Study On The Correlation Between TCM Syndrome Points And Imaging Performance Of Lumbar Intervertebral Disc Protrusion (Qi Stagnation And Blood Stasis Type)

Background:With the development of society and the quickening of the pace of life,LDH has become a common clinical disease,seriously affecting patients’ life and work.In recent years, with the development of the TCM and the understanding of this disease, the TCM treatment of LDH has attracted more and more attention.In order to improve the clinical effect of TCM treatment of this disease and carry on the standardized and objective research of TCM syndrome differentiation, Scholars associated TCM Syndrome Types with imaging findings, studying the correlation between the two and observing the imaging differences between different syndrome types.However, the TCM syndrome differentiation in this kind of studies only considered the existence of symptoms and signs of the disease, without taking the severity of the syndrome into consideration.And the patient’s overall condition is often reflected in the severity of the syndrome.Depending on the severity of the syndrome, the syndrome quantitative score can evaluate the patient’s overall syndrome more objectively, and facilitate the evaluation of clinical efficacy of the TCM and communication between scholars.If the syndrome score and objective imaging findings will be included in the study, it will not only contribute to the standardization and objectification of TCM syndrome differentiation, but also can provide a theoretical basis for the treatment of the disease and improve clinical efficacy.Objective:Study the characteristics of TCM syndrome score and imaging finds among patients with LDH(qi stagnation and blood stasis type),and the correlation between the two characteristics,provide a theoretical basis for standard and objective TCM syndrome differentiation of qi stagnation and blood stasis type of LDH,provide reference for the TCM treatment of LDH.Methods:According to the inclusion criteria,36 patients were included.Collect the basic information of the patients.Extract the main ones and the secondary ones among the clinical symptoms of the LDH of the qi stagnation and blood stasis type,according to the "Standards of TCM syndrome diagnosis and treatment" promulgated by the State Administration of TCM in 1994 and "Chinese medicine clinical research guiding principles (Trial)".Then according to the symptoms severity,the symptoms were divided into light, medium and heavy four levels.Every level of the main symptoms was given scores with0,2,4,6,and the secondary ones with 0,1,2,3.As a reference, tongue and pulse were not given scores.Draft the TCM symptom score table and score all patients with TCM syndrome.At the same time, all the patients were examined by lumbar spine X-ray,CT and MRI.Measure or judge the lumbar curvature,position and size of disc herniation and diameter of the lateral recess according to imaging findings.Nucleus protrusion rate stands for the size of disc herniation. According to whether there is Modic change,Modic type is used in endplate typing. Study the characteristics of TCM syndrome score and imaging finds among patients,and whether there is a correlation between the two characteristics.Results:Collect all data and process data with software SPASS20.0.1.The TCM syndrome scores of patients range from 8 to 23 points, about 15.67±4.41 points on average.The scores of every main and secondary symptoms were significantly correlated with the total score of syndrome.In the main symptoms,the main symptom 1 and 3 were correlated significantly higher than 2.In the secondary symptoms, the correlation with the second symptom 2 is higher than the second symptom 1.2.Lumbar curvatures of all the patients range from 0 to 19.9 mm,9.94±5.14mm on average.About the position of disc herniation,14 cases of central type account for 38.89%,11 cases of paracentral type account for 30.56%,6 cases of lateral type account for 16.67%,5 cases of extralateral account for 13.89%.The NPR ranges from 16.08% to 55.32%,29.378%±9.209% on average.Diameter of the lateral recess ranges from 1.9mm to 5.2mm,3.18±0.87mm on average.About endplate degeneration,9 cases without Modic changes account for 25%,14 cases with Modic type I change account for 38.89%,11 cases with type II account for 30.56%,2 cases of type III account for 5.56%.3.The TCM syndrome score is negatively correlated with lumbar curvature and diameter of lateral recess,positively size of disc herniation,not significantly position of disc herniation.Conclusion:1.Patients with LDH(qi stagnation and blood stasis type) have typical main and secondary clinical manifestations.In the main symptoms,lumbocrural pain and sciatica are more representative than lumbar stiffness.In the secondary syndromes,lumbocrural heaviness is more representative than numbness of lower limbs.2.The TCM syndrome score of patients with LDH(qi stagnation and blood stasis type)is correlative with lumbar curvature, size of disc herniation, diameter of the lateral recess and endplate degeneration in imaging findings.And there is no significant correlation between score and position of disc herniation.The straighter lumbar curvature,the larger size of disc herniation,narrower lateral recess and more serious endplate degeneration can increase the TCM syndrome score.