Study on the characteristics of pattern elements and the distribution of patterns of three kinds of early hip joint diseases with "different diseases with the same pattern".

Objective To analyze the characteristics of pattern elements and the distribution of patterns of femoral head necrosis, hip osteoarthritis, and hip rheumatoid arthritis, in order to provide a theoretical basis for the "different diseases with the same pattern" of chronic bone diseases. Methods A cross-sectional survey was conducted to select patients with femoral head necrosis Association Research Circulation Osseous I-II stages, hip osteoarthritis Kellgren & Lawrence I-II stages, and acute or subacute hip rheumatoid arthritis who visited the Minimally Invasive Arthrology Department, Traumatology Department, and Rheumatology and Immunology Department of Beijing University of Chinese Medicine Third Affiliated Hospital from June 2020 to June 2022. The "case report form - traditional Chinese medicine pattern manifestation scale" previously developed by our team was used to collect the pattern manifestations, which were included into an Excel 2020 spreadsheet to establish a database. SPSS 20.0 software was used for factor analysis and cluster analysis to extract pattern element information, such as disease nature and location, in order to summarize the characteristics of pattern elements, the distribution of patterns, and the similarities and differences of the three kinds of early hip joint diseases. Results A total of 410 patients were included, including 150 patients with femoral head necrosis, 160 patients with hip osteoarthritis, and 100 patients with hip rheumatoid arthritis. The pattern elements of the disease nature of femoral head necrosis include phlegm (dampness), blood stasis, yang deficiency, essence deficiency, and qi deficiency. The pattern types were initially divided into four categories: syndrome of meridian obstruction (43.33%), syndrome of phlegm and blood stasis blocking collaterals (38.00%), syndrome of liver and kidney deficiency (12.00%), and syndrome of kidney essence deficiency (6.67%). The pattern elements of the disease nature of hip osteoarthritis include phlegm (dampness), blood stasis, qi deficiency, essence deficiency, yang deficiency, and cold (dampness). The pattern types were preliminarily divided into five categories: syndrome of spleen and kidney deficiency (37.50%), syndrome of meridian obstruction (26.87%), syndrome of cold and dampness obstruction (18.75%), syndrome of phlegm and blood stasis obstruction (9.38%), and syndrome of liver and kidney deficiency (7.50%). The pattern elements of the disease nature of hip rheumatoid arthritis include phlegm (dampness), blood stasis, qi deficiency, yin and yang deficiency, cold (dampness), and essence deficiency. The pattern types were preliminarily divided into four categories: syndrome of phlegm and blood stasis obstruction (34.00%), syndrome of cold and dampness obstruction (28.00%), syndrome of blood stasis blocking collaterals (23.00%), and syndrome of liver and kidney deficiency (15.00%). Overall, the top five pattern manifestations of the three kinds of hip joint diseases were hip joint pain (96.59%), tenderness (93.90%), fixed pain (87.56%), heavy joints (85.37%), and sourness of lower limbs (75.37%). The pattern elements of the disease nature include phlegm (dampness), blood stasis, qi deficiency, etc. The pattern types were preliminarily divided into five categories: syndrome of phlegm stasis blocking collaterals (33.17%), syndrome of meridian obstruction (31.95%), syndrome of cold dampness obstruction (21.46%), syndrome of liver and kidney deficiency (7.32%), and syndrome of spleen and kidney deficiency (6.10%). There were 21 similar pattern manifestations in the three kinds of early hip joint diseases, with blood stasis and spleen deficiency being the main pattern. Conclusion The common pattern characteristics of three kinds of early hip joint diseases are spleen deficiency and blood stasis. In addition, femoral head necrosis is accompanied with phlegm-dampness pattern, hip osteoarthritis is accompanied with kidney deficiency and phlegm-dampness pattern, hip rheumatoid arthritis is accompanied with kidney deficiency and cold-dampness pattern. [ABSTRACT FROM AUTHOR]