Study On Traditional Chinese Medicine Syndromes Of Knee Osteoarthritis Based On Real World

Objective:Based on "real world" clinical research methods,using SPSS24.0 software and Liquorice software for complex network analysis,induction,summary,clear its syndrome characteristics in the acquisition of knee osteoarthritis(knee,osteoarthritis,KOA)based on clinical symptoms,signs and TCM diagnosis information,lay the foundation to study the clinical syndromes of KOA standard,in order to provides a "real world" evidence-based medicine support for Syndrome differentiation and treatment of KOA TCM.Methods:Based on the literature research,summarize the methods and ideas of KOA syndrome research by the "real world" in clinical research methods.According to the State Administration of traditional Chinese medicine "11th Five-Year" key specialty cooperative group of knee osteoarthritis(osteoarthritis)of the TCM clinical pathway,and the People's Republic of China Chinese medicine industry standards(Chinese medicine,orthopedics of TCM syndrome diagnostic efficacy of the standard ZY/T001.1-94),based on the clinical medical information collection in Wangjing Hospital of CACMS,through the clinical experts"brainstorming" and selected collect information about KOA syndrome clinical analysis,mading the clinic electronic medical record template information mining Set statistics questionnaire of KOA,and through 30 TCM syndromes with the title of senior science experts reached a consensus,to determine the clinical information collection point.Collected outpatient or inpatient cases met the inclusion criteria and diagnosis and treatment by senior doctors in one/two/three/four Department of bone and joint and Orthopedics department of Wangjing Hospital of CACMS from September 18,2014 to April 26,2016.The collected cases and completed information database,The collected case information was built into the database,and the Excel software was used for data cleaning and logic verification.Statistical analysis based on data mining platform of Guanganmen Hospital of CACMS,Calculated distribution frequency of the disease(the quantitative disease distribution in each sub sample frequency = total amount/*100%),then Selected TCM symptoms' distribution of frequency is greater than or equal to 5%,using the SPSS24.0 software system cluster analysis to summarize the syndrome characteristics,and using Liquorice complex network to analyse the correlation between the disease to form a syndrome information classification group.Then summarized the main symptoms and minor symptoms.on the basis of TCM syndrome classification and code(GB/T15657-1995),in terms of the basic theory of traditional Chinese medicine(GB/T20348-2006),TCM disease diagnosis Fault effect standard(ZY/T001.1.94),combined with traditional Chinese medicine bone science and TCM field experts,became an expert consensus,and form the decision and description of the syndrome,then formed the syndrome characteristics of KOA.To provide evidence-based medical science based on the unified reference for the classification of syndromes of this disease,syndrome differentiation and treatment.Results:1 Cases of outpatient or hospitalization in 803 cases,according to the exclusion criteria,excluding 27 cases,776 cases were included in the analysis,166 cases were male,and 610 were female,male to female ratio was 1:3.67,the minimum age of 22 years,the maximum age of 92 years old,the average age of 6 1.26 + 11.53.2 Using SPSS24.0 cluster analysis and principal component analysis showed that three kinds of syndrome information:G1(Obstruction of blood stasis):double lower limb muscle atrophy,tongue vein red,visible tortuous,tired after heating,with white Xiangjian,red tongue,dizziness,unsmooth,greasy fur;lower extremity limb chills under.G2(Cold damp stagnation):sour,Yaoxisuanruan,lower extremity weakness,pain,pain,chills,slippery pulse,pulse moisten,fat.G3(Deficiency of liver and kidney):sweats,moss white,pale tongue,thin fur.3 Using the frequency statistics method to classify the patients according to the three kinds of syndrome information weight:group G1 to group G1 syndrome information based(482 cases);group G2 to group G2 syndrome information mainly(208 cases);group G3 to group G3 syndrome information mainly(11 cases).Statistical analysis showed that the patients of syndrome and multiple phase,each group of syndrome information are weighted equally classified as group G4(75 cases).4 Using Liquorice complex network analysis,combining the results of cluster analysis,formed groups of the main disease and disease classification.Expounded and proved by traditional Chinese medicine bone science and TCM field experts,put the G3 group to G4 group according to the main symptoms of G4 group,and combined with clinical signs of tongue and pulse,and finally determine the syndrome:776 cases of KOA patients in medicine Syndromes and syndrome.the main syndrome classification:mainly for blood stasis obstructing the most,accounting for 62.11%;with cold damp stagnation accounted for 26.80%;the liver and kidney deficiency accounted for 11.08%.Conclusions:1 Knee osteoarthritis syndrome mainly divided into three kinds:Blood stasis stagnation,Cold and dampness,liver and kidney deficiency.The most common type is blood stasis obstructing.2 Most patients with knee osteoarthritis are Syndrome differentiation,and most are the main syndromes and with other syndromes meanwhile.3 Three main syndromes of knee osteoarthritis:Blood stasis stagnation type:knee pain,joint stiffness,fixed pain,dark red tongue,Thin fur,tongue veins visible tortuous,unsmooth pulse or pulse string.Cold and dampness type:knee ache or pain,lower limb flexion and extension,grief,or swelling,lower heavy,wind cold dampness after aggravating,chills,soreness and weakness of waist and knees,pale tongue,greasy moss,pulse moisten slip or pulse delay.Liver and kidney deficiency type:knee pain,flexion and extension,soreness and weakness of waist and knees,dizziness,tinnitus,or night sweats,or fatigue after the increase,pale tongue,thin tongue fur,pulse fine.The formation of each syndrome description can better provide a theoretical reference for clinicians in judging the type of KOA syndrome in the process of diagnosis and treatment.