基于病因学角度探究LDH中医证型职业风险的相关性  

Explore the Correlation between Traditional Chinese Medicine Classification of Lumbar Intervertebral Disc Herniation and Occupational Risk from the Perspective of Etiology

作　　者：周顺[1] 黄品强[1] 杨勇 ZHOU Shun;HUANG Pinqiang;YANG Yong(Pinghu Hospital of Traditional Chinese Medicine,Pinghu(314200),China;Pinghu First People's Hospital)

机构地区：[1]平湖市中医院,浙江平湖314200 [2]平湖市第一人民医院

出　　处：《浙江中医药大学学报》2021年第10期1125-1129,共5页Journal of Zhejiang Chinese Medical University

基　　金：2018年平湖市科技局课题(平科技[2018]66号)。

摘　　要：[目的]探讨腰椎间盘突出症(lumbar intervertebral disc herniation,LDH)中医证型与职业风险的相关性。[方法]2018年1月至2019年1月,在浙江省嘉兴市范围内,收集300份调查问卷,通过相关性分析,找出职业致病因素与LDH中医证型相关性强的几种职业,归纳出这些职业病的病因及相应中医证型。[结果]LDH中医证型与不同职业风险具有明确的相关性。LDH的发病具有明显特点:男性发病率高于女性;46~60岁年龄阶段发病率最高,与其他年龄阶段比较,差异有统计学意义(P<0.05);肝肾亏虚型在所有证型中发病率最高,与其他证型比较,差异有统计学意义(P<0.05)。统计结果显示,LDH好发人群具有以下职业分布特点:(1)同一职业内部各证型比较:一线重体力劳动者以血瘀型为多,与其他证型比较,差异有统计学意义(P<0.05),且椎间盘突出程度最为严重;司机及乘务员以湿热型为主,寒湿型为次,突出程度中等,该职业组别湿热型占比最高,与其他证型比较,差异有统计学意义(P<0.05);服装及箱包行业者多见血瘀型及肝肾亏虚型,中度突出为主,且两种证型间占比差异无统计学意义(P>0.05);教师及电脑操作者以肝肾亏虚型为主,突出一般较轻。(2)不同证型内部各职业类别间比较:血瘀型以一线重体力劳动者多见,寒湿型及湿热型以司机及乘务员职业为主,肝肾亏虚型以教师及电脑操作者为主,与同一证型内其他职业类别比较,以上各职业占比差异均有统计学意义(P<0.05)。[结论]LDH的不同中医证型与不同职业风险类别分布特点存在一定相关性,不同职业LDH的中医证型和分布占比中存在明显差异。[Objective]To explore the correlation between traditional Chinese medicine(TCM)syndrome types and occupational risk in patients with lumbar intervertebral disc herniation(LDH).[Methods]From January 2018 to January 2019,300 questionnaires were collected in Jiaxing area,Zhejiang Province.Through correlation analysis,several occupations with strong correlation between occupational pathogenic factors and LDH syndrome types were found,the etiological factors of these occupational diseases and the corresponding TCM syndrome types were summarized.[Results]LDH had clear correlation with different occupational risks.The incidence of LDH was higher in male than in female;the incidence of LDH was the highest in 46~60 years old people,and the difference was statistically significant compared with other age groups(P<0.05);the incidence of liver and kidney deficiency was the highest among all syndrome types,and the difference was statistically significant compared with other syndromes,there were significant differences compared with other syndrome types(P<0.05).The statistical results showed that the susceptible group of LDH had the following occupational distribution characteristics:Compared with the syndrome types in the same occupation,the blood stasis syndrome was the most among the first-line heavy physical workers,and the difference was significant compared with other syndrome types(P<0.05),the degree of intervertebral disc protrusion was the most serious;the driver and steward were of mainly damp-heat syndrome,followed by cold-damp syndrome,and the degree of protrusion was medium.The occupation group had the highest proportion of damp-heat syndrome,compared with other syndrome types,the difference was statistically significant(P<0.05).In clothing and bag trade,blood stasis syndrome and deficiency of liver and kidney syndrome were the main types,the degree of protrusion was medium,and there was no significant difference between the two types of syndrome(P>0.05).The deficiency of liver and kidney syndrome was the main typ

关 键 词：病因学 腰椎间盘突出症 中医证型 职业风险 相关性 调查问卷 职业分布 差异性 

分 类 号：R681[医药卫生—骨科学]