足阳明经筋型膝骨性关节炎患者结筋病灶点体表血流灌注量研究

发布时间：2018-03-16 14:23

  本文选题：经筋　切入点：膝骨性关节炎　出处：《辽宁中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:运用激光散斑成像技术观察健康志愿者筋结点与膝骨性关节炎患者结筋病灶点体表血流灌注量的差异,印证经筋结构-功能相关性,进一步探索经筋实质。材料与方法:健康组:健康志愿者全部来自2016.3~2017.3间在辽沈地区,经诊断无膝骨性关节炎及其他腿部疾病的健康社区居民100名,年龄40~70岁,并征得志愿者书面同意。KOA组:全部足阳明经筋型KOA病例为2016.3~2017.3间在辽宁中医药大学附属第一、第二医院门诊及住院的患者共103名。通过诊断标准、纳入标准、排除标准筛选病例。符合纳入标准的患者按次序进入研究,均自愿签署知情同意书。KOA患者经触诊后,记录结筋病灶点出现频次,并进行统计;健康组与KOA组均仰卧位平躺,保持环境安静,光线、温度稳定。待呼吸、心情平稳后,标记频次最高的前5个结筋病灶点,以激光散斑成像仪进行扫描,以1cm*1cm为ROI。若身体不稳造成图像抽动,则在数据处理时避开该运动伪迹部分,选择感兴趣时间段。利用moorFLPI-2Review V4.0图像在计算机显示器上同步生成血液灌注图、强度图和彩色照片,并记录这五个筋结点(结筋病灶点)的血流灌注量(血流灌注单位,prefusion unit,PU值)。保持体位15min后,采用新杏林牌0.35*50mm一次性毫针分别针刺这五个筋结点(结筋病灶点),以激光散斑成像仪进行扫描,以1cm*1cm为ROI,记录这五个筋结点(结筋病灶点)5min、10min、15min、20min的血流灌注量。观察指标:(1)KOA患者结筋病灶点定位和临床出现比率;(2)记录、统计、比较静态情况下KOA患者结筋病灶点以及健康志愿者相应筋结点的血流灌注量;(3)记录、统计、比较动态(针刺)情况下KOA患者结筋病灶点以及健康志愿者相应筋结点针刺即刻、5min、10min、15min、20min的血流灌注量。结果:1.观察103例足阳明经筋型KOA患者,频次最高的前5个结筋病灶点分别是:髌内下98例,比率为95.15%;胫骨内髁95例,比率为92.23%;髌下87例,比率为84.47%;髌外85例,比率为82.52%;足三里次75例,比率为72.82%。2.两组髌内下、胫骨内髁、髌下、髌外、足三里次的静态体表血流灌注量经统计学检验,P均0.05,具有统计学意义。3.两组膑内下、胫骨内髁、髌下、髌外、足三里次针刺即刻的体表血流灌注量经统计学检验,P均0.05,具有统计学意义;5min体表血流灌注量的体表血流灌注量经统计学检验,P均0.05,具有统计学意义;10min的体表血流灌注量经统计学检验,P均0.05,具有统计学意义;15min的体表血流灌注量经统计学检验,P均0.05,具有统计学意义;20min的体表血流灌注量经统计学检验,P均0.05,具有统计学意义结论:1.足阳明经筋型膝骨性关节炎患者髌骨内下侧的结筋病灶点损伤机会较多;2.与健康志愿者相比,在静态情况下足阳明经筋型KOA患者的结筋病灶点体表血流灌注量呈显著升高的特征;3.与健康志愿者相比,在动态情况下足阳明经筋型KOA患者的结筋病灶点体表血流灌注量呈显著升高的特征;4.膝骨性关节炎患者经筋损伤存在结构-功能特征的相关性,激光散斑成像技术有助于建立膝骨性关节炎客观疗效评价体系;5.体表血流灌注量增高、组织微循环改善可能是针刺结筋病灶点临床起效的机制之一。
[Abstract]:Objective: To study the difference and reinforcement of healthy volunteers of knee osteoarthritis, rib lesions skin blood perfusion imaging of laser spot node observation, confirmed by band structure function correlation, to further explore the essence of the tendons. Materials and methods: healthy group: healthy volunteers from all 2016.3~2017.3 in Liaoning Province, the community health residents in diagnosis of knee osteoarthritis and other leg disease in 100, aged 40~70 years, and obtain the written consent of the volunteer group.KOA: all meridian bar type KOA cases of 2016.3~2017.3 in Liaoning University of Traditional Chinese Medicine First Affiliated Hospital, second outpatient and inpatient patients were 103. The diagnostic criteria, inclusion criteria, exclusion criteria cases. Patients who met the inclusion criteria in order to enter the study voluntarily signed the informed consent of patients with.KOA by palpation, rib lesions frequently recorded, And statistics; health group and KOA group were lying supine, keep quiet, light, stable temperature. When breathing, feeling smooth, marking the highest frequency of the first 5 rib lesions, were scanned with laser speckle imaging instrument, using 1cm*1cm as ROI. if the body image is instability caused by TiC to avoid the motion artifacts in the part of the data processing, select the interest period. Blood perfusion maps generated synchronously on a computer monitor using moorFLPI-2Review V4.0 image intensity map and color photos, and record the five tendons node (node rib lesions) of blood perfusion (blood flow perfusion unit, prefusion unit, PU keep the position.) after 15min, the new brand 0.35*50mm disposable needle acupuncture respectively Xinglin the five tendons node (rib lesions), scanning by laser speckle imaging, 1cm*1cm ROI, to record the five tendons node (rib lesions) 5min, 10min,15min,20min鐨勮��娴佺亴娉ㄩ噺.瑙傚療鎸囨爣:(1)KOA鎮ｈ，

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