腰椎间盘突出症中医证型与影像和体征的关系研究  

Relationship of Traditional Chinese Medical Syndromes with Threedimensional Radiological Imaging and Physical Signs of Lumbar Intervertebral Disc Herniation

作　　者：李永巍[1] 张顺聪[2,3] 郭丹青[2] 李永贤[3] 莫国业 李大星[3] 

机构地区：[1]澳门科技大学,澳门999078 [2]广州中医药大学第一附属医院脊柱骨科,广东广州510405 [3]广州中医药大学第一临床医学院,广东广州510405

出　　处：《广州中医药大学学报》2016年第6期768-771,共4页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】分析腰椎间盘突出症(LDH)中医证型与影像和体征的关系。【方法】纳入2015年4月1日至2016年7月10日入院治疗的40例腰椎间盘突出症患者,分析其中医证型与影像或体征的关系。【结果】(1)中医证型与影像关系:不同中医证型在突出节段、突出程度、MRI表现、Pfirrmann椎间盘分级和突出位置分型上存在显著性差异,但当突出位于L4/5时,突出位置分型差异不显著(P>0.05)。(2)中医证型与体征关系:不同中医证型对腰椎活动、直腿抬高试验有影响(OR>0.5),但在不同中医证型中,其差异性并不显著(P>0.05),且不同中医证型对其阳性的敏感性和特异性亦不高[ROC曲线下的面积值(AUC)<0.5]。【结论】本研究填补了该研究领域的部分空白,对临床诊治腰椎间盘突出症有一定指导价值。Objective To investigate the relationship of traditional Chinese medical（TCM） syndromes with the three-dimensional radiologieal imaging and physical signs of lumbar intervertebral disc herniation （LDH）. Methods The retrospective study was carried out in 40 LDH inpatients admitted from the 1st April of 2015 to the 10th July of 2016. And the relationship of TCM syndromes with the three-dimensional radiologieal imaging and physical signs of LDH was analyzed. Results （ 1 ） The relationship between TCM syndromes and three-dimensional imaging showed as the segments, degrees, MRI performance, Pfirrmann disc grading and the localization of the herniated discs, which were significantly different in LDH patients with various TCM syndromes. But the differences of the localization of herniated discs in patients with different TCM syndromes were insignificant when the herniated lumbar discs was located in IA/5. （2） The analysis results of relationship between TCM syndromes and physical signs showed that syndromes had an effect on the lumbar activities and the Lasegue sign（OR 〉 0.5）, but the difference was insignificant among various syndromes （P 〉 0.05）. And the sensitivity and the specificity of TCM syndromes to the positive physical signs were low（AUC 〈 0.5）. Conclusion The results of the study will supply evidence for the diagnosis and treatment of LDH.

关 键 词：腰椎间盘突出症 体征 中医证型 影像 

分 类 号：R681.53[医药卫生—骨科学]