CAJ | 학술논문

目的：探讨膝骨性关节炎的中医证候特点，为其临床辨证论治提供理论依据。方法：制定《膝骨性关节炎的中医证候信息量表》，收集2012年9月-2013年3月间就诊于中国中医科学院望京医院的217例膝骨性关节炎患者临床资料，进行聚类分析及主成分分析，归纳出证候分型以及各型的主次症。结果：出现频率80%以上的症状依次为固定痛、刺痛、活动后加重、隐痛、关节肿胀、冷痛、痛处拒按、屈伸不利；频率在60%～80%区间的10个症状中6个为全身表现：腰膝酸软、畏寒肢冷、变天加重、面肢浮肿、酸困无力、形体肥胖。聚类后血瘀气滞型、脾肾阳虚型、肝肾亏虚型三型分别占17.5%、48.3%、34.1%。结论：临床辨证分型需同时参照局部和全身证候表现。血瘀气滞型、脾肾阳虚型、肝肾亏虚型为临床常见证型，就诊时以脾肾阳虚型最常见。
목적：탐토슬골성관절염적중의증후특점，위기림상변증론치제공이론의거。방법：제정《슬골성관절염적중의증후신식량표》，수집2012년9월-2013년3월간취진우중국중의과학원망경의원적217례슬골성관절염환자림상자료，진행취류분석급주성분분석，귀납출증후분형이급각형적주차증。결과：출현빈솔80%이상적증상의차위고정통、자통、활동후가중、은통、관절종창、랭통、통처거안、굴신불리；빈솔재60%～80%구간적10개증상중6개위전신표현：요슬산연、외한지랭、변천가중、면지부종、산곤무력、형체비반。취류후혈어기체형、비신양허형、간신우허형삼형분별점17.5%、48.3%、34.1%。결론：림상변증분형수동시삼조국부화전신증후표현。혈어기체형、비신양허형、간신우허형위림상상견증형，취진시이비신양허형최상견。
Objective: To investigate the characteristics of TCM syndrome on knee osteoarthritis, providing a theory basis for clinical differentiation and treatment. Methods: TCM syndrome scale of knee osteoarthritis was established, clinical information of 217 cases were collected in Wangjing hospital from March 2012 to September 2013, all cases received cluster and principal component analysis;TCM syndrome, primary symptoms and minor symptoms were summarized. Results: Frequency of symptoms was more than 80%, included fixed pain, twinge, the pain was increased after activity, dull pain, arthrocele, psychroalgia, the pain place was unpressable and the knee’s flexion and extension was limited. Between the frequency range of 60%-80%, 6 symptoms in 10 symptoms were general symptom, included soreness of loins and knees, aversion to cold, pain more at bad weather, puffiness of face and limbs, laziness and obesities. Xueyu Qizhi type accounted for 17.5%, Pishen Yangxu type accounted for 48.3%, Ganshen Kuixu type accounted for 34.1%by cluster analysis. Conclusion:Differentiation and classification of syndrome should rely on local and systemic symptoms. Xueyu Qizhi type, Pishen Yangxu type and Ganshen Kuixu type were common in clinic. Pishen Yangxu type was the most.