社区与住院的膝骨关节病患者中医证候以及膝骨关节功能积分比较

目的：了解已经确诊为膝骨关节病的浦东社区以及住院患者在中医证型与关节功能积分等方面的区别与联系。方法：根据膝骨关节病的诊断标准分别选取社区患者146例以及住院患者123例，并且分为风寒湿痹型、湿热蕴结型、气滞血瘀型、肝’肾亏虚型、脾肾不足型5型；依据评价膝骨关节病患者关节状况以及生存质量为主要目的的WOMAC、Lequesne积分对2组患者进行评分。结果：2组膝骨关节病患者在性别方面女性多于男性，但无明显差异；在年龄分布上2组间存在差异（P〈0．01）；2组各证型例数比较无明显差异；住院组患者膝骨关节功能积分均值高于浦东社区组（浦东组）（P〈0．01），住院组各证型积分也高于浦东组（P〈0．01）：住院组各证型积分均值比较有显著差异（P〈0．01），浦东组各证型积分均值比较无明显差异（P〉0．05）。结论：本研究再次证实，女性是患OA的危险人群。在确诊的膝骨关节病患者中，各中医证型人数不存在差异，也不存在某一证型在膝骨关节病患者中较为突出的现象。提示住院组患者疾病活动度显著高于浦东组患者，然而各中医证型与关节功能积分不存在显著的关联性。

Comparisons of TCM Syndromes and Functional Integrals of Knee Joint in Patients with Knee Osteoarthritis between Community and Hospital

Objective： To understand the differences and connections in TCM syndromes and functional integrals of joint in patients proved with knee osteoarthritis between Pudong community and hospital. Method： According to diagnostic standard of knee osteoarthritis, 146 community patients and 123 hospitalized ones were chosen and divided into five types： wind-cold-dampness-obstruction, accumulation of dampness-heat, stagnation of Qi and Blood, liver-kidney depletion, insufficiency of spleen-kidney; WOMAC and Lequesne integral of all patients were scored by evaluating joint conditions and life quality. Result： Knee osteoarthritis affected female more than males, but it showed no obvious difference; there existed distinction in age distribution（P〈 0.01）; numbers of cases indicated no remarkable difference in types of syndromes; means of hospitalized group were higher than that of Pudong community group （Pu.dong group） in functional integrals of knee joint （P〈0.01）, scores did higher than that of Pudong group in types of syndromes （P〈0.01）; comparisons of means among types of syndromes for hospitalized group suggested significant difference （P〈0.01）, while they had no obvious differences （P〉0.05）. Conclusion： The study proves again that female is at risk of OA. Among proved patients, there is no divergence in the numbers of patients suffering from TCM syndromes and no clear phenomenon in a certain type of syndrome. It also suggests that disease activity of hospitalized group is higher than that of Pudong group and there is no significant correlation between types of syndrome and functional integrals of knee joint.