腰椎间盘突出症的分型治疗研究

Research on Differentiating Patterns to Treat Prolapse of Lumber Intervertebral Disc by Traditional Chinese Medicine

目的 :研究腰椎间盘突出症中医辨证分型治疗及与病理分型之间的关系。方法 :2 64例患者病理分为弹力型、退变失稳型和增生狭窄型 ;中医辨证为血瘀型、寒湿型和虚损型 ,并予以相应的中药和手法治疗。结果 :按病理分型 ,弹力型 111例 ,痊愈 92例 (82 .89% )、有效 19例 (17.2 1% )、无效为 0 ;退变失稳型 63例 ,痊愈 34例 (5 3.97% )、有效 2 1例 (33.33% )、无效 8例 (12 .70 % ) ;增生狭窄型90例 ,痊愈 35例 (38.89% )、有效 36例 (4 0 .0 0 % )、无效 19例 (2 1.11% )。按中医辨证分型 ,血瘀型 90例 ,痊愈 87例 (96.67% )、有效 3例 (3.33% )、无效为 0 ;寒湿型 10 0例 ,痊愈 5 4例 (5 4 .0 0 % )、有效 37例 (37.0 0 % )、无效 9例 (9.0 0 % ) ;虚损型 74例 ,痊愈 2 0例 (2 7.0 3% )、有效 36例 (4 8.65 % )、无效 18例 (2 4 .32 % )。弹力型 111例中 ,78例辨证为血瘀型 ,33例为寒湿型 ;增生狭窄型 90例 ,5 4例辨证为虚损型 ,35例为寒湿型。结论 :腰椎间盘突出症病理改变与中医辨证分型之间有一定的相关规律 ,弹力型主要辨证为血瘀型 ,其次为寒湿型 ;增生狭窄型主要为虚损型和寒湿型。其中弹力型和血瘀型有共同的临床特点 。

Objective:To investigate the relationship between the treatment of prolapse of Lumber Intervertebral Disc through differentiating symptoms to divide patterns with Traditional Chinese Medicine and its pathologic types.Method:In accordance with pathologic types and differentiating patterns by TCM,264 caese were grouped into elastic type,retrograde type and stenotic type ,and blood stasis pattern,cold damp pattern,and consumptive pattern respectively,and at the same time they were treated by corresponding traditional Chinese herbs and massage therapies.Results:Ninety two cases(82.89%) got cure and 19 cases (17.21%)had effectiveness in 111 elastic type cases;34 cases(53.97%) were healed,21 cases (33.33%) obtained effectiveness and 8 cases had no effectiveness in 63 retrograde type cases and 35 cases(38.89%) were cured,36 cases (40.00%) got effectiveness and 19 cases (21.11%) had no effectiveness in 90 stenotic type cases.According to differentiating patterns with TCM,87 cases (96.67%)got cure and 3 cases (3.33%) had effectiveness in 90 cases of blood stasis pattern;54 cases (54.00%) were healed,37 cases (37.00%) obtained effectiveness and 9 cases had no effectiveness in 100 cases of cold damp pattern and 20 cases ((27.03%)were cured,36 cases (48.65%) got effectiveness and 18cases (24.32%) had no effectiveness in 90 cases of consumptive pattern.In 111 elastic type cases,78 cases belonged to blood stasis pattern and 33 cases to cold damp pattern;and in 90 stenotic type cases,54 cases were diagnosed as consumptive pattern and 35 cases as cold damp patterns.Conclusion:There was certain interrelation between the pathologic changes and the patterns differentiated by TCM,i.e,elastic type was mainly related to blood stasis pattern, and secondly to cold damp pattern;stenotic type was principally involved in consumptive and cold damp patterns.Especially,elastic type and blood stasis pattern had same clinical manifestations and the therapeutic effect in which was the best.