Knee Osteoarthritis Damp-heat Distribution Rules And Diagnostic Criteria Discussed

1 ObjectiveTo discuss the method of damp-heat syndrome distribution of knee OA , establish initially diagnostic criteria of damp-heat syndrome ,consummate system of determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs in order to provide thinking and means of TCM Pa disease's diagnosing and treating study.2 Method2.1 Literature Study :By sorting and analysising the literature of the damp-heat syndrome of knee OA ,which include six hundreds the literature of antiquity and cnki from 1994 to now ,to summarize archaic and modem doctor 's the thinking of the cause and disease and pathogenesis,therapeutical principle. To summarize the normal symptome of damp-heat syndrome.2.2 Clinical Study :To apply the methods of cross -sectional study of modem epidemiology and establish initially the TCM syndrome questionnaire of knee OA at biasis of the literature study ,then collect the information. To utilize Spss 12.0 to administer the data, apply specificly frequency distribution,Chi-square test,Binary logistic regression,Bayes discriminant and analysis the distribution rule of damp-heat syndrome of knee OA,the transformation rule of cold,hot,deficiency and excess in different period,correlated affection factor of damp-heat syndorm and establish initially the diagnostic criteria of damp-heat syndrome.3 Result3.1 The result of literature study:There are fourty chapter antique literature and ten chapter modem literature to fit investigation, to provide theory direction to clinical study. The cause of diease of damp-heat syndorme is complicated. Because damp-heat evil invade body or entrails have hot and make wind-cold damp pathogen change damp-heat or evil keep long time to change damp-heat. Clearing away heat evil and promoting diuresis is the major treatment method and should considerothers methods. The normal of the damp- heat syndrome is blow: pain in knee joint, swelling, the knee joint is hot by palpating, tenderness, flexion and extend is inactive, all over the body is febrile or to feel febrile by self-consciousness, dry mouth and bitter taste of mouth, dry pharynx or pharyngalgia, discomfort at heart, feverish palms and soles, brown urine, dry stool, body of tongue is red or purple red, coated tongue is yellowish greasy or light yellow, pulse is deep or wiry or slippery. 3.2 The result of clinical study :1 General state of health: The femal more than the male .Middle-old aged patients are common .86.5% patients is hypergravitation, the,hot and blood stasis are common in the physical capacity.Patients like to eat peppery and sweet food.2 The feature of disease: The patients both display pain of knee joint,the degree of pain mainly concentrate light and midrange.The nature of ache is mostly aching pain and pricking pain.To produce ache when the patients start to active and after weight loading.The motivation of ache is mainly cloudy-rainy weather and exertion.Half or double knee joint have light degree swlling.Morning stiffness is normal,but the time is below thirty minutes.The patients both show limitaion of motion in double knee joint. Pressure pain point is mainly medial collateral ligament,lateral collateral ligament,menisci,suprapatellar bursa. Patella grind test and bone friction sense respectively is positive in most patients. When the patient's condition is serious or the course of the disease is long, the patients show quadriceps femoris atrophy and malformation in knee joint.3 The symptom feature of damp-heat syndrome: According to the frequency statististics, high frequency symptom by turns is blow: pain in knee joint, limitation of motion, swelling, obesity, morning stiffness, blurred vision, oral lips cyanochroia, yellow fur, the knee joint is hot by palpating, dry mouth with desire for drinks, spontaneous perspiration, soreness and weakness of lower back and knee, xerophthalmia, febrility, upset, slippery and rapid pulse, irritable tantrum, dizziness, depression and easy to sign, ear noises, thick sublingual vessel, constipation, oliguria with reddish urine, slimy and greasy fur, insomnia. 4 The feature of damp-heat syndrome :Damp-heat syndrome is accompanied with compound syndrome which two and three syndrome combination are the common. The damp-heat blocken syndrome combined with the deficiency inliver and kidney is the most, the next is the damp-heat blocken syndrome combined with the deficiency in liver and kidney combined with phlegm and blood stasis blocken syndrome > damp-heat blocken syndrome combined with the deficiency in liver and kidney combined with insufficiency of qi and blood. 5 The influencing factor of damp-heat syndrome: The closely correlated factor is below: dry-heat physical capacity,floating patella test,food and drink appetite. 6 The syndrome developing rule: All kinds of pattern of syndrome have nothing to do with by chi square test. 7 The diagnostic criteria of damp-heat syndrome: By the Binary Logistic Regression analysis, the main symptome of damp-heat syndrome is below:the knee joint is hot by palpating,swelling,oliguria with reddish urine,yellow fur,body of tongue is intumescence,febrility. By the fitting text ,the accurate rate is 87.6%. By Bayes Discriminant analysis,to establish fisher's function, as the result is below: febrility,spontaneous perspiration,loose stool,constipation,oliguria with reddish urine,swelling,the knee joint is hot by palpating,body of tongue is intumescence. By validation cross,the accurate rate is 84.8%, sensitivity is 87.6%, the specificity is 83.2%.Conclusion1 Damp-heat syndrome is the one of normal syndrome in knee OA, it is accompanied with compound syndrome, the combined syndrome is blow: the damp-heat blocken syndrome combined with the the deficiency in liver and kidney, the damp-heat syndrome combined with the deficiency in liver and kidney combined with phlegm and blood stasis blocken syndrome, the damp-heat syndrome combined with the deficiency in liver and kidney combined with insufficiency of qi and blood.2 The diagnostic criteria of the damp-heat syndrome is blow: Main syndrome: knee joint is hot by palpating, swelling. Minor syndrome: oliguria with reddish urine, febrility, spontaneous perspiration, enlarged tongue. To diagnose the damp-heat syndrome need main syndrome combined minor syndrome.3 The cause of disease of damp-heat syndrome is complicated, dry-heat physical capacity, food and drink appetite is closely correlated. The feature of pathogenesis isdeficiency combined with excess, deficiency in origin and excess in superficiality. Clearing away heat evil and promoting diuresis is the major treatment method and should consider others methods.4 Syndrome study is the necessarily tendency to modern TCM , the study apply literature and clinical study to normalize damp-heat syndrome of knee OA , the outcome shown it is feasible and produce thinking and methods of knee OA's syndrome study.