| Objective:(1) To study the characteristics and TCM syndrome of patients with adolescent neck pain.(2) Draw up the syndromes of TCM observation table of adolescent neck pain. To differentiate symptoms of adolescent neck pain by means of large-scale clinical epidemiology.(3)To find the correlation between cervical spine X-ray imaging findings and TCM symptoms of patients with neck pain.Method:(1)On the basis of the previous investigators and literature for adolescent neck pain,203students in the two universities were investigated by means of finishing the adolescent cervical health questionnaire, to explore the etiology, pathogenesis, and TCM syndrome of adolescent neck pain.(2) According to the first part of study and expert advice,underlying diagnosis syndromes standardized reference book, to determine the adolescent neck pain syndromes observed table, and with NPQ scales and MPQ neck pain scale, we investigated1397patients with adolescents neck pain in five universities in Beijing.(3)By means of observating the cervical spine curvature, atlantoaxial joint stability, and cervical facet joints of X-rays of216adolescents with adolescent neck pain,we completed the clinical information collection form to summarize the feature of X-rays of patients with adolescents neck pain and to find the correlation between TCM syndrome and cervical spine X-ray imagine findings of patients with adolescent neck pain.Results:(1)203(96.67%) of210adolescents were evaluated by the means of questionnaire and eventually,137(67.5%)of203(65men and72women)were in accordance with the inclusive criteria. The investigator shows①gender, body mass index, hours at the desk a day, seated posture, backpack habits, the use of mobile phone time and exercise time each day on average are the risk factors for adolescent neck pain,﹑atients with adolescent neck pain are often complain of nek pain and other main symptoms(frequency>45%and the average number>2.5) which include fatigue, eyes train, neck stiffness, heaviness of the head, and adolescents minor symptoms, and③found a factor by means of factor analysis on behalf of qi stagnation and blood stasis is the most important pathogenesis.(2)1397adolescents (male25.4%, female74.6%)were evaluated by means of questionnaire and epidemiological investigator demonstrated①The pain of patients with adolescent neck pain is not severe with the total score of NPQ12.66+8.61, and an average score of MPQ4.35±4.88; Patients with adolescent neck pain commonly complain of a variety of pain, such as referred pain, distending pain, fixed pain, and stabbing pain localized in the neck and shoulder;②Frequency of greater than50%of the symptoms include five major symptoms of adolescent neck pain as well as drowsiness and vision loss;③Through cluster analysis,60TCM symptoms are classified into four categories:damp blockage syndrome, liver and spleen deficiency and heart and kidney Qi Deficiency;④Female patients NPQ neck pain score was significantly higher than male patients, age and the current level of educational attainment was positively correlated with the degree of neck pain;⑤In all TCM syndromes, the women syndromes coefficient is higher than men,where the highest correlation coefficient is liver and spleen deficiency;⑥Each syndrome has a high correlation with NPQ scores and MPQ scores, correlation coefficients were above0.6, where alpine blockage permit the highest correlation with the degree of neck pain.(3)176of216(81.48%,36male,140female)were observed with the average duration of8.68±7.70months, the average NPQ neck pain score20.59±10.0. The distribution of syndromes, stagnation and spleen deficiency syndrome is37.1%, alpine blockage certificate is34.9%,and heat blockage syndrome is25.1%, heart and kidney Qi deficiency is2.9%.①The mean curvature of the cervical spine in patients with adolescent neck pain were significantly lower than normal range. Straightened physiocurve or reverse is the main findings of X-ray of patients with adolescent neck pain. X-ray changes is negatively correlated with daily use of computer time, use the phone time, total desk time, NPQ, and cervical curvature index. Daily sleep time was positively correlated with X-ray changes;②the incidence of atlantoaxial instability in adolescent patients with neck pain was15.9%;③Measuring adolescent patients with cervical neck lateral X-ray C3-C7facet joint angle, shows the overall trend with normal cervical facet joint anatomical characteristics in line. Compared with the normal inclination of the facet joints, C3-C7angle of each facet joint abnormality rate was over40%. Total average daily use of mobile phone, desk time and C4-C6facet joint inclination showed a weak negative correlation, which total pour time and inclination C5maximum correlation coefficient. C5facet joint inclination and NPQ neck pain score was weak negative correlation;④Symptoms associated with the X-ray study found that only Borden’s method curvature measurements show relatively hot and humid with alpine blockage curvature measurement, that cervical curvature trend was more obvious straight.Conclusion:(1)The major TCM etiology of adolescent neck pain is long work injury. The involvement of long-term strain in the pathogenesis of adolescent neck pain leads to neck blood runs sluggish, blood stasis, qi stagnation, and muscle injury, blood stasis and stagnation of Qi is the main pathogenesis of disease.(2)Based on the statistical analysis and expert advice, adolescent neck pain classify4syndrome types:cold dampness syndrome, damp heat, liver stagnation and spleen deficiency and Qi Yin deficiency of heart.(3) Straightened physiocurve or reverse is the main findings of X-ray of patients with adolescent neck pain. The incidence of atlantoaxial instability of patients with adolescent neck pain is not high. Such patients can be found a variety of abnormality of C3-C7zygapophyseal may show a linkage to early stage of cervical degeneration. However, there is no significant correlation between TCM syndromes and cervical X-ray findings of patients with adolescent neck pain. |
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