| Purposes:KOA combined with sarcopenia has a high incidence and poor prognosis,which is a chronic complex disease,and modern medicine currently has insufficient understanding of this disease,and has not proposed some effective treatment methods.The use of Chinese medicine theory to understand and treat this disease has unique advantages and characteristics.In this study,by collecting personal general information and four diagnosis information of patients with knee osteoarthritis(KOA)and sarcopenia,this study summarized and sorted out the distribution of factors in patients with knee osteoarthritis and sarcopenia,and discussed the distribution characteristics of TCM evidence and TCM symptom type,in order to provide new ideas for the dialectical treatment of this disease in TCM,and also lay a solid foundation for the construction of KOA combined with sarcopenia in the future.Material and methods:From June 2021 to December 2022,107 patients who were treated in the Department of Orthopedics of the Affiliated Hospital of Liaoning University of Chinese Medicine and met the diagnostic criteria were selected,the general information and TCM evidence information of patients with KOA combined with sarcopenia were collected,and the position and pathogenic factors of patients with KOA combined with sarcopenia were obtained according to the dialectical diagnosis method of factor,and the distribution characteristics of TCM certificates and TCM symptom types were studied.Results:1.Among the 107 KOA patients with sarcopenia,there were 37 males,accounting for34.5%,and 70 females,accounting for 65.5%.In the age distribution,there were more patients aged 61-70,accounting for 48.5%,followed by those aged 71-80 Patients accounted for 30.8%,and the proportion of patients aged 51 to 60 was only 20.7%.There were 15 patients with BMI<18.5kg/m2,accounting for 14.1%,and the number of patients with 18.5≤BMI<24 There are 71 people,accounting for 66.3%.There were21 patients with BMI ≥ 24,accounting for 19.6%;12.1% had X-ray grades 0-Ⅰ,79.4%had grades Ⅱ-Ⅲ,and 8.5% had grade Ⅳ;patients with a disease course of 10-20 years The most,there were 56 cases,accounting for 52.3%,32 patients with a disease course of 21 to 30 years,accounting for 30.0%,and 19 patients with a disease course of less than 10 years,accounting for 17.7%.2.A total of 21 TCM syndrome elements were extracted,including 7 disease location syndrome elements and 14 disease nature syndrome elements.Disease location and syndrome elements are ranked from high to low as kidney(70.6%),muscles and bones(67.7%),muscle(39.9%),liver(33.2%),spleen(16.3%),heart(11.6%),meridian(9.1%);disease-related syndrome elements ranked from high to low were Yin deficiency(81.6%),Yang deficiency(77.9%),Qi deficiency(70.3%),Qi stagnation(67.5%),blood stasis(59.6%)%),cold(56.2%),blood deficiency(43.5%),dampness(35.2%),phlegm(32.1%),fire(26.3%),essence deficiency(25.2%),qi deficiency(17.2%),dryness(10.6%),bleeding(7.3%).3.In the combination of disease location and syndrome elements,in the combination of two disease locations,the combination of kidney,muscle and bone is the most,accounting for 53.2% in 57 cases;in the combination of three disease locations,the combination of kidney,muscle,bone and liver is the most,with 39 cases,accounting for 36.4%;Among the combination of disease locations,the combination of kidney,muscle,bone,liver and spleen accounted for the most,with 23 cases,accounting for21.5%.4.In the combination of disease-related syndrome elements,the highest proportion of yang deficiency and yin deficiency in the combination of dual disease syndrome elements was 75 cases,accounting for 68.8%;in the combination of three disease syndrome elements,there were 61 cases of yin deficiency,yang deficiency and qi deficiency,accounting for The highest was 57.0%;in the combination of syndrome elements of four diseases,the highest proportion was 51 cases of deficiency of yin and yang,accounting for 47.6%;66 cases of combinations of syndromes of five diseases and above,accounting for 61.6%.5.In terms of the grades of disease syndrome elements and the distribution of deficiency and excess,among the disease syndrome elements of grade I,deficiency syndrome elements appear 9 times(accounting for 9.0%),and excess syndrome elements appear 3 times(accounting for 3.0%);Among the sexual syndrome elements,deficiency syndrome elements appeared 11 times(accounting for 11.2%),and excess syndrome elements appeared 5 times(accounting for 5.1%);among grade III disease syndrome elements,deficiency syndrome elements appeared 59 times(accounting for59.5%)),the excess syndrome elements appeared 12 times(accounting for 12.2%);the proportions of deficiency syndrome and excess syndrome in the grade of disease syndrome elements were 79.7% and 20.3%.Deficiency syndrome elements were significantly more than excess syndrome elements,and the difference was statistically significant(P<0.05).The disease syndrome elements of patients with KOA complicated with sarcopenia were mainly deficiency and excess syndrome.And it is mostly manifested as "coexistence of fiction and reality".6.The common TCM syndrome types of patients with KOA complicated with sarcopenia are liver and kidney deficiency syndrome,spleen and stomach weakness syndrome,kidney yang deficiency syndrome,spleen and kidney yang deficiency syndrome,and yin deficiency syndrome.Conclusion:1.The disease position of patients with KOA combined with sarcopenia mainly involves the spleen,kidney,liver and meridians,and the disease is mainly virtual and real inclusion,the deficiency is mainly qi deficiency and yang deficiency,and the solid nature is mainly phlegm,drinking and wetness.2.The longer the course of the disease,the more vulnerable and kidney and meridians,the higher the frequency of qi deficiency,blood deficiency,wetness,phlegm symptoms,the course of KOA combined with sarcopenia is the main influencing factor of kidney,meridian,wet position and disease evidence.3.The distribution of kidneys and meridians in different course and age groups,spleen and meridians in different functional severity can be seen that there is a gradual deepening process of the disease,which is consistent with the view of "long-term illness into the network",and the lesion process can be summarized as internal organs-meridians-musculoskeletal.4.The most common types of TCM certificates are liver and kidney deficiency,spleen and stomach weakness,kidney yang deficiency,spleen and kidney yang deficiency,and yin deficiency.5.This study is of great significance for enriching and improving the TCM evidence differentiation system of KOA complicated with sarcopenia,and also provides a basis for the standardized research and clinical diagnosis and treatment of the symptom type of KOA combined with sarcopenia. |
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