南宁市城区中老年人膝骨关节炎流行病学调查及中医证型分析

目的：了解南宁市青秀区中老年人膝骨关节炎(knee Osteoarthritis, KOA)的流行病学和相关危险因素及中医证型分布情况。方法于2014年3月1日至2015年12月31日，采用《KOA危险因素调查表》和自制膝痹病中医辨证分型调查表，对南宁市青秀区常住居民进行流行病学问卷调查和中医的辨证调查。采用非条件Logistic回归分析筛选出膝骨关节炎的危险因素。结果发放调查问卷2000份，收回完整有效问卷1859份。最后322例居民被确诊为KOA，发病率为17.3%(322/1859)；中医辨证分型中，各类型为：肝肾亏虚证169例(52.5%)、气滞血瘀证84例(26.1%)、寒湿痹阻证35例(10.9%)和气血虚弱33例(10.2%)；经非条件Logistic回归分析结果显示，性别(OR=1.045)、年龄(OR=1.086)；高层无电梯楼房(OR=1.933)、BMI (OR=1.072)、关节经常负重(OR=3.273)、膝关节既往外伤史(OR=5.832)，吸烟(OR=1.456)是膝骨关节炎的危险因素，而民族、腰围、职业、受教育情况与膝关节骨性关节炎不相关。结论膝骨性关节炎发病受到性别、高层无电梯楼房、关节经常负重以及膝关节既往外史的影响；膝骨性关节炎中医证型以肝肾亏虚证最多，与中老年人肝肾亏虚为主相一致，气滞血瘀证次之，可能是与膝关节外伤史有关。

Epidemiological investigation of knee osteoarthritis and analysis of TCM syndrome types in the middle and old aged in Nanning city

Objective To understand the epidemiology and related risk factors of knee osteoarthritis (KOA) and TCM syndrome type distribution in the middle and old aged in Qingxiu District of Nanning city. Methods KOA risk factors questionnaire and self-made TCM syndrome type questionnaire of knee osteoarthritis were used for epidemi-ological survey and TCM syndrome types analysis in residents from Qingxiu District of Nanning city from March 1, 2014 to December 31, 2015. The risk factors of knee osteoarthritis were selected by the non-conditional Logistic regres-sion analysis. Results There were 2,000 questionnaires distributed, and a total of 1, 859 complete questionnaires were recovered. Finally, 322 cases were diagnosed with KOA, and the incidence was 17.3%(322/1,859). For TCM syndrome types, there were liver and kidney deficiency syndrome in 169 cases (52.5%), qi and blood stasis syndrome in 84 cases (26.1%), cold-dampness syndrome in 35 cases (10.9%), and the weakness of qi and blood in 33 cases (10.2%). In the analysis of the 11 variables, seven variables was statistically significant, including gender (OR=1.045), age (OR=1.086), high-rise building without elevator (OR=1.933), BMI (OR=1.072), joint bearing weights (OR=3.273), the history of trau-ma in knee joint (OR=5.832), smoking (OR=1.456). The nationality, waist circumference, occupation, education situa-tion were not related with knee osteoarthritis. Conclusion Knee osteoarthritis is influenced by gender, high-rise build-ing without elevator, joint bearing weights and history of trauma in knee joint. The most common TCM syndrome type of KOA is the liver and kidney deficiency, which is consistent with liver and kidney deficiency in the middle and old aged, with the second type of qi and blood stasis syndrome. It may be associated with knee injury history.