586例腰椎间盘突出症患者中医体质分类与证型分布的研究

Study on TCM Constitution Classification and Syndrome Type Distribution of 586 Patients with Lumbar Disc Herniation

目的对586例腰椎间盘突出症患者进行调查,了解其中医体质分类及证型的分布规律,探讨LDH患者中医体质与证型的相关性,为临床治疗LDH“辨体质-辨病-辨证”三辨诊疗提供参考和依据。方法采用王琦体质九分法和《中医病证诊断疗效标准》中关于LDH的中医证候分类标准对纳入患者进行体质分类和辨证分型。结果患者的中医偏颇体质以血瘀质(28.84%)、阳虚质(18.60%)和湿热质(15.87%)为主;中医辨证分型以血瘀证(36.01%)和湿热证(26.11%)为主;对中医证型分布和体质分类进行Fisher确切检验,有统计学差异(P<0.01),提示LDH患者中医体质分类与证型之间有相关性。结论LDH患者主要偏颇体质为血瘀质、阳虚质和湿热质,主要证型为血瘀证和湿热证,体质和证型之间有相关性,临床治疗时需“辨体质-辨病-辨证”三辨诊疗相结合。

Objective:To investigate 586 patients with lumbar disc herniation,understand the classification of medical constitution and the distribution of syndrome types among them,and explore the correlation between TCM constitution and syndrome types of LDH patients,so as to provide reference and basis for clinical treatment of LDH based on the "differentiation of constitution,disease and syndrome". Methods:The nine points of constitution of Prof. Wang Qi and the TCM syndrome classification standard of LDH in the Diagnostic Efficacy Standard of TCM Diseases and Syndromes were used to classify the patients′ constitution and syndrome differentiation.Results:Blood stasis(28.84%),yang deficiency(18.60%)and damp heat(15.87%)were the main biased constitution of the patients;the main syndrome types of TCM were blood stasis(36.01%)and damp heat(26.11%);Fisher′s exact test of TCM syndrome type distribution and constitution classification showed that there was a statistical difference(P < 0.01),indicating that there was a correlation between TCM constitution classification and syndrome type in LDH patients. Conclusion:The main biased constitution of patients with LDH is blood stasis,yang deficiency and damp heat,and the main syndrome types are blood stasis and damp heat. There is a correlation between constitution and syndrome types. The clinical treatment requires the combination of "constitution differentiation,disease differentiation and syndrome differentiation".