脊髓型颈椎病的中医证型规范与证候特征研究  

Research on Syndromes Elements Characteristic and Syndromes Differentiation Standard of Cervical Spondylotic Myelopathy

作　　者：崔学军 杨龙[1,2] 姚敏 徐保平[1,2] 施杞 王拥军[1,2,3] CUI Xuejun;YANG Long;YAO Min;XU Baoping;SHI Qi;WANG Yongjun(Institute of Spine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China;Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education（Shanghai University of Traditional Chinese Medicine）, Shanghai 200032, China;Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.)

机构地区：[1]上海中医药大学附属龙华医院脊柱病研究所,上海200032 [2]筋骨理论与治法教育部重点实验室 [3]上海中医药大学

出　　处：《中国中医骨伤科杂志》2018年第6期11-16,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：国家自然科学基金面上项目(81373666);国家中医药管理局中医药行业科研专项(201407001-2);上海市科学技术委员会项目(16401970100)

摘　　要：目的:对脊髓型颈椎病的中医证型规范与证候分布特征进行初步探讨,以期对今后进行更加深入的脊髓型颈椎病的理论研究及中医药诊疗临床提供实践依据与临床参考。方法:通过德尔菲法制定"脊髓型颈椎病的中医四诊资料采集问卷"。采用临床流行病学现场调查的方法,对脊髓型颈椎病患者进行问卷调查,采用关联规则分析脊髓型颈椎病的证候分布规律,采用聚类分析法对脊髓型颈椎病的中医证素进行聚类,明确其证型特点。结果:通过文献研究,共得出脊髓型颈椎病相关证素17条,分别是肝、脾、肾、心、筋骨、气虚、血虚、气滞、血瘀、风、寒、湿、痰、阴虚、阳虚、精亏;相关证候340条。筛选后选择相关性较高的87条建立了"脊髓型颈椎病中医四诊资料采集问卷"。通过统计学分析得到脊髓型颈椎病证候分布规律18条;通过聚类分析得出脊髓型颈椎病的中医证型可分为心脾两虚,肾阳亏虚及经脉闭阻三大类。结论:脊髓型颈椎病的中医证型总体上可分为心脾两虚,肾阳亏虚及经脉闭阻三大类。Objective：To research the Chinese medicine syndromes characteristic and syndromes differentiation standard of cervical spondylotic myelopathy.Methods：To system review all of the literature about the Chinese medicine for cervical spondylotic myelopathy and get to know the Chinese medicine theory for cervical spondylotic myelopathy,then used the clinical presentation in the literature and Delphi method to build a scale for collected the Chinese medicine syndromes.Clinical epidemiology research was performed to collect the Chinese medicine syndromes on cervical spondylotic myelopathy patients.The method of association rules and cluster analysis was used to statistic the collected data information.Results：It was found that the Chinese medicine theory was imperfect in etiology pathogenesis of cervical spondylotic myelopathy.We also build a scale for collected the Chinese medicine syndromes.The clinical epidemiology research was performed in101 patients of cervical spondylitis myelopathy.After statistic the collected data information,we found there are 18 association rules existed in the Chinese medicine syndromes of cervical spondylotic myelopathy.The Chinese medicine syndromes differentiation could be summarized to this：deficiency of both the heart and the spleen,deficiency of kidney-yang and blocking meridian.Conclusion：＂The scale for cervical myelopathy diagnostic data collection＂ will help to further explore cervical myelopathy traditional Chinese medicine syndromes and pathogenesis.The Chinese medicine syndromes differentiation can be summarized to this：deficiency of both the heart and the spleen,deficiency of kidney-yang and blocking meridian.In the Chinese medicine syndromes distribution research,there are 18 association rules existed in the Chinese medicine syndromes of cervical spondylotic myelopathy.

关 键 词：脊髓型颈椎病 辨证论治 证候 关联规则 聚类分析 

分 类 号：R681.5[医药卫生—骨科学]