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[1]沈瑩姍,何曉銘,趙雄,等.關(guān)于“血瘀證是股骨頭壞死主要證候”的調(diào)查研究[J].中醫(yī)正骨,2022,34(04):25-29.
　SHEN Yingshan,HE Xiaoming,ZHAO Xiong,et al.A survey of osteonecrosis of the femoral head presenting mainly with blood stasis syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(04):25-29.
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關(guān)于“血瘀證是股骨頭壞死主要證候”的調(diào)查研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年04期
頁碼:
25-29
欄目:
調(diào)查研究
出版日期:
2022-04-20

文章信息/Info

Title:
A survey of osteonecrosis of the femoral head presenting mainly with blood stasis syndrome
作者:
沈瑩姍1; 何曉銘1; 趙雄2; 何煒3; 董庸偉3; 鄭越生3; 李子祺4; 何偉4; 魏秋實(shí)4
(1.廣州中醫(yī)藥大學(xué)第三臨床醫(yī)學(xué)院,廣東 廣州 510006; 2.成都中醫(yī)藥大學(xué),四川 成都 610075; 3.廣州中醫(yī)藥大學(xué)金沙洲醫(yī)院,廣東 廣州 510168; 4.廣州中醫(yī)藥大學(xué)骨傷科研究所,廣東 廣州 510240)
Author(s):
SHEN Yingshan1; HE Xiaoming1; ZHAO Xiong2; HE Wei3; DONG Yongwei3; ZHENG Yuesheng3; LI Ziqi4; HE Wei4; WEI Qiushi4
1.The Third Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,China 2.Chengdu University of TCM,Chengdu 610075,Sichuan,China3.Jinshazhou Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510168,Guangdong,China4.The Institute of Traumatology and Orthopedics Affiliated to Guangzhou University of Chinese Medicine,Guangzhou 510240,Guangdong,China
關(guān)鍵詞:
股骨頭壞死;  血瘀;  問卷調(diào)查
Keywords:
femur head necrosis;  blood stasis;  questionnaires
摘要:
目的:初步驗證“血瘀證是股骨頭壞死(osteonecrosis of the femoral head,ONFH)主要證候”這一理論。方法:①應(yīng)用計算機(jī)檢索中國知網(wǎng)、萬方數(shù)據(jù)庫、維普網(wǎng)1997年1月至2018年12月收錄的所有有關(guān)ONFH血瘀證的中文文獻(xiàn),提取文獻(xiàn)中關(guān)于ONFH血瘀證中醫(yī)癥狀的描述,總結(jié)歸納ONFH血瘀證的中醫(yī)癥狀。②根據(jù)文獻(xiàn)研究總結(jié)歸納的ONFH血瘀證的中醫(yī)癥狀,制定《“血瘀證”在股骨頭壞死中的診斷標(biāo)準(zhǔn)調(diào)查問卷》,通過問卷調(diào)查選擇其中專家意見協(xié)調(diào)度較高的中醫(yī)癥狀,確定ONFH血瘀證判斷標(biāo)準(zhǔn)。③從廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院關(guān)節(jié)骨科數(shù)據(jù)庫系統(tǒng)V1.0,選取2018年4—12月在廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院治療的ONFH患者的病例資料。選擇其中具有完整中醫(yī)證候信息的資料,按照擬定的ONFH血瘀證判斷標(biāo)準(zhǔn)判定患者是否存在血瘀證癥狀。結(jié)果:①通過文獻(xiàn)研究共總結(jié)出19條ONFH血瘀證的中醫(yī)癥狀。②共有來自17個省、自治區(qū)、直轄市的99位專家(中醫(yī)或中西醫(yī)結(jié)合骨科專業(yè))參與了問卷調(diào)查,問卷回收率100%。99位參與問卷調(diào)查的專家中,中級及以下職稱48人、副高級職稱28人、高級職稱23人,工作年限(12.63±8.55)年。參與問卷調(diào)查的99位專家均同意“血瘀證是ONFH的主要證候”; 19個血瘀證的中醫(yī)癥狀中,“舌質(zhì)紫暗”“痛如針刺,且痛點(diǎn)固定”“舌下絡(luò)脈色深”的專家意見協(xié)調(diào)度較好、集中程度較高。③臨床調(diào)查共納入302例ONFH患者的病例資料,男203例、女99例,年齡(35.9±12.9)歲,激素性O(shè)NFH144例、酒精性O(shè)NFH97例、創(chuàng)傷性O(shè)NFH54例、特發(fā)性O(shè)NFH7例。按照問卷調(diào)查確定的ONFH血瘀證判斷標(biāo)準(zhǔn)(3條中醫(yī)癥狀符合其中1條),有血瘀證癥狀者共240例(79%),男155例、女85例; 舌質(zhì)紫暗者211例,舌下絡(luò)脈色深者112例,疼痛如針刺且痛點(diǎn)固定者73例。結(jié)論:血瘀證是ONFH的主要證候,“舌質(zhì)紫暗”“痛如針刺,且痛點(diǎn)固定”“舌下絡(luò)脈色深”是判斷ONFH血瘀證的主要中醫(yī)癥狀。
Abstract:
