[1]崔学军 杨龙 姚敏 徐保平 施杞 王拥军△.脊髓型颈椎病的中医证型规范与证候特征研究[J].中国中医骨伤科杂志,2018,26(06):11-16.
　CUI Xuejun YANG Long YAO Min XU Baoping SHI Qi WANG Yongjun.Research on Syndromes Elements Characteristic and Syndromes Differentiation Standard of Cervical Spondylotic Myelopathy[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(06):11-16.
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脊髓型颈椎病的中医证型规范与证候特征研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第26卷
期数:
2018年06期
页码:
11-16
栏目:
临床研究
出版日期:
2018-06-02

文章信息/Info

Title:
Research on Syndromes Elements Characteristic and Syndromes Differentiation Standard of Cervical Spondylotic Myelopathy
文章编号:
1005-0205(2018)06-0011-06
作者:
崔学军1; 2 杨龙1; 2 姚敏1; 2 徐保平1; 2 施杞1; 2 王拥军1; 2; 3△
1上海中医药大学附属龙华医院脊柱病研究所(上海,200032) 2筋骨理论与治法教育部重点实验室 3上海中医药大学 △通信作者 E-mail:yjwang8888@126.com
Author(s):
CUI Xuejun1; 2 YANG Long1; 2 YAO Min1; 2 XU Baoping1; 2 SHI Qi1; 2 WANG Yongjun1; 2; 3△
1Institute of Spine,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China; 2Key Laboratory of Theory and Therapy of Muscles and Bones,Ministry of Education(Shanghai University of Traditional Chinese Medicine),Shanghai 200032,China; 3Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China.
关键词:
脊髓型颈椎病;  辨证论治;  证候;  关联规则;  聚类分析
Keywords:
Keywords: cervical spondylitis myelopathy;  syndrome differentiation Chinese medicine theory;  Chinese medicine syndromes;  association rules;  cluster analysis
分类号:
R681.5
文献标志码:
A
摘要:
目的:对脊髓型颈椎病的中医证型规范与证候分布特征进行初步探讨,以期对今后进行更加深入的脊髓型颈椎病的理论研究及中医药诊疗临床提供实践依据与临床参考。方法:通过德尔菲法制定“脊髓型颈椎病的中医四诊资料采集问卷”。采用临床流行病学现场调查的方法,对脊髓型颈椎病患者进行问卷调查,采用关联规则分析脊髓型颈椎病的证候分布规律,采用聚类分析法对脊髓型颈椎病的中医证素进行聚类,明确其证型特点。结果:通过文献研究,共得出脊髓型颈椎病相关证素17条,分别是肝、脾、肾、心、筋骨、气虚、血虚、气滞、血瘀、风、寒、湿、痰、阴虚、阳虚、精亏; 相关证候340条。筛选后选择相关性较高的87条建立了 “脊髓型颈椎病中医四诊资料采集问卷”。通过统计学分析得到脊髓型颈椎病证候分布规律18条; 通过聚类分析得出脊髓型颈椎病的中医证型可分为心脾两虚,肾阳亏虚及经脉闭阻三大类。结论:脊髓型颈椎病的中医证型总体上可分为心脾两虚,肾阳亏虚及经脉闭阻三大类。
Abstract:
Abstract Objective:To research the Chinese medicine syndromes characteristic and syndromes differentiation standard of cervical spondylotic myelopathy.Methods:To system review all of the literature about the Chinese medicine for cervical spondylotic myelopathy and get to know the Chinese medicine theory for cervical spondylotic myelopathy,then used the clinical presentation in the literature and Delphi method to build a scale for collected the Chinese medicine syndromes.Clinical epidemiology research was performed to collect the Chinese medicine syndromes on cervical spondylotic myelopathy patients.The method of association rules and cluster analysis was used to statistic the collected data information.Results:It was found that the Chinese medicine theory was imperfect in etiology pathogenesis of cervical spondylotic myelopathy.We also build a scale for collected the Chinese medicine syndromes.The clinical epidemiology research was performed in 101 patients of cervical spondylitis myelopathy.After statistic the collected data information,we found there are 18 association rules existed in the Chinese medicine syndromes of cervical spondylotic myelopathy.The Chinese medicine syndromes differentiation could be summarized to this:deficiency of both the heart and the spleen,deficiency of kidney-yang and blocking meridian.Conclusion:“The scale for cervical myelopathy diagnostic data collection” will help to further explore cervical myelopathy traditional Chinese medicine syndromes and pathogenesis.The Chinese medicine syndromes differentiation can be summarized to this:deficiency of both the heart and the spleen,deficiency of kidney-yang and blocking meridian.In the Chinese medicine syndromes distribution research,there are 18 association rules existed in the Chinese medicine syndromes of cervical spondylotic myelopathy.

