[1]刘云,张斌青,宋青凤,等.红外热成像在膝骨关节炎中医辨证中的应用价值[J].中医正骨,2016,28(04):6-8.
　LIU Yun,ZHANG Binqing,SONG Qingfeng,et al.Applied value of infrared thermography in TCM syndrome differentiation for patients with knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):6-8.
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红外热成像在膝骨关节炎中医辨证中的应用价值()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年04期
页码:
6-8
栏目:
临床研究
出版日期:
2016-04-20

文章信息/Info

Title:
Applied value of infrared thermography in TCM syndrome differentiation for patients with knee osteoarthritis
作者:
刘云1; 张斌青2; 宋青凤2; 张敏2
1.河南中医药大学,河南 郑州 450008;
2.河南省洛阳正骨医院/河南省骨科医院,河南 洛阳 471002
Author(s):
LIU Yun1; ZHANG Binqing2; SONG Qingfeng2; ZHANG Min2
1.Henan University of Traditional Chinese Medicine,Zhengzhou 450008,Henan,China
2. Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
关键词:
骨关节炎; 膝;  辨证;  热痹;  痛痹;  红外热成像术;  皮肤温度
Keywords:
osteoarthritis; knee;  syndrome differentiation;  heat arthralgia;  pain arthralgia;  infrared thermography;  skin temperature
摘要:
目的:探讨红外热成像在膝骨关节炎(knee osteoarthritis,KOA)中医辨证中的应用价值。方法:选取31例双侧KOA患者,按照KOA中医辨证分型,热痹21例(热痹组)、痛痹10例(痛痹组),同时选取28例健康志愿者(健康志愿组)。用SP-9000医用红外热像仪采集31例KOA患者和28例健康志愿者双下肢红外热像图,根据采集的红外热像图用计算机软件测定受检者双侧膝关节前、内、外侧温度。结果:热痹组21例患者红外热像图表现为高温充血型,膝关节周围主体区域呈均匀红色,周围依次呈现黄色、黄色和绿色过渡带,过渡带之间存在交叉,不能明确分界; 痛痹组10例患者红外热像图表现为低温瘀血型,膝关节周围主体区域呈绿色,边界相对清晰,周围无明显的色阶混杂; 健康志愿组28例健康志愿者红外热像图表现为等温型,膝关节周围主体区域呈黄绿色,无明显异常温区分布,皮肤温度值与局部血流分布一致。3组受检者膝关节前侧、内侧、外侧温度比较,组间差异均有统计学意义[(36.11±0.78)℃,(32.88±0.48)℃,(33.69±1.42)℃,F=40.220,P=0.000;(36.05±0.75)℃,(32.81±0.65)℃,(33.94±1.38)℃,F=37.030,P=0.000;(36.04±0.66)℃,(33.28±0.72)℃,(34.45±1.03)℃,F=39.290,P=0.000]。热痹组膝关节前侧、内侧、外侧温度均高于健康志愿组(P=0.000; P=0.000; P=0.000); 痛痹组膝关节内侧、外侧温度均低于健康志愿组(P=0.007; P=0.001),痛痹组和健康志愿组膝关节前侧温度比较,差异无统计学意义(P=0.052)。结论:通过膝关节红外热成像检查,能准确区分热痹和痛痹,为KOA的中医辨证提供客观依据。
Abstract:
Objective:To explore the applied value of infrared thermography in TCM syndrome differentiation for patients with knee osteoarthritis(KOA).Methods:Thirty-one patients with bilateral KOA were selected and divided into heat arthralgia group(21 cases)and pain arthralgia group(10 cases)according to TCM syndrome differentiation of KOA.Meanwhile,28 healthy volunteers were recruited(healthy volunteers group).The infrared thermal imagings of both lower limbs of 31 KOA patients and 28 healthy volunteers were collected by using SP-9000 medical infrared thermal imaging instrument; and the anterior,medial and lateral temperatures of bilateral knee joints were measured by using computer software and the infrared thermal imagings.Results:Hyperthermia and engorgement were presented in the infrared thermal imagings of 21 patients in heat arthralgia group,and uniform red was presented in main regions of the knee,around which yellow and yellow green transition zone were presented in turn and crossed each other.Hypothermia and blood stasis were presented in the infrared thermal imagings of 10 patients in pain arthralgia group,and green was presented in main regions of the knee with relatively clear boundary,around which no obvious mixed colors were found.The infrared thermal imagings of 28 healthy volunteers in healthy volunteers group presented with normal temperature,and yellow green was presented in main regions of the knee.No obvious abnormal temperature zones were found and the skin temperature values were consistent with the local blood flow distribution.There were statistical differences in anterior,medial and lateral temperatures of knee joints between the 3 groups(36.11+/-0.78,32.88+/-0.48,33.69+/-1.42 centi-degrees,F=40.220,P=0.000; 36.05+/-0.75,32.81+/-0.65,33.94+/-1.38 centi-degrees,F=37.030,P=0.000; 36.04+/-0.66,33.28+/-0.72,34.45+/-1.03 centi-degrees,F=39.290,P=0.000).The anterior,medial and lateral temperatures of knee joints were higher in heat arthralgia group compared to healthy volunteers group(P=0.000; P=0.000; P=0.000).The medial and lateral temperatures of knee joints were lower in pain arthralgia group compared to healthy volunteers group(P=0.007; P=0.001).There was no statistical difference in the anterior temperatures of knee joints between pain arthralgia group and healthy volunteers group(P=0.052).Conclusion:The infrared thermography can be used to accurately distinguish heat arthralgia from pain arthralgia,so it can provide objective evidence for TCM syndrome differentiation of KOA.

