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[1]翁汭,何曉銘,何敏聰,等.基于絡病理論探討股骨頭壞死患者的疼痛特點及疼痛區(qū)域經(jīng)脈循行特點[J].中醫(yī)正骨,2023,35(12):25-29.
　WENG Rui,HE Xiaoming,HE Mincong,et al.Investigation on the characteristics of pain and running courses of meridians in the pain areas of patients with osteonecrosis of the femoral head based on the collateral disease theory[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(12):25-29.
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基于絡病理論探討股骨頭壞死患者的疼痛特點及疼痛區(qū)域經(jīng)脈循行特點()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年12期
頁碼:
25-29
欄目:
臨床研究
出版日期:
2023-12-20

文章信息/Info

Title:
Investigation on the characteristics of pain and running courses of meridians in the pain areas of patients with osteonecrosis of the femoral head based on the collateral disease theory
作者:
翁汭; 何曉銘; 何敏聰; 林天燁; 何偉; 魏秋實
廣州中醫(yī)藥大學第三附屬醫(yī)院,廣東 廣州 510378
Author(s):
WENG Rui; HE Xiaoming; HE Mincong; LIN Tianye; HE Wei; WEI Qiushi
The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378,Guangdong,China
關鍵詞:
股骨頭壞死;  疼痛;  經(jīng)絡循行;  絡病學說;  足三陰經(jīng);  足三陽經(jīng)
Keywords:
femur head necrosis;  pain;  running course of meridian;  collateral disease theory;  three yin meridians of foot;  three yang meridians of foot
摘要:
目的:探討股骨頭壞死(osteonecrosis of the femoral head,ONFH)患者的疼痛特點及疼痛區(qū)域經(jīng)脈循行特點。方法:選擇2020年5月至2021年7月在廣州中醫(yī)藥大學第三附屬醫(yī)院門診或住院治療的ONFH患者為研究對象。國際骨循環(huán)學會(Association Research Circulation Osseous,ARCO)分期均為Ⅰ期、Ⅱ期,男209例、女74例,年齡(42.87±14.52)歲,左側(cè)97例、右側(cè)81例、雙側(cè)105例,酒精性ONFH101例、激素性ONFH85例、特發(fā)性ONFH59例、創(chuàng)傷性ONFH38例。收集患者信息,進行ONFH臨床病例信息登記。統(tǒng)計登記的信息,包括患者性別、年齡、病變側(cè)別、中醫(yī)證型及疼痛情況(包括性質(zhì)、程度、區(qū)域、晝夜變化、是否固定、誘發(fā)因素、休息是否緩解)等; 比對患者疼痛區(qū)域足三陰經(jīng)和足三陽經(jīng)的循行情況,統(tǒng)計各條經(jīng)脈出現(xiàn)的頻次; 按年齡和中醫(yī)證型分組,分析不同年齡和不同中醫(yī)證型患者疼痛區(qū)域經(jīng)脈循行的特點。結(jié)果:①疼痛情況。283例ONFH患者,疼痛性質(zhì)以隱痛較常見,疼痛程度以輕中度為主且晝夜變化不明顯,疼痛區(qū)域以腹股溝和股外側(cè)最多見且位置多固定,誘發(fā)疼痛的因素有多種,大部分患者休息后疼痛能緩解。②疼痛區(qū)域經(jīng)脈循行情況。283例(388髖)ONFH患者,疼痛區(qū)域有單一經(jīng)脈循行186髖,有2條或2條以上經(jīng)脈循行202髖; 疼痛區(qū)域循行經(jīng)脈出現(xiàn)頻次較高的為足厥陰肝經(jīng)和足少陽膽經(jīng)。③不同年齡和不同中醫(yī)證型患者疼痛區(qū)域經(jīng)脈循行情況。283例ONFH患者,年齡<50歲186例,年齡≥50歲97例; 氣滯血瘀證56例,腎虛血瘀證142例,痰瘀互結(jié)證85例。疼痛區(qū)域循行經(jīng)脈按出現(xiàn)頻次由高至低排序,年齡<50歲組為足厥陰肝經(jīng)、足少陽膽經(jīng)、足太陽膀胱經(jīng)、足太陰脾經(jīng)、足少陰腎經(jīng)、足陽明胃經(jīng),年齡≥50歲組為足少陽膽經(jīng)、足厥陰肝經(jīng)、足太陽膀胱經(jīng)、足陽明胃經(jīng)、足太陰脾經(jīng)、足少陰腎經(jīng),氣滯血瘀證組為足厥陰肝經(jīng)、足少陽膽經(jīng)、足太陽膀胱經(jīng)、足陽明胃經(jīng)、足太陰脾經(jīng)、足少陰腎經(jīng); 腎虛血瘀證組、痰瘀互結(jié)證組均為足厥陰肝經(jīng)、足少陽膽經(jīng)、足太陽膀胱經(jīng)、足太陰脾經(jīng)、足陽明胃經(jīng)、足少陰腎經(jīng)。結(jié)論:ARCO分期Ⅰ期、Ⅱ期ONFH患者的疼痛多為位置固定的輕中度隱痛,疼痛程度晝夜變化不明顯,大部分患者休息后疼痛能緩解,疼痛區(qū)域以腹股溝和股外側(cè)最多見; 疼痛區(qū)域有足三陰經(jīng)和足三陽經(jīng)循行,循行經(jīng)脈中足厥陰肝經(jīng)和足少陽膽經(jīng)最多見。
Abstract:
Objective:To explore the characteristics of pain and running courses of meridians in the pain area of patients with osteonecrosis of the femoral head(ONFH).Methods:Two hundred and eighty-three ONFH patients treated in the outpatient or inpatient department of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from May 2020 to July 2021 were selected as the subjects.The patients included 209 males and 74 females,with the age of 42.87±14.52 years.The ONFH located in left side for 97 patients,right for 81 ones and bilateral for 105 ones,and belonged to stageⅠand stageⅡaccording to the staging standard issued by the Association Research Circulation Osseous(ARCO),besides,the ONFH covered alcohol-induced ONFH(101 cases),steroid-induced ONFH(85 cases),idiopathic ONFH(59 