膝骨关节病痛点分布规律初探

目的：观察膝骨关节病患者常见膝周压痛点及结筋病灶点的分布规律，以期为临床针刀诊治提供依据。方法：对72例膝骨关节病患者进行膝部触诊检查，确定并统计压痛点及结筋点。结果：共115只患膝，其中102只（占88．70％）患膝有数量不等的压痛点。膝骨关节病患者压痛点主要分布在关节内侧，如髌尖内侧面、鹅足腱、胫骨内侧髁等。髌尖外侧在膝关节外侧中出现频率最高。足六条经筋中足三阴经筋结筋点压痛频率均超过70％，足太阳、足少阳经筋膝周经筋结点压痛频率均在50％以下。结论：膝骨关节病患者膝周压痛点及经筋结筋点有其分布规律，此特征与膝关节解剖学结构及生物力学特性密切相关，这将为针刀临床诊治选择有效治疗点提供依据。

The Study on Tenderness Distribution of Knee Osteoarthritis

Objective.. To explore the distribution of tenderness points and positive reflexive points on patients with knee os- teoartbritis, which will be benefit for acupotomy therapy. Methods：72 cases with knee osteoarthritis were palpated in order to determine and assessed the tenderness points and positive reflexive points. Results.. Within the total of 115 knees, 102 （88.70%） have different amounts of tenderness points. The tenderness points was mainly located in the interior region such as medial region of apex of patella, pes anserinus and medial tibial condyle. For the lateral area of the knee, the ten- derness points was mainly located in lateral region of apex of patella. The frequency of positive reflexive points was more than 70% in three Foot-Yin meridians. The frequency of positive reflexive points was less than 50% in foot Taiyang vessel and foot Shaoyang vessel. Conclusion：The tenderness points and positive reflexive points of knee osteoarthritis have their distribution law and feature, which is significantly associated with anatomic structure and biomechanical properties of knee joint. It will provide evidence for the selection of effective treatment points in acupotomy therapies.