参考文献/References:

[1] 侯德才.膝关节骨性关节炎的分期治疗[J].中医正骨,2014,26(1):3-5.
[2] 陈湘君,张伯礼.中医内科学[M].北京:科学出版社,2007:175-183.
[3] Zore Z,Boras I,Stanec M,et al.Influence of hormonal status on thermography findings in breast cancer[J].Acta Clinica Croatica,2013,52(1):35-42.
[4] Balbinot LF,Canani LH,Robinson CC,et al.Plantar thermography is useful in the early diagnosis of diabetic neuropathy[J].Clinics,2012,67(12):1419-1425.
[5] Van Haren FG,Kadic L,Driessen JJ.Skin temperature measured by infrared thermography after ultrasound-guided blockade of the sciatic nerve[J].Acta Anaesthesiol Scand,2013,57(9):1111-1117.
[6] 李惠军,刘兆平,张美娜.红外热成像诊断增生、炎症和癌症的临床价值[J].中国医学影像技术,2001,17(7):681-683.
[7] 孙丽滨,李雁平,张蔚,等.彩超和红外热图对乳腺肿块良恶性鉴别价值的探讨[J].中国超声诊断杂志,2002,3(11):878-880.
[8] 张斌青,张敏,郭会利,等.冰敷干预动态观察在红外热成像诊断软组织及周围神经损伤中的应用[J].中医正骨,2015,27(1):27-29.
[9] Sylvain G,Hak Soo C,Frangioni JV.Image-guided surgery using invisible near-infrared light:fundamentals of clinical translation[J].Molecular Imaging,2010,9(5):237-255.
[10] Sampath L,Wang W,Sevick-Muraca E.Near infrared fluorescent optical imaging for nodal staging[J].J Biomed Opt,2008,13(4):041312.
[11] Fikackova H,Ekberg E.Can infrared thermography be a diagnostic tool for arthralgia of the temporomandibular joint?[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2004,98(6):643-650.
[12] 赵明媛,曹向阳,翟远坤,等.红外热成像技术在骨伤科中的应用进展[J].中国中医骨伤科杂志,2015,23(8):78-80.

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更新日期/Last Update: 2016-08-30