cases)and traumatic ONFH(38 cases).The patient information,including gender,age,affected side,traditional Chinese medicine(TCM)syndrome type and pain characteristics(nature,degree,area,day-night variation,fixed position or not,inducing factors,and relief upon rest or not,etc.),was collected and recorded.The running courses of the three Yin meridians and three Yang meridians of the foot in the pain areas was compared,followed by statistics on the occurrence frequency of each meridian.The patients were grouped according to their ages and TCM syndrome types,and the characteristics of running courses of each meridian in the pain areas of patients with different TCM syndrome types in different ages were analyzed.Results:①The 283 ONFH patients mainly presented mild-to-moderate dull pain with the unobvious day-night variation.The pain mainly occurred in the groin and lateral femur mostly with the fixed position,and it could be triggered by multiple factors.Most patients experienced pain relief upon rest.②Among the 283 ONFH patients(388 hips),a single meridian was found in 186 hips,and 2 or more meridians were found in 202 hips in the pain area,among which the liver meridian of Foot-Jueyin and gallbladder meridian of Foot-Shaoyang appeared most frequently.③The 283 ONFH patients included 186 patients aged less than 50 years and 97 ones aged over 50 years.The qi-stagnation and blood-stasis syndrome was found in 56 patients,kidney-deficiency and blood-stagnation syndrome in 142 ones as well as intermingled phlegm and blood stasis syndrome in 85 ones.The meridians in the pain areas were separately ranked in a descending order by the occurrence frequency as follows:the liver meridian of Foot-Jueyin,followed by gallbladder meridian of Foot-Shaoyang,bladder meridian of Foot-Taiyang,spleen meridian of Foot-Taiyin,kidney meridian of Foot-Shaoyin and stomach meridian of Foot-Yangming in patients aged less than 50 years; while,the gallbladder meridian of Foot-Shaoyang,followed by liver meridian of Foot-Jueyin,bladder meridian of Foot-Taiyang,stomach meridian of Foot-Yangming,spleen meridian of Foot-Taiyin and kidney meridian of Foot-Shaoyin in patients aged over 50 years.Furthermore,the most frequently appeared meridian was the liver meridian of Foot-Jueyin,followed by gallbladder meridian of Foot-Shaoyang,bladder meridian of Foot-Taiyang,stomach meridian of Foot-Yangming,spleen meridian of Foot-Taiyin and kidney meridian of Foot-Shaoyin in patients with the qi-stagnation and blood-stasis syndrome; while,the liver meridian of Foot-Jueyin appeared most frequently,followed by gallbladder meridian of Foot-Shaoyang,bladder meridian of Foot-Taiyang,spleen meridian of Foot-Taiyin,stomach meridian of Foot-Yangming and kidney meridian of Foot-Shaoyin in patients with the kidney-deficiency and blood-stagnation syndrome as well as intermingled phlegm and blood stasis syndrome.Conclusion:The patients with ONFH in ARCO stageⅠandⅡmainly presented mild-to-moderate dull pain with the fixed position and the unobvious day-night variation.The pain mainly occurred in the groin and lateral femur and can be relieved after having a rest.The pain area involved three Yin meridians and three Yang meridians of the foot,among which the liver meridian of Foot-Jueyin and gallbladder meridian of Foot-Shaoyang are more common.

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備注/Memo

備注/Memo:
基金項目:國家自然科學基金項目(82274544); 廣東省中醫(yī)骨傷研究院開放課題(GYH202101-04)
通訊作者:魏秋實 E-mail:[email protected]
更新日期/Last Update: 1900-01-01