来源：风湿病与关节炎,2023,12（11）:16-21.

膝骨关节炎膝周经筋分布特点的临床研究（临床研究）

邓伟哲^1,2，刘亚娴¹，魏　博²，李陆琦²，张　筠²，杨志欣¹

　　【摘　要】目的：通过分析膝骨关节炎患者的膝周经筋分布特点，为经筋治疗提供理论依据。方法：对68例活动期膝骨关节炎患者膝周分布的结筋点进行触诊，确定相关结筋病灶点分布，记录并建立数据库，进行统计学描述。结果：膝骨关节炎患者多为双膝发病，女性的平均结筋病灶点数略高于男性；女性的结筋病灶点分布较男性略微集中；病程 > 10年的结筋病灶点较病程 < 5年与病程5～10年分布频率来说，相对明显增高；不同年龄组患者结筋病灶点数量总体差异不大，仅个别结筋病灶点如血海次的比例随年龄组增长频率明显增高。各种分组下，最常见结筋病灶点为髌内下、胫骨内髁、胫骨结节、合阳次、委阳次、承山次、足三里次、胫骨外髁、髌外上、成腓间、血海次。从全膝关节整体来看，结筋病灶点分布于膝关节内侧频次明显大于膝关节外侧频次。分布于关节间隙或者较大肌肉间隙间的结筋病灶点频次，整个膝关节最常见疼痛部位在髌内侧。结论：膝骨关节炎膝周结筋病灶点分布存在明显规律，该规律与膝周经筋的生理功能密切相关，对临床运用经筋理论指导膝骨关节炎的膝周治疗具有重要意义。

　　【关键词】　膝骨关节炎；经筋理论；经筋分布规律；结筋病灶点

Clinical Study on the Distribution Characteristics of Channel Sinew Around the Knee in Patients with Knee Osteoarthritis

DENG Wei-zhe,LIU Ya-xian,WEI Bo,LI Lu-qi,ZHANG Yun,YANG Zhi-xin

　　【ABSTRACT】Objective:To provide theoretical basis for the treatment of channel sinews by analyzing their distribution characteristics around the knee of patients with knee osteoarthritis.Methods:Sixty-eight patients with active knee osteoarthritis were palpated to determine the distribution of related channel sinews around the knee,and a database was established for statistical description.Results:Patients with knee osteoarthritis mostly suffer from both knees;the average number of nodules in women is slightly higher than that in men;the distribution of nodules in women is slightly more concentrated than that in men;the distribution frequency of nodules with a disease course of more than ten years is relatively significantly higher than that with a disease course of less than five years or five to ten years.The overall difference in the number of nodules in patients of different age groups is not significant,with only a few nodules showing a significant increase in frequency as the age group increases.In various groups,the most common focal points are:infrapatellar,internal tuberosity of tibia,tibial tuberosity,Heyangci,Weiyangci,Chengshanci,Zusanlici,tibial intercondylar,suprapatellar,intercondylar,and Xuehaici.From the overall perspective of the entire knee joint,the frequency of sinew lesions distributed on the medial side of the knee joint is significantly higher than that on the lateral side of the knee joint.The frequency of knot sinew lesions distributed between joint gaps or larger muscle gaps,and the most common pain site of the entire knee joint is on the medial side of the patella.Conclusion:There is a clear pattern in the distribution of focal points of knee osteoarthritis around the knee,which is closely related to the physiological function of the sinew around the knee.It is of great significance for the clinical application of channel sinew theory to guide the treatment of knee osteoarthritis around the knee.

　　【Keywords】 knee osteoarthritis;channel sinew theory;the distribution pattern of channel sinew;nodular lesion point