| Objective:To probe the characteristics of distribution of TCM Syndrome of knee osteoarthritis (KOA) and the affect of type 2 diabetes mellitus (DM)on the TCM syndromes of KOA by means of clinical investigation, so as to facilitate the treatment of KOA with Chinese medicine.Methods:We collected clinical data, including general materials and four diagnostic materials of TCM, from 40 eligible patients with a diagnosed simple KOA (Group A) and 40 patients with diagnosed KOA combined DM (Group B). Two deputy chief physician differentiated the TCM Syndromes blindly on these patients, Based on those data, we analyzed the distribution pattern of TCM Syndromes of KOA and the specialty of TCM Syndromes on KOA+DM。Information and data were analyzed statistically by using SPSS13.0.Results:(1) KOA was more common in the elderly, the average age was 68.65±10.10 years old.The comparison of the average ages between the two groups showed no statistics meaning (P=0.515>0.05);(2) With an average age of initial onset age of 62.13±9.327 in Group A, and an average age of initial onset age of 54.563±6.722 in Group B, there was significant difference in statistics between them (P=0.048<0.05);(3) The incidence of KOA increased when the men with DM, difference between the two groups was significant in statistics (x2=4.588, P=0.032<0.05);(4) The average index of severity for osteoarthritis (ISOA) of Group B higher than that of Group A, with significant difference in statistics (P=0.048<0.05).(5) We differentiated and summarized the manifestations of KOA into 7 TCM syndrome-elements (TCMSEs):Spleen Insufficiency (SI), Kidney Deficiency(KD), YIN-Deficiency, YANG-Insufficiency, Blood Stasis(BS), Dampness and Heat Syndrome (HS). The patients whose TCMSEs contained only TCMSEs of SI, KD, YIN-Deficiency and YANG-Insufficiency could summarized as Deficiency Syndrome (DS); and those whose TCMSEs contained only TCMSEs of BS, Dampness and HS could summarized as Excessive Syndrome(ES);and the cases whose TCMSEs contained both kinds of TCMSEs mentioned above could be defined as Syndrome of Defficiency Complicated with Excess(SDCE).The TCM syndromes of patients with KOA were dominated by SDCE, accounting for 78.8% of all patients,77.5% of patients in Group A, and 80% of patients in Group B, with no statistically significant difference between the two groups. The average ISOA of the patients with DS was 13.75±0.96; that of the patients with ES was 10.38±3.01;and the average ISOA of the cases of SDCE was 15.81±4.89.There was statistically significant difference in ISOA (F=7.78, P=0.001) when pairwise comparisons were performed among these three kinds of patients.(6)The comparison of the incidences of SI and KD between the two groups revealed statistically significant differences. The incidences of SI was higher in Group A,while the incidences of KD was higher in Group B. TheYIN-Deficiency happened more often in Group B than in Group A, the YANG-Insufficiency appeared less in Group B than in Group A.(7) Data of clinical TCM manifestations of the two groups of patients were managed by means of Cluster Analysis.The TCM syndromes of the two group could summarized as Disturbance of the Spleen by Dampness (DSD),KD and BS. Comparison of the incidences of DSD and KD of the two groups showed statistics meaning. (X2=5.0, P=0.025<0.05 andX2= 4.053, P=0.044<0.05). However, comparison of the incidences of BS between the two group showed no statistics meaning (X2=0.058, P=0.809>0.05).(8) The main risk factors in ES of KOA was Dampness and BS. Comparison between Group A and Group B showed that:the incidence of Dampness in Group A was higher than that of Group B (P=0.000<0.05), with statistical significance in the difference. While the incidences of BS syndrome in the two groups were not statistically significantly different (P=0.117>0.05);(9) Comparison of the incidences of "Swollen Knee "between Group A and Group B showed no statistical meaning (X2=2.464, P=0.116>0.05). But, the incidences of Swollen Knee had statistically significant difference when comparisons were done among the three kinds patients with the three kinds of TCM Syndromes of KOA(X2=11.38, P=0.003<0.05); and, the patients with DSD, BS had Swollen knee more often.10.Comparison of incidences of "Rest Pain at Night (RPN)" between Group A and Group B showed no statistical meaning (X2=1.289, P=0.256>0.05). But, the incidence of RPN had statistically significant difference when comparisons were done among the three kinds patients with the three kinds of TCM Syndromes of KOA(X2=6.322, P=0.042<0.05); and the patients with BS had RPN the most often among the all patients.Conclusion:(1) DM may increase the incidence of KOA in men;(2) DM may advance the onset age of KOA;(3) Most of patients with KOA receive treatment when they are dominated by SDCE; the organs which DS involved mainly are the liver, the spleen, the kidney,and the main pathogenic factors relate to ES are BS and Dampness;(4) The distribution of TCM syndromes of KOA:The TCM syndromes of KOA has some regularity in distribution. Syndrome of DSD appeares in the mild stage of KOA, and the Syndrome of KDand the Syndrome of BS usually emerge when KOA are relatively grave(5) Type 2 DM affect the TCM Syndrome of KOA in the following ways:①Patients with KOA combined DM and DS tend to present Syndrome of Deficiency of the Kidney-YIN, and the incidence of SI on these patients was significantly reduced;②Patients with KOA combined DM and ES are more likely to have BS and HS; nevertheless, the incidence of Dampness on these patients was significantly decreased.(6) On KOA, Type 2 DM has the adverse effects of advancing the onset age of KOA, accelerating progress of existing KOA and deteriorating conditions of existing KOA. When treating KOA, attention should also be paid to the treatment of DM.This is consistent with the basic principles of TCM:Concept of Wholism and Differentiating TCM Syndromes before Treatment...
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