参考文献/References:

[1] 文天林,孙天胜.脊髓型颈椎病的病理演变和治疗研究进展[J].人民军医,2017,60(1):75-76.
[2] 苏亮磊,曹林忠.脊髓型颈椎病发病机制研究进展[J].甘肃中医学院学报,2017,34(1):91-94.
[3] Broughton E.Cervical spondylotic myelopathy[J].Challenging Concepts in Neurosurgery:Cases with Expert Commentary,2015:161.
[4] 杨龙,姚敏,孙悦礼,等.脊髓型颈椎病的自然病史研究现状[J].颈腰痛杂志,2016,37(1):58-61.
[5] 余利鹏,殷国勇.脊髓型颈椎病研究中的争议与进展[J].中国骨与关节外科,2016,8(3):265-268.
[6] 睦顺姬,叶秀兰,姚敏,等.中医药治疗脊髓型颈椎病的机理研究概况[J].世界中医药,2017,12(1):222-224.
[7] 姜文涛,梅伟,王庆德,等.脊髓型颈椎病的中医治疗[J].中国实用医药,2016,11(2):263-264.
[8] 杨宇,夏建龙,陈刚,等.中药治疗脊髓型颈椎病的研究进展[J].中国中医急症,2016,25(4):685-687.
[9] 戴锋,姜宏.脊髓型颈椎病的中医药治疗进展[J].中医正骨,2014,26(1):52-54.
[10] 吴剑铧.温针灸配合中药外敷治疗脊髓型颈椎病疗效观察[J].中医临床研究,2016,8(14):29-30.
[11] 杨宇,夏建龙,陈刚,等.益气活血方对大鼠慢性脊髓压迫后脊髓功能恢复的影响[J].西部中医药,2017,30(4):16-19.
[12] 汤宏.中医药干预对脊髓型颈椎病术后脊髓功能恢复的影响[J].中医临床研究,2014,6(19):11-13.
[13] 李永文,庞梅桂,薛翠珍,等.益气通络汤对脊髓型颈椎病术后残余脊髓神经功能的影响[J].中国中医骨伤科杂志,2017,25(6):15-18.
[14] 杨龙,姚敏,孙悦礼,等.脊髓型颈椎病的循证治疗研究现状[J].世界中医药,2015,10(11):1796-1801.
[15] 吴杨鹏,范筱,张俐.张俐教授运用活血通督汤治疗脊髓型颈椎病的经验介绍[J].中国中医骨伤科杂志,2016,24(8):68-70.
[16] 朱文峰.中医主证辨证诊断学[M].长沙:湖南科学技术出版社,2000:316-331.
[17] 朱文锋,晏峻峰,黄碧群.贝叶斯网络在中医证素辨证体系中的应用[J].中西医结合学报,2006,4(6):567-571.
[18] 朱文锋,何军锋,晏峻峰,等.确定证素辨证权值的“双层频权剪叉”算法[J].中西医结合学报,2007,5(6):607-611.
[19] 朱文锋.证素辨证学[M].北京:人民卫生出版社,2008:89-90.
[20] 姜春艳.辨证分型治疗脊髓型颈椎病62例[J].实用中医内科杂志,2012,26(12):44-45.
[21] 李建民.脊髓型颈椎病的中医治疗[J].中华中医药杂志,2007,22(5):276-277.
[22] 马建国,葛青山.地黄饮子加减治疗脊髓型颈椎病的体会[J].山西中医,1991,7(6):21-22.
[23] 马立银.脊髓型颈椎病治验[J].河北中医,1991,13(1):42.
[24] 马晓春,张春光.补阳还五汤加味治疗脊髓型颈椎病12例[J].四川中医,1994,12(5):40-41.
[25] 唐晓栋,樊成虎.黄芪桂枝五物汤治疗脊髓型颈椎病27例[J].现代中医药,2013,33(3):41-42.
[26] 韦贵康,陈锋.中药“脊髓康”内服治疗脊髓型颈椎病 32 例临床观察与实验研究[J].广西中医学院学报,2001,4(4):86-88.
[27] 杨茂清.中医综合治疗脊髓型颈椎病60例观察[J].现代临床医学,2009,35(5):355-356.
[28] 张淑静.脊髓型颈椎病治验[J].四川中医,1991,19(1):40.
[29] 赵树军,常秀龙,白明泽.中药疗法对156例脊髓型颈椎病临床研究[J].中国社区医师:医学专业,2007,9(6):70.
[30] 周林宽,章明.脊髓型颈椎病的辨证论治[J].浙江中医学院学报,1997,21(2):13-14.
[31] 吴相春,杨晓黎,陈金亮,等.益督通络汤治疗脊髓型颈椎病60例[J].陕西中医,2006,27(8):952-953.
[32] 赵树军,HyangEa J,于涛,等.整骨理筋手法结合中药对脊髓型颈椎病的临床分析[J].世界中医骨科杂志,2010,(2):93-95.
[33] 卢彬,吴军豪.自拟石氏颈髓通络方治疗脊髓型颈椎病临床研究[J].上海中医药杂志,2012,46(1):49-51.
[34] 高泉阳.名老中医张天健治疗脊髓型颈椎病的经验[J].中医正骨,2006,18(2):64.
[35] 吴弢.从痉,痿证论治脊髓型颈椎病——施杞临床经验介绍[J].上海中医药杂志,1998,32(11):14-15.
[36] 张淳,张军,唐东昕,等.孙树椿从痿证、痹证论治脊髓型颈椎病[J].中国中医骨伤科杂志,2007,15(6):61.
[37] 张鞠华,顾佩莉,徐春巍,等.两步手法联合中药汽疗治疗神经根型颈椎病的临床观察[J].中国中医骨伤科杂志,2018,26(3):14-16.
[38] 杨克新,孙武,朱立国,等.颈舒颗粒联合旋提手法治疗神经根型颈椎病的临床观察[J].中国中医骨伤科杂志,2018,26(10):11-13.
[39] 谭明生.明病证结合,“从督论治”颈脊髓损伤的思考[J].中国中医骨伤科杂志,2018,26(1):1-2.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金面上项目(81373666) 国家中医药管理局中医药行业科研专项(201407001-2) 上海市科学技术委员会项目(16401970100)
更新日期/Last Update: 2018-06-02