| ObjectiveThis study through the collection and observation of Knee Osteoarthritisi(KOA) in patients with four clinical syndrome of TCM, to explore the TCM syndrome type of knee osteoarthritis and clinical distribution characteristics, in order to provide theoretical guidance for the clinical treatment.MethodsFrom January2013to March2014, collected total of418cases of patients who meet the criteria from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, affiliated Orthopedic Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital and Zhongshan Hospital of knee osteoarthritis patients and outpatient orthopedic ward. A collection of clinical data and the four diagnostic methods of TCM syndromes in patients with knee osteoarthritis by design information questionnaire, using doubledatabase alternate input method, using the method of descriptive statistics andfrequency distribution analysis of distribution of different clinical symptoms, by the cluster analysis and principal component analysis method, summed up the intrinsic link between related symptoms, summary the TCM syndrome type corresponding and to discuss its pathogenesis and distribution characteristics.Results418cases of KOA patients,141cases of male and female277cases, the ratio is about1:2, the minimum age of40years, the maximum age of78years, the overall average age was59.54±8.62. Through the Chinese medical syndromes cluster analysis and statistical description, combined with the practical application of the relevant clinical diagnostic criteria, concluded that knee osteoarthritis clinical syndromes are divided into five types is the most reasonable, such as the liver and kidney deficiency, the weakness of spleen and stomach, qi stagnation and blood stasis, sputum dampness resistance and wind cold wetness type, the syndromes of dispersion is relatively average and syndrome distribution is most clear. At the same time review418cases clinical investigation in patients with syndrome of liver and kidney deficiency was found, the most common type,164cases, accounting for39.2%; the weakness of spleen and stomach type in80cases, accounting for19.2%; Qi stagnation and blood stasis type in70cases, accounting for16.7%; wind cold dampness type in48cases, accounting for11.5%; sputum dampness resistance type in56cases, accounting for13.4%. Treatment based on syndrome differentiation the syndrome can be summarized as follows:(1) liver and kidney deficiency type:①the main symptoms:knee numbness weakness, low back and legs, knee pain, knee pain, nocturia, five upset hot, clear urine long, insomnia, dry mouth, dry stool, red tongue, moss and little or no, pulse number, pulse fine.②time card:knee pain according to hi, hectic fever night sweat, tongue thin, flushing, afternoon fever, thirst and polydipsia, dry eyes, back pain, dizziness, tinnitus, menopause, pulse Shen, irritability.(2) the weakness of spleen and stomach type:①the main symptoms:loss of appetite, chills like warm, pale, pale lips, Less gas lazy words, constipation, moss white, pulse.②time card:abdominal distension discomfort during the day, sweating, pale red tongue, pale tongue, pale tongue, pale mouth tender.(3)qi stagnation and blood stasis type:①the main symptoms:knee pain, pain reduction in the heat, sallow complexion, pale tongue, dark, rough pulse, pulse string.②time card:menstruation, red lips, thirsty and do not drink.(4) sputum dampness resistance:①the main symptoms:knee swelling, tongue edge teeth marks, head and body trapped heavy, greasy tongue coating, slippery pulse.②time card:Sweet greasy, severe knee pain, loose stools.(5) wind cold wetness type:①the main symptoms:knee pain and night light weight, knee pain, knee cold attack in rainy days increased pain, knee pain refused to press, moss thin, floating pulse.②time card:go on knee pain, knee pain, yellow moss, pulse tight, knee cold pain. ConclusionThe incidence of knee osteoarthritis is relate with age, gender and obesity, and the factors affecting the characteristic. By cluster analysis of the four diagnostic methods of TCM syndrome that the knee osteoarthritis syndrome were divided into five types is the most reasonable, such as the deficiency of the liver and kidney, qi stagnation and blood stasis type, wind cold wetness type, sputum dampness resistance and weakness of spleen and stomach. So we can infer that its deficiency in origin and excess in superficialitymainly.The kidney, liver and spleen is the main pathogenesis basis, qi stagnation, blood stasis and phlegm is an important link in the development of the disease in pathology. wind, cold and dampness as the common pathogenic factors. |
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