Research Of The Traditional Chinese Medicine Syndrome Essence Of Osteoarthristis Of Lumbar Vertebrae (OLV) And The Relativity Of OLV And The Incidence Of Osteoporosis Ⅰ

[Objective]1.To sum up and conclude the main traditional chinese medical(TCM) syndrome of osteoarthritis(OA) of lumbar vertebrae2.To analyze and explore the TCM syndrome essence of osteoarthritis of lumbar vertebrae3.To analyze and explore the correlation between Osteoarthritis of Lumbar Vertebrae and osteoporosis I.[Methods]1.The epidemiology research method was used to carry on questionnaire inquiry to 88 patients with osteoarthritis of lumbar vertebrae.The traditional Chinese medicine syndrome types were confirmed by the collected TCM syndrome and diagnostic criterion. Then screen the main TCM syndrome types with hierarchial cluster analysis method. Meanwhile,the TCM syndrome types were diagnosed by TCM syndrome diagnostic criterion.The two kinds of methods were used associatively to analyze the main TCM syndrome types of osteoarthritis of lumbar vertebrae.2.To exam the level of gonadal hormone and the change of hemorheology of the 88 patients with osteoarthritis of lumbar vertebrae and 80 normal cases.At the same time,the level of gonadal hormone and the change of hemorheology of 20 rats with osteoarthritis of lumbar vertebrae were observed to explore the TCM pathologic hypostasis of it.3.the morphology,bone mineral density(BMD),Osteoarthritis degree,clinical symptom and so on of 323 patients with osteoarthritis of lumbar vertebrae and 138 patients with osteoporosis I were recorded by questionnaire inquiry method.The correlations of the coincidence of this disease,clinical symptom and BMD,clinical symptom and Osteoarthritis degree,BMD and Osteoarthritis degree with correlation analysis method.4.the animal model with osteoarthritis of lumbar vertebrae or osteoporosis I were set by lamvar Cast immobilization method and Ovariectomising method respectively.The changes of histomorphology,the influence of BMD of upper femur and the apoptosis of cartilage were analyzed to conclude the intrinsic correlation between them.[Results]1.There were 9 kinds of syndrome factors in the research of 88 cases with osteoarthritis of lumbar vertebrae,such as deficiency of kidney yang,deficiency of kidney yin,blood stasis,cold- dampness,phlegm,blood deficiency,deficiency of liver yin,spleen deficiency and dampness- heat,in which the appear frequencies of deficiency of kidney yang,deficiency of kidney yin,blood stasis and cold- dampness were much higher. deficiency of kidney yang,deficiency of kidney yin,blood stasis and cold- dampness were the 1st kind of syndrome types(r_1.2=0.793;r_3.9=0.374;P＜0.01);phlegm,blood deficiency,deficiency of liver yin,spleen deficiency and dampness- heat belonged to the 2nd kind of syndrome types.The correlation quotiety of the 1st kind was remarkably higher than that of 2nd kind.The differentiation factors of 1st kind were the chief parts.By the TCM syndrome diagnosis,the diagnostic rate of the syndrome of blood stasis due to kidney deficiency was the highest(60.23%).The results indicates that the level of estrogen in the female patients was obviously lower than that of normal group(P＜0.01), while that of Serum testosterone had no remarkable difference(P＞0.05).the level of androgenin the male patients was obviously lower than that of normal group(P＜0.05).the result in rats was as the same as that in clinic.2.(1) In 323 cases with Osteoarthritis of Lumbar Vertebrae,it is detected that:①The absolute frequency ratio of the patients with OA of lumbar vertebrae simplex and the patients with OA of lumbar vertebrae with osteoporosis I combined was 1:3.75.And the ratio of incidence of osteoporosis I in patients with OA was 78.95%.②In morphology,there was obvious difference between the patients with OA of lumbar vertebrae simplex and the patients with OA of lumbar vertebrae with osteoporosis I combined(p＜0.01);③In integral analysis of pain,the integral of the patients with OA of lumbar vertebrae simplex was lower than that of the patients with OA of lumbar vertebrae with osteoporosis I combined,even low back pain or leg radialized pain.④The X ray integral of the patients with OA of lumbar vertebrae with osteoporosis I combined was remarkable higher than that of the patients with OA of lumbar vertebrae simplex(P＜0.01),and the X ray integral had the linear correlation with BMD(r_1.2=0.006; r_3.9=-0.001;P＜0.01).⑤There was a decreasing trend of bones density in the patients with OA of lumbar vertebrae simplex;the averages of bones density of the two groups were lower than that of homoage-persons.⑥The levels of estradiol of the two groups had no obvious difference(P＞0.05).(2) In 138 cases with osteoporosis I,it is detected that:①The absolute frequency ratio of the patients with osteoporosis I simplex and the patients with osteoporosis I with OA combined was 1:14.34.And the ratio of incidence of OA of lumbar vertebrae in patients with osteoporosis I was 93.48%.②In the aspects of age,weight,body mass index(BMI) and stature,there was no difference between the patients with osteoporosis I simplex and the patients with osteoporosis I with OA combined(p＞0.05);③In the level and integral of BMD,there was no obvious difference between the patients with osteoporosis I simplex and the patients with osteoporosis I with OA combined(p＞0.05);④In integral analysis of pain,the integral of the patients with OA of lumbar vertebrae simplex was lower than that of the patients with OA of lumbar vertebrae with osteoporosis I combined,even low back pain or leg radialized pain(P＜0.01).⑤There was no linear correlation between clinical symptom and OA degree(r=0.061;r=0.000;P＞0.05);while there was linear correlation between clinical symptom and BMD(r=0.799;r=0.853;P＜0.01).The increasing of BMD made the clinical symptom become worse.⑥In the level of estradiol,there was no remarkable difference between the patients with osteoporosis I simplex and the patients with osteoporosis I with OA combined(p＞0.05).3.In the histomorphology integral,the level of BMD and the apoptosis of cartilage,there was no obvious difference between the patients with osteoporosis I simplex and the patients with osteoporosis I with OA combined(p＞0.05);while compared with the normal group,there was remarkable difference(P＜0.01).[Conclusion]1.①The main TCM syndrome type of osteoarthritis of lumbar vertebrae was the syndrome of blood stasis due to kidney deficiency,and its pathologic hypostasis materialized on the shortage of gonadal hormone.②The syndrome of blood stasis of osteoarthritis of lumbar vertebrae exist objectively.2.The relation of OA of lumbar vertebrae and osteoporosis I is materialized on co-existence of high rate of incidence;osteoporosis can affect the change of morphology; The clinical symptoms can interact with each other;BMD can affect both of pathological status and clinical symptoms;There is no contradiction restriction between bone matrix hyperplasia and osteoporosis.3.The pathologic changes of OA of lumbar vertebrae and osteoporosis I is complex,but still there are some similitudes.