肝肾亏虚型膝骨性关节炎平衡失稳的生物力学临床研究

发布时间：2018-07-21 09:03

【摘要】：研究目的：从生物力学角度分析肝肾亏虚型膝骨性关节炎的平衡稳定状态,探讨其病理机转,为今后防治该病提供参考。研究方法：选择30例诊断为肝肾亏虚型单侧膝骨性关节炎患者作为试验组,30例正常青年人作为对照组,分别对两组的股骨角(F)、胫骨角(T)、关节间隙角(JS)、髌骨上10cm周径、压力中心值、功能表面区轨迹长度(LFS)指数进行观察记录处理；对比分析两组数据情况,论证膝关节平衡失稳是肝肾亏虚膝型骨性关节炎的重要病理机制。研究结果：1.股骨角(F)观察结果显示,试验组双侧股骨角角度差值的平均数(0.18±0.071°)与对照组双侧股骨角角度差值的平均数(0.18±0.076°)比较,无显著性差异(P0.05)；表明试验组患侧股骨角未见明显改变。2.胫骨角(T)观察结果显示,试验组双侧胫骨角角度差值的平均数(0.18±0.076°)与对照组双侧胫骨角角度差值的平均数(0.19±0.084°)比较,无显著性差异(P0.05)；表明试验组患侧胫骨角未见明显改变。3.关节间隙角(JS)观察结果显示,试验组双侧关节间隙角角度差值的平均数较对照组角度差值的平均数有显著性差异(P0.05)；试验组角度差值的平均数(4.29±0.707°)高于对照组角度差值的平均数(0.13±0.069°)；表明试验组患侧内侧关节间隙相对变小。4.髌骨上10cm周径观察结果显示,试验组双下肢周径差值的平均数较对照组双下肢周径差值的平均数有显著性差异(P0.05)；试验组周径差值的平均数(4.29±0.707cm)高于对照组周径差值的平均数(1.11±0.230cm)；表明试验组患侧股四头肌肌容积减小,膝骨性关节炎患者膝关节动力装置生物机能下降。5.压力中心X轴观察结果显示,试验组压力中心较对照组压力中心有显著性差异(P0.05)；试验组平均值(123.53±12.765mm)高于对照组平均值(21.17±3.514mm)；表明试验组重心偏移明显,立位时下肢力线偏移。6.功能表面区轨迹长度(LFS)指数观察结果显示,试验组指数像较对照组指数像有显著性差异(P0.05)；试验组平均值(0.411±0.063mm2)显著低于对照组平均值(1.219士0.135mm2)；表明试验组患侧膝关节肌肉控制能力下降,膝关节平衡稳定受到破坏。结论：1.肝肾亏虚型膝骨性关节炎膝关节内侧形态学的改变是导致膝关节静态平衡失稳的重要因素。2.肝肾亏虚型膝骨性关节炎股四头肌形态学的改变是导致膝关节动态平衡失稳的重要因素。3.肝肾亏虚型膝骨性关节炎患者平衡能力及膝关节周围肌肉控制能力的下降是是人体膝关节静力平衡稳定及动力平衡稳定下降的结果。4.膝关节平衡失稳是引起肝肾亏虚型膝骨性关节炎发病的重要机制。
[Abstract]:Objective: to analyze the balance and stability of osteoarthritis of knee due to deficiency of liver and kidney from the biomechanical point of view, and to explore the pathological mechanism of osteoarthritis in order to provide reference for the prevention and treatment of the disease in the future. Methods: thirty patients with unilateral knee osteoarthritis diagnosed as deficiency of liver and kidney were selected as control group (n = 30). Femur angle (F), tibia angle (T), joint space angle (JS) and 10cm circumference of patella were measured in two groups. The values of pressure center and locus length of functional surface area (LFS) were observed and recorded, and the data of two groups were compared and analyzed. It was proved that the instability of knee joint balance was an important pathological mechanism of osteoarthritis with deficiency of liver and kidney. The result of the study was: 1. The results of femur angle (F) observation showed that there was no significant difference between the two groups (0.18 卤0.071 掳) and the control group (0.18 卤0.076 掳) (P0.05), indicating that there was no significant change in the femur angle of the experimental group (0.18 卤0.071 掳) and that of the control group (0.18 卤0.076 掳). The results of tibial angle (T) observation showed that there was no significant difference between the two sides of tibial angle difference (0.18 卤0.076 掳) and the control group (0.19 卤0.084 掳) (P0.05), indicating that there was no significant change in the tibial angle of the affected side in the experimental group (0.18 卤0.076 掳). The results of joint space angle (JS) observation showed that the average of the angle difference between the two sides of joint space in the test group was significantly different from that in the control group (P0.05). The average angle difference of the experimental group (4.29 卤0.707 掳) was higher than that of the control group (0.13 卤0.069 掳), indicating that the medial joint space of the affected side in the test group was relatively smaller. The observation of 10cm circumference on patella showed that the average of circumference difference of lower extremity in the test group was significantly different from that in the control group (P0.05), the mean value of the circumference difference of the trial group (4.29 卤0.707cm) was higher than that of the control group (1.11 卤0.230cm). The results showed that the volume of quadriceps femoris muscle was decreased in the experimental group, and the biological function of the knee joint dynamic device in the patients with knee osteoarthritis was decreased by .5. The results of pressure center X axis observation showed that the pressure center of the test group was significantly different from that of the control group (P0.05), the mean value of the test group (123.53 卤12.765mm) was higher than that of the control group (21.17 卤3.514mm). The observed results of functional surface area locus length (LFS) index showed that there was significant difference between the experimental group and the control group (P0.05), the average value of the experimental group (0.411 卤0.063mm2) was significantly lower than that of the control group (1.219 卤0.135mm2). The results showed that the control ability of knee joint muscle was decreased and the stability of knee joint balance was destroyed in the experimental group. Conclusion 1. The morphological changes of the medial knee joint of the knee osteoarthritis with deficiency of liver and kidney are the important factors leading to the instability of the knee joint static balance. The morphological changes of quadriceps femoris muscle in knee osteoarthritis with deficiency of liver and kidney are important factors leading to instability of dynamic balance of knee joint. The decrease of balance ability and muscle control ability in patients with knee osteoarthritis due to deficiency of liver and kidney is the result of the decrease of static balance and dynamic balance of human knee. Instability of knee joint balance is an important mechanism of knee osteoarthritis with deficiency of liver and kidney.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

【相似文献】