神经根型颈椎病中医证型规范研究

The Study on TCM Syndromes Specifications of Cervical Spondylotic Radiculopathy

目的:神经根型颈椎病(Cervical Spondylotic Rradiculopathy,CSR)辨证分型多属总结个人经验,急需统计学的验证与完善,提供规范和标准依据。方法:采用因子分析法和聚类分析法统计,初步确立神经根型颈椎病的中医证型。结果:本次研究发现所采集病例的基本病机以"邪实"(寒凝、气滞、血瘀、痰湿)为主,"正虚"(气、血、阴、阳及肝脾肾)为辅。通过统计学分析初步得出CSR分六证型:寒湿痹阻,气血两虚,气滞血瘀,痰湿阻络,肝肾亏虚,脾肾阳虚。结论:通过对证候群进行因子分析和聚类分析,最后以中医理论为指导进行辨证,拟定CSR中医证候按发病率由高到低依次为寒湿痹阻、气滞血瘀、气血两虚、痰湿阻络、肝肾亏虚、脾肾阳虚,为中医药辨证论治CSR提供较为客观的证型依据。

Objective： To provide the basis for the specifications and standard by proving and perfecting the statistics since the syndrome differentiation and patterns of cervical spondylotic radiculopathy （CSR） were of concluding personal experiences mostly. Methods： TCM syndromes of CSR were initially ensured by adopting factor analysis and cluster analysis. Results： In the study, the basic pathogenesis of the collected medical cases was ＂excess evils （cold accumulation, Qi stagnation, and blood stasis, phlegm dampness）＂ mainly, and ＂weakened healthy Qi （Qi, blood, Yin and Yang, liver, spleen and kidney）＂ as subsidiary. According to statistical analysis, CSR could be divided into six syndromes： cold-dampness obstruction, dual deficiency of Qi and blood, Qi stagnation and blood stasis, phlegm-dampness obstructing the collaterals, deficiency of liver and kidney, and Yang deficiency of spleen and kidney. Conclusion： By performing factor analysis and cluster analysis for syndromes and differentiating guiding by TCM theory, TCM syndromes of CSR ranked from high to low according to the morbidity： cold-dampness obstruction, Qi stagnation and blood stasis, dual deficiency of Qi and blood, phlegm-dampness obstructing the collaterals, deficiency of liver and kidney, and Yang deficiency of spleen and kidney, which could provide objective evidence for syndrome differentiation and treatment of CSR.