2004-2011年甘肃省中医院采用非手术方法治疗的腰椎间盘突出症患者的临床特征分析

目的：分析甘肃省中医院近年来采用非手术方法治疗的腰椎间盘突出症患者的临床特征.方法：调查整理2004-2011年4 880例在甘肃省中医院采用非手术方法治疗的腰椎间盘突出症患者的病历资料,建立资料库,从性别、年龄、病因、突出节段、合并症、职业及医疗付款方式7各方面分析患者的临床特点.结果：①性别.纳入研究的4 880例患者中,男2 548例,女2 332例.②年龄.20岁以下患者38例,21 ～30岁患者332例,31 ～40岁患者996例,41～50岁患者1 392例,51～60岁患者1 152例,61～70岁患者672例,70岁以上患者298例.③病因.有慢性劳损史者1 598例,有明确外伤史者942例,有明确扭伤史者690例,无明显诱因者1 668例.④突出节段.L1～2突出82例,L2～3突出224例,L3～4突出1 194例,L4～5突出3 420例,L5S1突出2 560例;单节段突出2 996例,双节段突出1 182例,三节段突出702例.⑤合并症.合并高血压病684例,糖尿病537例,骨质疏松症402例,胆囊炎270例,膝骨关节炎204例.⑥职业.工人1 202例,农民1 084例,干部894例,学生86例,军人26例,会计38例,文员232例,教师212例,司机94例,其他职业者1 010例.⑦医疗付款方式.社会基本医疗保险2 550例,自费2 030例,商业保险26例,公费医疗26例,大病统筹8例.结论：2004-2011年甘肃省中医院采用非手术治疗的腰椎间盘突出症患者男性多于女性,以20～40岁的青壮年患者为主,慢性劳损、外伤和扭伤是发病的主要原因,突出节段以L4～5和L5S1多见,工人、农民和干部所占比例最高.

Analysis on clinical characteristics of patients with lumbar disc herniation treated by non-surgical methods in Gansu Provincial Hospital of TCM, 2004-2011

Objective： To analyze the clinical characteristics of patients with lumbar disc herniation （LDH） treated by non-surgical methods in Gansu provincial hospital of TCM.Methods：The medical records of 4 880 patients with LDH treated by non-surgical methods in Gansu provincial hospital of TCM from 2004 to 2011 were investigated and sorted,and then a database was built,after that,the clinical characteristics of the patients were analyzed in such parameters as gender,age,pathogenesis,protrusion segments,complications,occupation and medical payment method.Results：The 4 880 patients that included in the study consisted of 2 548 males and 2 332 females.The patients who under 20 years were 38 cases,21-30 years were 332,31-40 years were 996,41-50 years were 1 392,51-60 years were 1152,61 -70 ys were 672,older than 70 were 298.The pathogenesis of the patients include chronic strain（1 598 cases）,trauma（942 cases）,sprain （690 cases）.The 4 880 patients with protrusion segments in L1～2 were 82 cases,L2～3 were 224 cases,L3 ～4 were 1 194 cases,L4～5 were 3 420 cases,L5S1 were 2 560 cases ;in which consisted of single segmental protrusion （2 996 cases）,double segmental protrusion （1 182 cases） and three segmental protrusion （702 cases）.The complications of the patients include hypertension （684 cases）,diabetes mellitus （537 cases）,osteoporosis（402 cases）,cholecystitis （270 cases） and knee osteoarthritis （204 cases）.The 4 880 patients that included in the study consisted of worker （1202 cases）,peasants （1084 cases）,cadre （894 cases）,student （86 cases）,soldier （26 cases）,accountant （38 cases）,office clerk（232 case）,teacher（212 cases）,driver（94 cases） and other occupations （1010 cases）.And the medical payment methods were adopted for them were social basic medical insurance（2 550 cases）,self-supporting（2 030 cases）,commerial insurance （26 cases）,free medical service （26 cases） and comprehensive arrangement for serious disease （2 cases）.Conclusion： There were more males than females in the patients with LDH treated by non-surgical methods in Gansu provincial hospital of TCM from 2004 to 2011,and mainly dominated by young adults aged （20-40 years old）,chronic strain,trauma and sprain were the main causes of this disease,and the protrusion segments were mainly in L4～5 and L5S1,besides,workers,peasants and cadres were the highest proportion.