MRI在椎间盘源性腰痛中医辨证分型中的应用价值

The Value of MR in TCM Differentiation Typing of Low Back Pain

目的探究MRI在椎间盘源性腰痛中医辨证分型中的应用价值。方法选取2017年3月至2018年5月间西南医科大学附属中医医院符合纳入标准的233例椎间盘源性腰痛的患者,所有病例行腰椎MRI扫描,并分析椎间盘改变及相应终板变化情况。结果在233例患者中,血瘀型有69例(29.6%)、寒湿型有53例(22.7%)、湿热型有62例(26.6%)、肝肾亏虚型有49例(21.1%),各中医辨证分型的病例数行χ2检验,差异无统计学意义。在不同中医辨证分型中,椎间盘变性、HIZ征及腰椎终板Modic征差异具有统计学意义,腰椎终板Modic征的不同分型差异也具有统计学意义,Schmorl结节出现比例不具有统计学意义。其中肝肾亏虚型的椎间盘变性比例最大,血瘀型的椎间盘HIZ征象、Modic征的比例最大。结论椎间盘源性腰痛的不同中医辨证分型间MRI征象具有差异,MRI在椎间盘源性腰痛中具有重要的应用价值。

Objective To explore the application value of MRI in Traditional Chinese Medicine(TCM)differentiation of discogenic low back pain.Methods 233 patients from March 2017 to May 2018 admitted in Affilited Traditional Chinese Medicine Hospital of SouthWest Medical University with discogenic low back pain were collected.All patients were scanned by MRI.The changes of intervertebral disc and corresponding endplate were analyzed.Results In 233 cases,blood stasis type(69,29.6%),cold-dampness type(53,22.7%),62 cases of dampnessheat type(62,26.6%),liver and kidney deficiency type(49,21.1%).Among the different TCM dialectical types,there were statistical differences in disc degeneration,HIZ sign and Modic sign of lumbar.There were also statistical differences in different types of Modic sign of lumbar.There was no statistical difference in the proportion of Schmorl nodules.liver and kidney deficiency type had the largest proportion of disc degeneration,and blood stasis type had the largest proportion of HIZ sign and Modic sign.Conclusion Different type low back pain have special MRI imaging,it has important application value in low back pain.