β=42.86,P=0.000;β=6.89,P=0.018);排除年龄、性别、体质量指数的影响后,KOA风寒湿痹证素评分≥12分对WOMAC评分具有正向影响(β=24.13,P=0.016),对WORMS无影响(β=4.87,P=0.120)。结论:KOA风寒湿痹证素评分与KOA的病情严重程度呈正相关,KOA风寒湿痹证素评分≥12分可提示KOA患者病情较重。
Objective:To explore the correlation between the syndrome element score of wind-cold-dampness arthralgia and the severity of knee osteoarthritis(KOA).Methods:The medical records of patients were selected from the previous cohort trial of wind-cold-dampness arthralgia conducted by research group;and the information about gender,age,body mass index(BMI),traditional Chinese medicine(TCM)syndrome,Western Ontario and McMaster Universities osteoarthritis index(WOMAC)score and whole-organ magnetic resonance imaging score(WORMS)was extracted from the medical records.A syndrome element scoring scale including 25 TCM syndrome entry of KOA wind-cold-dampness arthralgia was developed,and the syndrome elements of the included patients were scored.The correlations between KOA wind-cold-dampness arthralgia syndrome element score and WOMAC score as well as between KOA wind-cold-dampness arthralgia syndrome element score and WORMS were analyzed.Results:①One hundred and two KOA patients were included in the study,and they consisted of 22 males and 80 females and ranged in age from 47 to 73 years(Median=61 yrs),BMI from 17.87 to 31.14 kg/m(2)(Median=23.43 kg/m(2)),KOA wind-cold-dampness arthralgia syndrome element score from 0 to 21 points(Median=7 points),WOMAC score from 0 to 159.4 points(Median=39.7 points)and WORMS from 6 to 60 points(Median=18.75 points).②The results of correlation analysis revealed that the KOA wind-cold-dampness arthralgia syndrome element score was positively correlated with WOMAC score and WORMS respectively(r=0.495,P=0.000;r=0.243,P=0.014).After excluding the influences of age,gender and BMI,the KOA wind-cold-dampness arthralgia syndrome element score was positively correlated with WOMAC score(r=0.419,P=0.000)and had no correlation with WORMS(r=0.163,P=0.108).③The results of regression analysis showed that the KOA wind-cold-dampness arthralgia syndrome element score of≥12 points had a positive effect on both WOMAC score and WORMS(β=42.86,P=0.000;β=6.89,P=0.018).After excluding the influences of age,gender and BMI,the KOA wind-cold-dampness arthralgia syndrome element score of≥12 points had a positive effect on WOMAC score(β=24.13,P=0.016),but no effect on WORMS(β=4.87,P=0.120).Conclusion:The KOA wind-cold-dampness arthralgia syndrome element score is positively correlated with the severity of KOA,and the KOA wind-cold-dampness arthralgia syndrome element score of≥12 points may indicate a severe condition in KOA patients.
作者
王林
徐勤光
蒋鼎
谭则成
王学宗
申安平
陈博
庞坚
詹红生
曹月龙
WANG Lin;XU Qinguang;JIANG Ding;TAN Zecheng;WANG Xuezong;SHEN Anping;CHEN Bo;PANG Jian;ZHAN Hongsheng;CAO Yuelong(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《中医正骨》
2023年第9期8-11,共4页
The Journal of Traditional Chinese Orthopedics and Traumatology
基金
国家自然科学基金项目(81973874,81373665,82274553)
上海市2020年度“科技创新行动计划”医学创新研究专项项目(20MC1920600)。
关键词
骨关节炎
膝
痹证
风寒湿痹
证候
因素分析
统计学
osteoarthritis,knee
arthromyodynia
wind-cold-dampness arthralgia
syndrome complex
factor analysis,statistical
