【摘要】：研究目的：從生物力學(xué)角度分析肝腎虧虛型膝骨性關(guān)節(jié)炎的平衡穩(wěn)定狀態(tài),探討其病理機(jī)轉(zhuǎn),為今后防治該病提供參考。研究方法：選擇30例診斷為肝腎虧虛型單側(cè)膝骨性關(guān)節(jié)炎患者作為試驗(yàn)組,30例正常青年人作為對照組,分別對兩組的股骨角(F)、脛骨角(T)、關(guān)節(jié)間隙角(JS)、髕骨上10cm周徑、壓力中心值、功能表面區(qū)軌跡長度(LFS)指數(shù)進(jìn)行觀察記錄處理；對比分析兩組數(shù)據(jù)情況,論證膝關(guān)節(jié)平衡失穩(wěn)是肝腎虧虛膝型骨性關(guān)節(jié)炎的重要病理機(jī)制。研究結(jié)果：1.股骨角(F)觀察結(jié)果顯示,試驗(yàn)組雙側(cè)股骨角角度差值的平均數(shù)(0.18±0.071°)與對照組雙側(cè)股骨角角度差值的平均數(shù)(0.18±0.076°)比較,無顯著性差異(P0.05)；表明試驗(yàn)組患側(cè)股骨角未見明顯改變。2.脛骨角(T)觀察結(jié)果顯示,試驗(yàn)組雙側(cè)脛骨角角度差值的平均數(shù)(0.18±0.076°)與對照組雙側(cè)脛骨角角度差值的平均數(shù)(0.19±0.084°)比較,無顯著性差異(P0.05)；表明試驗(yàn)組患側(cè)脛骨角未見明顯改變。3.關(guān)節(jié)間隙角(JS)觀察結(jié)果顯示,試驗(yàn)組雙側(cè)關(guān)節(jié)間隙角角度差值的平均數(shù)較對照組角度差值的平均數(shù)有顯著性差異(P0.05)；試驗(yàn)組角度差值的平均數(shù)(4.29±0.707°)高于對照組角度差值的平均數(shù)(0.13±0.069°)；表明試驗(yàn)組患側(cè)內(nèi)側(cè)關(guān)節(jié)間隙相對變小。4.髕骨上10cm周徑觀察結(jié)果顯示,試驗(yàn)組雙下肢周徑差值的平均數(shù)較對照組雙下肢周徑差值的平均數(shù)有顯著性差異(P0.05)；試驗(yàn)組周徑差值的平均數(shù)(4.29±0.707cm)高于對照組周徑差值的平均數(shù)(1.11±0.230cm)；表明試驗(yàn)組患側(cè)股四頭肌肌容積減小,膝骨性關(guān)節(jié)炎患者膝關(guān)節(jié)動力裝置生物機(jī)能下降。5.壓力中心X軸觀察結(jié)果顯示,試驗(yàn)組壓力中心較對照組壓力中心有顯著性差異(P0.05)；試驗(yàn)組平均值(123.53±12.765mm)高于對照組平均值(21.17±3.514mm)；表明試驗(yàn)組重心偏移明顯,立位時(shí)下肢力線偏移。6.功能表面區(qū)軌跡長度(LFS)指數(shù)觀察結(jié)果顯示,試驗(yàn)組指數(shù)像較對照組指數(shù)像有顯著性差異(P0.05)；試驗(yàn)組平均值(0.411±0.063mm2)顯著低于對照組平均值(1.219士0.135mm2)；表明試驗(yàn)組患側(cè)膝關(guān)節(jié)肌肉控制能力下降,膝關(guān)節(jié)平衡穩(wěn)定受到破壞。結(jié)論：1.肝腎虧虛型膝骨性關(guān)節(jié)炎膝關(guān)節(jié)內(nèi)側(cè)形態(tài)學(xué)的改變是導(dǎo)致膝關(guān)節(jié)靜態(tài)平衡失穩(wěn)的重要因素。2.肝腎虧虛型膝骨性關(guān)節(jié)炎股四頭肌形態(tài)學(xué)的改變是導(dǎo)致膝關(guān)節(jié)動態(tài)平衡失穩(wěn)的重要因素。3.肝腎虧虛型膝骨性關(guān)節(jié)炎患者平衡能力及膝關(guān)節(jié)周圍肌肉控制能力的下降是是人體膝關(guān)節(jié)靜力平衡穩(wěn)定及動力平衡穩(wěn)定下降的結(jié)果。4.膝關(guān)節(jié)平衡失穩(wěn)是引起肝腎虧虛型膝骨性關(guān)節(jié)炎發(fā)病的重要機(jī)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 鹵0.071 擄) and the control group (0.18 鹵0.076 擄) (P0.05), indicating that there was no significant change in the femur angle of the experimental group (0.18 鹵0.071 擄) and that of the control group (0.18 鹵0.076 擄). The results of tibial angle (T) observation showed that there was no significant difference between the two sides of tibial angle difference (0.18 鹵0.076 擄) and the control group (0.19 鹵0.084 擄) (P0.05), indicating that there was no significant change in the tibial angle of the affected side in the experimental group (0.18 鹵0.076 擄). 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 鹵0.707 擄) was higher than that of the control group (0.13 鹵0.069 擄), 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 鹵0.707cm) was higher than that of the control group (1.11 鹵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 鹵12.765mm) was higher than that of the control group (21.17 鹵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 鹵0.063mm2) was significantly lower than that of the control group (1.219 鹵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.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.9

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