腰椎间盘突出症辨证分型与MRI影像学表现相关性研究

Study on correlativity between TCM syndrome differentiation typing and MRI imaging manifestations of lumbar intervertebral disc protrusion

目的:回顾性分析90例腰椎间盘突出症患者中医辨证分型与MRI影像学表现的关系,探讨腰椎间盘突出症中医辨证分型的MRI影像学依据。方法:分析90例腰间盘突症患者临床资料及中医辨证分型,并观察常规腰椎MRI影像学表现中的椎间盘本身的改变、椎体及附件的改变,研究腰椎间盘突出症患者中医辨证分型与MRI影像学表现的关系。结果:中医辨证分型包括血瘀型22例、寒湿型16例、湿热型14例、肝肾亏虚型38例,肝肾亏虚型发病率42.2%最高;血瘀型多为青年人,肝肾亏虚型多为老年人;血瘀型多为侧后突,寒湿型和湿热型多为侧旁型突出,肝肾亏虚型多为中央型突出;椎间盘突出程度分析:血瘀型最重,肝肾亏虚型最轻;椎体和附件改变情况:肝肾亏虚型最重。结论:腰椎间盘突出症中医辨证分型与椎间盘突出MRI影像学存在相关性,磁共振影像学表现结合临床症状可以较准确地确定腰椎间盘患者的中医分型,为临床治疗椎间盘病变提供客观依据。

Objective:To retrospectively analyze the correlativity between TCM syndrome differentiation typing and MRI imaging manifestations of 90 patients with lumbar intervertebral disc protrusion,and to approach MRI imaging basis for TCM syndrome differentiation typing of lumbar intervertebral disc protrusion.Methods:The clinical data and TCM syndrome differentiation typing of 90 patients with lumbar intervertebral disc protrusion were analyzed.The changes of intervertebral disc itself,vertebral body and appendages in conventional MRI imaging manifestations of lumbar vertebrae were observed.The relationship between TCM syndrome differentiation typing and MRI imaging manifestations of patients with lumbar intervertebral disc protrusion was studied.Results:TCM syndrome differentiation typing of all cases included 22 cases of blood stasis type,16 cases of cold dampness type,14 cases of damp heat type and 38 cases of liver-kidney both deficiency type;the incidence rate of liver-kidney both deficiency type was 42.2%,which was highest.The blood stasis type was mostly in young people;the liver-kidney both deficiency type was mostly in elderly people.The blood stasis type was mostly lateral-posterior protrusion;the cold damp type and damp heat type were mostly lateral-side protrusion;the liver-kidney both deficiency type was mostly central protrusion.The analysis of degree of intervertebral disc protrusion showed that blood stasis type was the most serious,liver-kidney both deficiency type was mildest.The changes of vertebral body and appendages showed that liver-kidney both deficiency type was the most serious.Conclusion:There is the correlativity between TCM syndrome differentiation typing of lumbar intervertebral disc protrusion and MRI imaging of intervertebral disc protrusion.MRI imaging manifestations in combination with clinical symptoms can more accurately determine TCM typing of patients with lumbar intervertebral disc protrusion,which provides an objective basis for clinical treatment of intervertebral disclesions.