Objective:To preliminarily verify the theory of osteonecrosis of the femoral head(ONFH)presenting mainly with blood-stasis syndrome.Methods:All the Chinese articles about blood-stasis-type ONFH included from January 1997 to December 2018 were retrieved from China national knowledge internet,WanFang Database and VIP Database through computer.The descriptions of TCM symptoms of blood-stasis-type ONFH were extracted from the involved articles,and the TCM symptoms of blood-stasis-type ONFH were summarized and analysed.A questionnaire on the diagnostic criteria of blood-stasi-type ONFH was made according to the above-summarized TCM symptoms of blood-stasis-type ONFH.The TCM symptoms with high coordination degree of expert opinions were obtained through the questionnaire survey for determining the judgment criteria of blood-stasis-type ONFH.The medical records of ONFH patients who were treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from April 2018 to December 2018 were screened out from database system V1.0 of the department of joint surgery of the First Affiliated Hospital of Guangzhou University of Chinese Medicine,and the medical records containing complete information of TCM syndrome were selected out for judging whether the ONFH patients had blood-stasis syndrome according to above judgment criteria.Results:Nineteen TCM symptoms of blood-stasis-type ONFH were obtained through analyzing on the involved articles.Ninety-nine experts,including 48 intermediate and below professional titles,28 associate senior professional titles and 23 senior professional titles,came from 17 provinces,autonomous regions and direct-controlled municipality and participated in the questionnaire survey(100% response rate),and their current working experiences were 12.63±8.55 years.The theory of ONFH presenting mainly with blood-stasis syndrome was recognised by all the involved experts,and the experts had good coordination and a high degree of concentration on dark purple tongue,fixed piercing pain and dark-coloured sublingual collaterals,which were part of the 19 TCM symptoms of blood-stasis syndrome.The medical records of 302 ONFH patients were included in the clinical investigation.The patients consisted of 203 males and 99 females,and ranged in age of 35.9±12.9 years.The ONFH included steroid-induced ONFH(144 cases),alcohol-induced ONFH(97 cases),traumatic ONFH(54 cases)and idiopathic ONFH(7 cases).According to the judgment criteria confirmed by the questionnaire survey,the blood-stasis syndrome was found in 240 patients(79%)including 155 males and 85 females,and the dark purple tongue was found in 211 patients,dark-coloured sublingual collaterals in 112 patients and fixed piercing pain in 73 patients.Conclusion:ONFH presents mainly with blood-stasis syndrome.The dark purple tongue,fixed piercing pain and dark-coloured sublingual collaterals are the main TCM symptoms of blood-stasis-type ONFH.

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備注/Memo

備注/Memo:
基金項目:國家自然科學(xué)基金項目(81904226,81873327); 廣東省自然科學(xué)基金項目(2017A030313698)通訊作者:魏秋實(shí) E-mail:[email protected]
更新日期/Last Update: 1900-01-01