非特异性腰痛的中医体质类型及其黄韧带厚度的影响因素分析

Analysis of Traditional Chinese Medicine Constitution Types of Nonspecific Low Back Pain and the Influencing Factors for the Thickness of Ligamentum Flavum

【目的】探究非特异性腰痛(nonspecific low back pain,NLBP)患者的中医体质类型及其黄韧带厚度与年龄、体质量指数(body mass index,BMI)、性别、中医体质类型、有无糖尿病、高血压分级的相关性。【方法】选取2023年1月~2023年6月广东省第二中医院收治的60例NLBP患者为研究对象,辨别患者的中医体质类型,测量电子计算机断层扫描(CT)图像腰椎4/5节段(L4/5)椎间盘水平黄韧带的厚度,记录患者的年龄、性别、中医体质类型、BMI、有无糖尿病、高血压分级,通过相关分析、线性回归分析探讨NLBP患者黄韧带厚度的相关影响因素。【结果】(1)60例NLBP患者黄韧带厚度平均为(2.60±0.72)mm。(2)NLBP患者的中医体质呈4类,其中以血瘀质分布最多,达21例(35.0%),其他从高到低依次为湿热质19例(31.7%)、痰湿质12例(20.0%)、气虚质8例(13.3%)。(3)相关分析结果显示:NLBP患者的BMI、性别、中医体质类型、有无糖尿病对黄韧带厚度的影响差异无统计学意义(P>0.05),而不同年龄、高血压分级对黄韧带厚度的影响差异有统计学意义(P<0.01)。(4)线性回归分析结果显示:不同年龄对黄韧带厚度的影响差异有统计学意义(b=0.034,t=6.282,P<0.01),而不同高血压分级对黄韧带厚度的影响差异无统计学意义(P>0.05)。【结论】NLBP患者的中医体质类型以血瘀质为主,其黄韧带厚度受年龄影响较为显著,而高血压可能是潜在的黄韧带厚度的影响因素。

Objective To investigate the distribution of the traditional Chinese medicine(TCM)constitution types in the patients with nonspecific low back pain(NLBP)and to explore the correlation of the thickness of ligamentum flavum with the age,body mass index(BMI),gender,the presence of diabetes mellitus,and the grading of hypertension.Methods Sixty patients with NLBP admitted to Guangdong Second Traditional Chinese Medicine Hospital from January 2023 to June 2023 were selected as the study subjects.The TCM constitution types of the patients were identified,the thickness of the ligamentum flavum at lumbar vertebrae 4/5 segment(L4/5)disc level was measured by computerized tomography(CT)scanning,and the patients'age,genders,TCM constitution types,BMI,the presence or absence of diabetes mellitus,and hypertension grading were recorded.Correlation analysis and linear regression analysis were used for the exploration of the relevant influencing factors for the thickness of the ligamentum flavum of patients with NLBP.Results(1)The average thickness of ligamentum flavum in the 60 patients with NLBP was(2.60±0.72)mm.(2)The TCM constitutions of NLBP patients were classified into four types,of which blood stasis constitution was the most common,accounting for 21 cases(35.0%),followed by 19 cases(31.7%)of damp-heat constitution,12 cases(20.0%)of phlegm-damp constitution,and 8 cases(13.3%)of qi deficiency constitution.(3)The results of correlation analysis showed that BMI,gender,TCM constitution type and the presence or absence of diabetes mellitus had no influence on the thickness of ligamentum flavum in NLBP patients(P>0.05),while the age and hypertension grading had an influence on the thickness of ligamentum flavum(P<0.01).(4)The results of linear regression analysis showed that the age had an influence on the thickness of the ligamentum flavum(b=0.034,t=6.282,P<0.01),while the influence of the hypertension grading had no influence on the thickness of the ligamentum flavum(P>0.05).Conclusion The TCM constitution type of NLBP patients is predominated by blood stasis constitution,the thickness of ligamentum flavum is significantly affected by the age,and hypertension may be a potential factor affecting the thickness of ligamentum flavum.