目的:探讨髌骨软化症(chondromalacia patellae,CMP)中医证型的分布规律及危险因素.方法:收集2018年1月至2023年6月在天长市中医院收治的CMP患者的病例资料,提取中医证型、年龄、性别、体质量指数(body mass index,BMI)、饮食偏嗜、吸烟情况、饮酒情况、合并症等信息.按照中医证型不同将纳入的CMP患者分为肝肾亏虚组、痰湿痹阻组和气滞血瘀组.先对3组患者的相关信息进行单因素对比分析,然后将其中组间差异具有统计学意义的因素作为自变量,将CMP中医证型作为因变量,进行多因素Logistic回归分析.采用Hosmer-Lemeshow检验判断模型拟合优劣.结果:共纳入122例CMP患者,其中肝肾亏虚组60例、痰湿痹阻组45例、气滞血瘀组17例.3组患者年龄、吸烟情况、饮食偏嗜、体质量指数、是否合并腰椎病、是否合并甲状腺功能减退的组间差异均有统计学意义,其余各因素的组间差异均无统计学意义.多因素Logistic回归分析结果显示,以气滞血瘀证为对照,年龄＞65岁、合并腰椎病、合并甲状腺功能减退是CMP肝肾亏虚证的危险因素(β=2.366,P=0.000,OR=20.544;β=3.479,P=0.003,OR=28.328;β=1.371,P=0.030,OR=3.936),饮食偏咸、BMI＞28 kg·m-2是 CMP 痰湿痹 阻证的危险因素(β=2.234,P=0.000,OR=9.341;β=1.845,P=0.046,OR=6.896).Hosmer-Lemeshow 检验显示回归模型对数据拟合度较好(x2=2.372,P=0.726).结论:肝肾亏虚证和痰湿痹阻证是CMP的主要中医证型;相对于气滞血瘀证,年龄＞65岁、合并腰椎病、合并甲状腺功能减退是CMP肝肾亏虚证的危险因素,饮食偏咸、BMI＞28 kg·m-2是CMP痰湿痹阻证的危险因素.
Analysis of distribution rules and risk factors for traditional Chinese medicine syndrome types in patients with chondromalacia patellae
Objective:To investigate the distribution rules and risk factors for traditional Chinese medicine(TCM)syndrome types in patients with chondromalacia patellae(CMP).Methods:The medical records of CMP patients who were diagnosed and treated in the Tian-chang Hospital of Traditional Chinese Medicine from January 2018 to June 2023 were collected,and the information,including TCM syn-drome type,age,gender,body mass index(BMI),dietary preferences,smoking,drinking and comorbidity,was extracted from the electronic medical record system(EMRS).According to the TCM syndrome type,the included CMP patients were divided into liver-kidney deficiency group,phlegm-dampness impediment group,qi-stagnation and blood-stasis group.Single-factor analysis was conducted on the information of patients in the 3 groups,followed by multi-factor logistic regression analysis by taking the factors with significant differences among the 3 groups as independent variable,and the TCM syndrome type of CMP patients as dependent variable,respectively.Furthermore,the good-ness-of-fit(GOF)of the logistic regression model was assessed by using Hosmer-Lemeshow(HL)test.Results:One hundred and twenty-two patients were included in the final analysis,60 ones in liver-kidney deficiency group,45 ones in phlegm-dampness impediment group,and 17 ones in qi-stagnation and blood-stasis group.The differences were statistically significant in age,smoking,dietary preferences,BMI,whether combined with lumbar diseases,and whether combined with hypothyroidism among the 3 groups,while,were not statistically signifi-cant in the rest factors.The results of logistic regression analysis revealed that,with qi-stagnation and blood-stasis syndrome as a reference,age of＞65 years,combined with lumbar disease and combined with hypothyroidism were the risk factors for liver-kidney deficiency syn-drome(β=2.366,P=0.000,OR=20.544;β=3.479,P=0.003,OR=28.328;β=1.371,P=0.030,OR=3.936),and high-salt diets,a BMI of＞28 kg/m(2)were the risk factors for phlegm-dampness impediment syndrome in CMP patients(β=2.234,P=0.000,OR=9.341;β=1.845,P=0.046,OR=6.896).The results of HL test showed that the logistic regression model had a good GOF(x2=2.372,P=0.726).Conclusion:Liver-kidney deficiency syndrome and phlegm-dampness impediment syndrome are the main TCM syndrome type of CMP patients.Age of＞65 years,combined with lumbar disease and combined with hypothyroidism are the risk factors for liver-kidney deficiency syndrome,and high-salt diets,a BMI of＞28 kg/m(2)are the risk factors for phlegm-dampness impediment syndrome in CMP patients,with qi-stagnation and blood-stasis syndrome as a reference.
NETL
NSTL
万方数据
