腰椎间盘突出症中医证型与1.5T磁共振影像的相关性探讨(1)
【摘要】 目的：探讨腰椎间盘突出症中医各证型的1.5 T磁共振(MRI)影像学表现，为中医辨证分型提供影像学参考。方法：对150例腰椎间盘突出症进行1.5 T磁共振检查和中医辨证分型，分析各证型的1.5 T磁共振影像学特点，并进行统计分析。结果：与其他类型比较，血瘀型单个椎间盘的突出程度重(P<0.05)，椎体、小关节及椎间盘退变程度轻(P<0.05)；肝肾亏虚型腰椎间盘突出数量多，椎体、小关节及椎间盘退变程度重(P<0.05)；寒湿型、湿热型介于两者之间。结论：腰椎间盘突出症中医证候分型与1.5 T磁共振影像学表现有一定的相关性，磁共振影像学表现可以作为腰椎间盘突出症中医辨证施治的量化参考。
【关键词】 腰椎间盘突出症； 辨证分型； 磁共振
doi：10.14033/j.cnki.cfmr.2016.35.002 文献标识码 A 文章编号 1674-6805(2016)35-0003-03
, 百拇医药 【Abstract】 Objective：To explore the 1.5 T magnetic resonance(MRI) imaging features of various syndromes of lumbar intervertebral disc herniation，and to provide the imaging reference for TCM syndrome differentiation and typing.Method：150 cases of lumbar disc herniation were examined by 1.5 T magnetic resonance examination and TCM syndrome differentiation.The characteristics of each syndrome type in 1.5 T magnetic resonance imaging were analyzed，and statistical treatment was performed.Result：Blood stasis type was characterized by single disc protrusion in heavy degree，and degeneration of vertebral body，small joints and intervertebral disc inlight degree，which compared with the other type，there were significant differences(P<0.05). The type of liver and kidney deficiency was characterized by more lumbar intervertebral disc herniation，and degeneration of vertebral body，small joints and intervertebral disc in heavy degree，which compared with the other type，there were significant differences(P<0.05).Cold type and damp heat type was somewhere in between.Conclusion：TCM syndrome points and 1.5 T magnetic resonance imaging findings of lumbar disc herniation has certain correlation，and magnetic resonance imaging findings can be as a quantitative reference for lumbar disc herniation syndrome differentiation of traditional Chinese medicine treatment.
, 百拇医药
【Key words】 Lumbar disc herniation； Syndrome differentiation； Magnetic resonance
First-author’s address：Qingyuan TCM Hospital Affiliated to Guangzhou University of Chinese Medicine，Qingyuan 511500，China
腰椎間盘突出症是骨伤科常见多发病，占椎管疾病的第一位，本病属中医“腰痛”“痹证”等中医范畴，是骨伤科和推拿科常见疾病之一[1]。腰椎间盘突出症的中医辨证分型的准确与否直接关系着治疗效果，为了进一步探讨腰椎间盘突出症中医症候分型与磁共振(MRI)表现之间的相关性，对笔者所在医院150例腰椎间盘突出症中医症候分型与1.5 T磁共振检查结果进行对应性分析，现总结如下。
1 资料与方法
, http://www.100md.com
1.1 一般资料
随机选择笔者所在医院就诊的腰椎间盘突出症150例，其中男80例，女70例；年龄18～70岁，平均42.4岁；病程1 d～40年；有明确外伤史者86例，无明确腰部外伤却有慢性劳损或久居湿地史64例。所有患者临床表现主要为腰腿痛，体征：突出节段相应椎旁压痛121例，伴有放射痛95例，直腿抬高试验阳性103例，趾背伸和跖屈肌力均减弱35例，跟腱反射减弱47例。
1.2 中医辨证分型
参照文献[2]国家中医药管理局1994年发布的《中医病证诊断疗效标准》分为血瘀证、寒湿证、湿热证、肝肾亏虚四种证型，由2名中级以上职称中医师于患者就诊当天严格按照标准进行共同判定。, http://www.100md.com(梁喜章 胡德志)
【关键词】 腰椎间盘突出症； 辨证分型； 磁共振
doi：10.14033/j.cnki.cfmr.2016.35.002 文献标识码 A 文章编号 1674-6805(2016)35-0003-03
, 百拇医药 【Abstract】 Objective：To explore the 1.5 T magnetic resonance(MRI) imaging features of various syndromes of lumbar intervertebral disc herniation，and to provide the imaging reference for TCM syndrome differentiation and typing.Method：150 cases of lumbar disc herniation were examined by 1.5 T magnetic resonance examination and TCM syndrome differentiation.The characteristics of each syndrome type in 1.5 T magnetic resonance imaging were analyzed，and statistical treatment was performed.Result：Blood stasis type was characterized by single disc protrusion in heavy degree，and degeneration of vertebral body，small joints and intervertebral disc inlight degree，which compared with the other type，there were significant differences(P<0.05). The type of liver and kidney deficiency was characterized by more lumbar intervertebral disc herniation，and degeneration of vertebral body，small joints and intervertebral disc in heavy degree，which compared with the other type，there were significant differences(P<0.05).Cold type and damp heat type was somewhere in between.Conclusion：TCM syndrome points and 1.5 T magnetic resonance imaging findings of lumbar disc herniation has certain correlation，and magnetic resonance imaging findings can be as a quantitative reference for lumbar disc herniation syndrome differentiation of traditional Chinese medicine treatment.
, 百拇医药
【Key words】 Lumbar disc herniation； Syndrome differentiation； Magnetic resonance
First-author’s address：Qingyuan TCM Hospital Affiliated to Guangzhou University of Chinese Medicine，Qingyuan 511500，China
腰椎間盘突出症是骨伤科常见多发病，占椎管疾病的第一位，本病属中医“腰痛”“痹证”等中医范畴，是骨伤科和推拿科常见疾病之一[1]。腰椎间盘突出症的中医辨证分型的准确与否直接关系着治疗效果，为了进一步探讨腰椎间盘突出症中医症候分型与磁共振(MRI)表现之间的相关性，对笔者所在医院150例腰椎间盘突出症中医症候分型与1.5 T磁共振检查结果进行对应性分析，现总结如下。
1 资料与方法
, http://www.100md.com
1.1 一般资料
随机选择笔者所在医院就诊的腰椎间盘突出症150例，其中男80例，女70例；年龄18～70岁，平均42.4岁；病程1 d～40年；有明确外伤史者86例，无明确腰部外伤却有慢性劳损或久居湿地史64例。所有患者临床表现主要为腰腿痛，体征：突出节段相应椎旁压痛121例，伴有放射痛95例，直腿抬高试验阳性103例，趾背伸和跖屈肌力均减弱35例，跟腱反射减弱47例。
1.2 中医辨证分型
参照文献[2]国家中医药管理局1994年发布的《中医病证诊断疗效标准》分为血瘀证、寒湿证、湿热证、肝肾亏虚四种证型，由2名中级以上职称中医师于患者就诊当天严格按照标准进行共同判定。, http://www.100md.com(梁喜章 胡德志)