摘要
目的 采用倾向性评分匹配分析方法,观察中医症候与腰椎间盘突出症复发的关系.方法 选择2020年1月至2023年1月在该院治疗的245例腰椎间盘突出症患者作为研究对象,其中包括35例复发性腰椎间盘突出症患者.为了减少炎症、感染和神经根受压等混杂因素对研究的影响,选择复发和未复发患者进行PSM 1∶1配对,每组30例患者.收集两组患者相关临床指标,根据《中医病证诊断疗效标准》评估患者的四种中医症候类型:血瘀证、寒湿证、湿热证、肝肾亏虚证的分布频率和差异,采用多因素Logistic回归方法分析中医症候类型对腰椎间盘突出症复发的影响.结果 匹配后,复发组患者的肝肾亏虚证、血瘀证、湿热证、寒湿证的占比分别为56.67％、13.33％、16.67％、13.33％,未复发组四者的占比分别为20.00％、26.67％、26.67％、26.66％,肝肾亏虚证在复发组比例显著高于未复发组(P＜0.05).单因素分析显示,两组患者在吸烟史、糖尿病史、矢状面旋转程度、矢状面滑移程度中差异明显(P＜0.05);Logistic回归结果显示:糖尿病史、矢状面旋转程度、矢状面滑移程度、中医症候类型是腰椎间盘突出症患者复发的影响因素.结论 腰椎间盘突出症复发患者的中医症候类型中,肝肾亏虚证所占百分比高于未复发患者,糖尿病史、矢状面旋转程度、矢状面滑移程度、中医症候类型是腰椎间盘突出症患者复发的影响因素.
Abstract
Objective To observe the relationship between traditional Chinese medicine(TCM)symptoms and recurrence of lum-bar disc herniation using propensity score matching analysis method.Method 245 patients with lumbar disc herniation who were treated in our hospital from January 2020 to January 2023 were selected as the study subjects,including 35 patients with recurrent lumbar disc herniation.In order to reduce the impact of confounding factors such as inflammation,infection,and nerve root compression on the study,recurrent and non recurrent patients were selected for PSM1∶1 pairing,with 30 patients in each group.Relevant clinical indi-cators from two groups of patients were collected,and the distribution frequency and differences of four types of TCM syndromes were e-valuated;blood stasis syndrome,cold dampness syndrome,damp heat syndrome,and liver kidney deficiency syndrome according to the"Diagnostic Efficacy Standards for Traditional Chinese Medicine Syndrome".Multivariate logistic regression method was used to ana-lyze the impact of TCM syndrome types on the recurrence of lumbar disc herniation.Result After matching,the proportions of liver and kidney deficiency syndrome,blood stasis syndrome,damp heat syndrome,and cold dampness syndrome in the recurrent group were 56.67％,13.33％,16.67％,and 13.33％,respectively.The proportions of the non recurrent group were 20.00％,26.67％,26.67％,and 26.66％,respectively.The proportion of liver and kidney deficiency syndrome in the recurrent group was significantly higher than that in the non recurrent group(P＜0.05).Univariate analysis showed that there were significant differences in smoking history,diabetes history,sagittal rotation and sagittal slip between the two groups(P＜0.05);Logistic regression results showed that the history of diabetes,the degree of sagittal rotation,the degree of sagittal slip,and the type of TCM symptoms were the influencing factors for recurrence of lumbar disc herniation.Conclusion The percentage of liver and kidney deficiency syndrome in the TCM syn-drome types of patients in the recurrent group is higher than that of patients in the non recurrent group.The history of diabetes,the de-gree of sagittal rotation,the degree of sagittal slip,and the TCM syndrome types are the influencing factors for the recurrence of pa-tients with lumbar disc herniation.
维普
万方数据