长宁社区腰椎间盘突出症患者病因学和中医证型的调查研究

目的:通过对长宁社区腰椎间盘突出症的分布规律、中医证型特点和诊治现状进行调查统计,对其原发病因、中医证型与效应指标之间的关系进行分析.方法:随机取样收集病例500例,采用SPSS 13.0软件包,对患者的症状、体征、舌脉采用K-means聚类分析,再对各种类型进行主成分分析,判定各种类型的代表症状,归纳出基本证型；对每位患者的治法和疗效进行分析.结果:调查收集的LDH常见症状24种,症状出现频率较高的是腰骶疼痛、腰腿疼痛、腰部胀痛、单侧下肢放射痛、单侧下肢麻木,活动后加重；症状出现频率较低的是髋部疼痛、鞍区麻木、大小便失禁.91％的患者首选非手术治疗,疗效达95％以上；辨证分型与X线、CT扫描结果有一定的相关性.结论:肝肾亏虚、气滞血瘀是腰椎间盘突出症的根本病机；X线、CT扫描可作为LDH辨证分型的客观指标之一；非手术治疗为LDH首选治疗,疗效满意.

Etiology and TCM Syndrome Type of Patients with Lumbar Disc Herniation in Changning Community

Objective: To research and count the distribution rule,characteristics of TCN syndrome type and the present situation of diagnosis and treatment of lumbar disc herniation(LDH)in Changning community,and to analyze the relationships of the original courses,TCM syndrome type and effect index.Methods: 500 cases were randomly collected,SPSS software package was used to analyze the patients′ syndromes,physical signs and tongue vein with K cluster,then the various types of principal component were analyzed to determine the representative symptoms of various types and summarize the basic syndrome types.Lastly,each patient′s treatment and curative effects were analyzed.Results: The collected 24 common symptoms of LDH were investigated.These syndromes,such as lower waist pain,lumbocrural pain,waist pain and unilateral lower limb radiation pain and lower limb numbness appeared at the tallest frequency and increased after activity;while the symptoms,such as hip pain,saddle anesthesia and incontinence showed a lower frequency.91% of patients preferred non-operational treatment and the curative effect reached more than 95%;syndrome differentiation and X-ray,CT scan results had certain relevance.Conclusion: The deficiency of the liver and kidney and qi stagnation and blood stasis were the fundamental pathogenesis of this disease;X line,CT scan can be regarded as the objective index of LDH syndrome differentiation;non-operative treatment for LDH is preferred most with satisfied curative effect.