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[1]顧力軍,董福慧.疼痛客觀化指標(biāo)在膝骨關(guān)節(jié)炎患者 膝關(guān)節(jié)功能和疼痛評(píng)價(jià)中的應(yīng)用[J].中醫(yī)正骨,2013,25(09):22-24.
　Gu Lijun*,Dong Fuhui.*.Application of objective detection indicators of pain for assessing knee function and knee pain in patients with knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(09):22-24.
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疼痛客觀化指標(biāo)在膝骨關(guān)節(jié)炎患者 膝關(guān)節(jié)功能和疼痛評(píng)價(jià)中的應(yīng)用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期數(shù):
2013年09期
頁(yè)碼:
22-24
欄目:
臨床研究
出版日期:
2013-09-30

文章信息/Info

Title:
Application of objective detection indicators of pain for assessing knee function and knee pain in patients with knee osteoarthritis
作者:
顧力軍; 董福慧
中國(guó)中醫(yī)科學(xué)院望京醫(yī)院,北京 100102
Author(s):
Gu Lijun*; Dong Fuhui.*
The Wangjing hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝 關(guān)節(jié)痛 關(guān)節(jié)功能 疼痛測(cè)定
Keywords:
Osteoarthritis; knee;  Arthralgia;  Joint function;  Pain measurement
摘要:
目的:探討壓痛值、軟組織位移值及香蕉面積比值等疼痛客觀化指標(biāo)在膝骨關(guān)節(jié)炎患者患膝關(guān)節(jié)功能和疼痛評(píng)價(jià)中的作用 ,為膝骨關(guān)節(jié)炎的臨床診治提供依據(jù)。方法:2011年3月至2012年8月,利用人體壓痛力學(xué)定量測(cè)試儀和軟組織張力儀對(duì)120例膝骨 關(guān)節(jié)炎患者進(jìn)行檢查,男23例,女97例; 年齡40～70歲,中位數(shù)58.5歲; 左側(cè)62例,右側(cè)58例; 病程3個(gè)月至2年,中位數(shù)11.5個(gè)月。 記錄患膝的壓痛值、軟組織位移值及香蕉面積比值,分別采用美國(guó)特種外科醫(yī)院膝關(guān)節(jié)功能評(píng)分標(biāo)準(zhǔn)和疼痛視覺(jué)模擬評(píng)分標(biāo)準(zhǔn)對(duì) 患膝關(guān)節(jié)功能和疼痛進(jìn)行評(píng)分,分析疼痛客觀化指標(biāo)對(duì)患膝功能評(píng)分和疼痛評(píng)分的影響。結(jié)果:本組120例,壓痛值X1 為(7.02±0.48)kPa,軟組織位移值X2為(3.19±0.25)mm,香蕉面積比值X3為 (74.15±6.01)%,疼痛視覺(jué)模擬評(píng)分YVAS為(5.20±0.67)分,膝關(guān)節(jié)功能評(píng)分YHSS為 (88.83±3.06)分。對(duì)自變量進(jìn)行篩選后回歸方程分別為YHSS=-0.343X2+114.299 (F=99.236,P=0.000),YVAS=-0.666-0.394X2+0.096X3(F=654.165,P=0.000); 即壓痛值和 香蕉面積比值對(duì)患膝關(guān)節(jié)功能評(píng)分沒(méi)有影響; 但軟組織位移值增加1 mm,患膝關(guān)節(jié)功能評(píng)分就減少0.343分 (R2=0.457); 壓痛值對(duì)患膝疼痛視覺(jué)模擬評(píng)分無(wú)影響; 但在香蕉面積比值不變的前提下,軟組織位移值增加1 mm,疼 痛視覺(jué)模擬評(píng)分下降0.394分; 在軟組織位移值保持不變的情況下,香蕉面積比值增加1%,疼痛視覺(jué)模擬評(píng)分增加0.096分 (R2=0.918)。結(jié)論:測(cè)量膝骨關(guān)節(jié)炎患者患膝局部壓痛點(diǎn)的軟組織位移值,對(duì)評(píng)價(jià)其膝關(guān)節(jié)功能有一定的意義,而測(cè) 量局部壓痛點(diǎn)的軟組織位移值和香蕉面積比值可用于患膝疼痛的客觀評(píng)估。
Abstract:
Objective:To study the role of objective detection indicators of pain in assessing knee function and knee pain in patients with knee osteoarthritis,including tenderness values,soft tissue displacement values,banana area ratio and so on,so as to provide the basis for the diagnosis and treatment of knee osteoarthritis in clinic.Methods:From March 2011 to August 2012,120 patients with knee osteoarthritis,23 males and 97 females,62 cases in the left knee and 58 cases in the right knee,were examined by using the quantitative tester of human tenderness and the soft tissue tensiometer.The mean age of patients was 58.5 years(range from 40 to 70 years)and the mean course of disease was 11.5 months(range from 3 months to 2 years).Tenderness values,soft tissue displacement values and banana area ratio were recorded; and knee function and knee pain were measured respectively by using American Hospital for Special Surgery knee performance score and visual analogue scale; and then the impact of pain objective detection indicators on knee function and knee pain were analyzed.Results:For 120 patients,the tenderness values(X1)was 7.02+/-0.48 kPa,the soft tissue displacement values(X2)was 3.19+/-0.25 mm,the banana area ratio(X3)was 74.15+/-6.01%,the visual analogue scale(YVAS)was 5.20+/-0.67 points,and the knee function score(YHSS)was 88.83+/-3.06 points.After screening the independent variables,the regression equation were obtained (YHSS=-0.343X2+114.299(F=99.236,P=0.000),YVAS=-0.666-0.394X2 +0.096X3(F=654.165,P=0.000)).As the regression equation showed,the tenderness values and banana area ratio had no impact on knee function scores,however,the knee function scores decreased by 0.343 points (R2=0.457)while the soft tissue displacement values increased 1 mm.The tenderness values had no impact on visual analogue scale,however,the visual analogue scales decreased by 0.394 points while the soft tissue displacement values increased by 1 mm and the banana area ratio remained unchanged.The visual analogue scales increased by 0.096 points(R2=0.918)while the banana area ratio increased by 1% and the soft tissue displacement values remained unchanged.Conclusion:The measurement of displacement values of soft tissue on the tenderness points of the knee is helpful to assess knee function in patients with knee osteoarthritis,and the measurement of the soft tissue displacement values and banana area ratio on the tenderness points of the knee can be used to evaluate the knee pain objectively.

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備注/Memo

備注/Memo:
2012-10-26收稿 2013-03-27修回
更新日期/Last Update: 2013-09-30