| 椎间盘源性腰腿痛诊治规范化研究 |
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Received:March 30, 2004
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| 作者 | Author | 单位 | Unit | E-Mail |
| 蒋位庄 |
JIANG Wei-zhuang |
中国中医研究院骨伤科研究所,北京100700 |
Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine |
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| 周卫 |
ZHOU Wei |
中国中医研究院骨伤科研究所,北京100700 |
Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine |
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| 张禄堂 |
ZHANG Lu-tang |
中国中医研究院骨伤科研究所,北京100700 |
Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine |
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| 张世民 |
ZHANG Shi-min |
中国中医研究院骨伤科研究所,北京100700 |
Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine |
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| 章永东 |
ZHANG Yong-dong |
中国中医研究院骨伤科研究所,北京100700 |
Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine |
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| 李星 |
LI Xing |
中国中医研究院骨伤科研究所,北京100700 |
Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine |
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| 期刊信息：《中国骨伤》2004年17卷，第11期，第643-646页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目:国家中医药管理局科研基金课题(编号:9221C4) |
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目的:评价椎间盘源性腰腿痛病名及分型诊治的实用价值。明确中医药和手法辨证施治为主的非手术和手术适应证,寻找中西医结合诊治该证的切入点。
方法:经近2000例住院病人诊疗经验的总结,制订出椎间盘膨出(Ⅰ型)、弹力型突出(Ⅱ型)、退变失稳型(Ⅲ型)、增生狭窄型(Ⅳ型)、软骨板破裂(Ⅴ型)五个病理类型及诊治标准。根据中医辨证论治原则,制订出气滞血瘀、湿热痹痛、风寒湿困和肝肾亏损四个中医证型。
结果:从1997-2002年12月对668例分型治疗结果中看出,采取中医药手段为主的非手术治疗率为68%,其中Ⅱ型为90%,Ⅲ型为69%,Ⅳ型为44%,Ⅴ型43%。以中医药非手术治疗的优良率达79%。经非手术治疗无效的213例改为手术治疗的优良率为94%。经非手术效果不良者,使手术目的性更明确故显效率高。
结论:椎间盘源性腰腿痛分型治疗有利于发挥中医药治疗优势,降低了手术率,提高手术的正确性和目的性,为中西医结合治疗腰腿痛提供了可靠的理论依据。 |
| [关键词]:椎间盘移位 腰腿痛 中医现代化 |
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| Standardized study of diagnosis and treatment for discogenic lumbago-leg pain |
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Abstract:
Objective:To evaluate the practical significance of classification of diagnosis and treatment for discogenic lumbago-leg pain and to determine the indications of nonoperative and operative treatment with traditional chinese medicine and manipulative methods,according to symptomatic differentiation,so as to seek the contacting point of the integrated treatment of western medicine and TCM.
Methods:Based on the experienced summarization of diagnosis and treatment of 2 000 inpatients,five pathological types and standard of diagnosis and treatment were established:disc bulge type(type Ⅰ),elastic herniation type(type Ⅱ),degenerative unstability type(typeⅢ),hyperplasia stenosis type(type Ⅳ)and cartilage endplate rupture type(type Ⅴ).Four types syndrome of TCM were also formulated based on the principle of treatment according to syndrome differentiation of TCM,namely type of stagnancy of qi and blood stasis,type of disturbance due to wind-cold-dampness,and type of deficiency of liver-kidney.
Results:Among 668 patients,the rate of nonoperative treatment was 68%,out of them,type Ⅱ was 90%,type Ⅲ 69%,type Ⅳ 44% and type Ⅴ43%.The markedly effective rate treated with nonoperative treatment of TCM reached 79%.The failed 213 patients were retreated with surgical operation,and the rate of excellent and good was 94%.In the way the objective of operation would be more precise and the rate of excellent and good would be higher.
Conclusion:The classification treatment for lumbar discogenic lumbago-leg pain is beneficial to development of TCM advantages,and to raising the total curative rate,so as to provide the reliable theoretical basis for the treatment of lumbago-leg pain with the combined method of western medicine and TCM. |
| KEYWORDS:Intervertebral disk displacement Lumbago-leg pain Modernization(TCM) |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 蒋位庄,周卫,张禄堂,张世民,章永东,李星.椎间盘源性腰腿痛诊治规范化研究[J].中国骨伤,2004,17(11):643~646 |
| 英文格式: | JIANG Wei-zhuang,ZHOU Wei,ZHANG Lu-tang,ZHANG Shi-min,ZHANG Yong-dong,LI Xing.Standardized study of diagnosis and treatment for discogenic lumbago-leg pain[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(11):643~646 |
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