颈椎病前路手术后咽痛中医证候分布回顾性分析
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摘要
目的:回顾性分析颈椎病前路手术后咽痛中医证型分布。方法:对本院骨科2013年1月-2014年1月收治的285例颈椎前路手术出现术后咽痛患者164例的证候分布情况进行了回顾性分析,统计其中医症状、舌象以及中医证型分布,探讨颈椎前路手术术后咽痛的中医内在规律。结果:164例患者中,阴虚火旺证53例,占32.3%;气滞血瘀证48例,占29.3%;痰结咽喉证39例,占23.8%;气虚津亏证24例,占14.6%。按患者咽痛严重程度分:轻度(4～7分)93例(56.7%),中度(8～11分)47例(28.7%),重度(12～15分)24例(14.6%)。结论:颈椎前路手术后咽痛中医辨证以本虚标实、虚实夹杂多见,本虚以阴虚火旺、气虚津亏为主,而标实则以血瘀、痰结多见。轻度以阴虚为主,中度多分别兼夹痰热证和血瘀证,重度多见痰瘀互结,痰瘀化热伤气伤津,兼见气虚津亏。
Objective:To retrospectively analyze the TCM syndrome distribution of pharynx pain after anterior cervical surgery.Method:The distribution of syndromes of 164 patients with pharynx pain in 285 patients after anterior cervical surgery admitted in our hospital from January 2013 to January 2014 was retrospectively analyzed.The TCM symptoms,tongue images and distribution of TCM syndromes were counted,and the internal law of TCM for pharynx pain after anterior cervical surgery was discussed. Result:Among 164 patients,53 cases were Yin deficiency and fire excess syndrome,accounting for 32.3%;48 cases were Qi stagnation and blood stasis syndrome,accounting for 29.3%;39 cases were phlegm stagnation and throat syndrome,accounting for 23.8%;24 cases were Qi deficiency and Jin deficiency syndrome,accounting for 14.6%.According to the severity of pharynx pain,93 cases(56.7%)were mild(4-7 points),47 cases(28.7%)were moderate(8-11 points)and 24 cases(14.6%)were severe(12-15 points).Conclusion:The syndrome differentiation of pharynx pain after anterior cervical surgery in traditional Chinese medicine is mainly based on the deficiency of Ben and excess of Biao and the mixture of deficiency and excess.Yin deficiency,fire excess and Qi deficiency and Jin deficiency are the main causes of Ben deficiency,while blood stasis and phlegm stagnation are the main causes of Biao excess.Mild Yin deficiency mainly,moderate more than the phlegm heat syndrome and blood stasis syndrome,severe phlegm and blood stasis,phlegm and blood stasis heat injury Qi injury Jin and see deficiency of Qi and Jin.
Objective:To retrospectively analyze the TCM syndrome distribution of pharynx pain after anterior cervical surgery.Method:The distribution of syndromes of 164 patients with pharynx pain in 285 patients after anterior cervical surgery admitted in our hospital from January 2013 to January 2014 was retrospectively analyzed.The TCM symptoms,tongue images and distribution of TCM syndromes were counted,and the internal law of TCM for pharynx pain after anterior cervical surgery was discussed. Result:Among 164 patients,53 cases were Yin deficiency and fire excess syndrome,accounting for 32.3%;48 cases were Qi stagnation and blood stasis syndrome,accounting for 29.3%;39 cases were phlegm stagnation and throat syndrome,accounting for 23.8%;24 cases were Qi deficiency and Jin deficiency syndrome,accounting for 14.6%.According to the severity of pharynx pain,93 cases(56.7%)were mild(4-7 points),47 cases(28.7%)were moderate(8-11 points)and 24 cases(14.6%)were severe(12-15 points).Conclusion:The syndrome differentiation of pharynx pain after anterior cervical surgery in traditional Chinese medicine is mainly based on the deficiency of Ben and excess of Biao and the mixture of deficiency and excess.Yin deficiency,fire excess and Qi deficiency and Jin deficiency are the main causes of Ben deficiency,while blood stasis and phlegm stagnation are the main causes of Biao excess.Mild Yin deficiency mainly,moderate more than the phlegm heat syndrome and blood stasis syndrome,severe phlegm and blood stasis,phlegm and blood stasis heat injury Qi injury Jin and see deficiency of Qi and Jin.
引文
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[12]孙旗,姜孟家,王淑斌,等.针刺疗法预防肱骨近端骨折内固定术后肩关节功能障碍的临床研究[J].中医正骨,2016,28(4):29-32.
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[15]张建政,高杰,韩力,等.不停用氯吡格雷早期髓内固定治疗老年股骨转子间骨折围手术期的安全性研究[J].中华创伤骨科杂志,2016,18(8):720-724.
[16]苏书栋,李忱,张欣,等.透析患者髋关节置换围手术期的处理[J].中国实验诊断学,2017,21(1):181-184.
[17]刘立云,王璘琳,高书图,等.平乐正骨“破、和、补”三期辨证用药理论在老年股骨颈骨折围手术期中的应用[J].世界中西医结合杂志,2017,12(9):1253-1256,1260.
[18]孙旗,贾育松,陈江,等.养阴利咽汤治疗颈椎前路术后咽痛的临床报道[J].中国中医骨伤科杂志,2015,23(9):41-43.
[19]陈智,黄轩,李凤宁,等.颈椎前路术后吞咽困难的相关因素分析[J].中国脊柱脊髓杂志,2012,22(11):979-983.
[20]黄佳洋,刘会长.气管插管型喉罩在肥胖患者前路颈椎手术中的应用效果[J].实用临床医药杂志,2016,20(1):91-93.
[21]郑梅涧著.郭君双整理.重楼玉玥[M].北京:人民卫生出版社,2006:70-71.
[22]朱宝.中药联合Hybrid术式治疗颈椎病的临床疗效分析[D].北京:北京中医药大学,2016:1-46.
[2]陈霞,戚思华.药物防治全身麻醉气管插管术后咽喉痛的研究进展[J].新医学,2016,47(4):218-221.
[3]冷方南.中医证候辨证规范[M].北京:人民卫生出版社,1991:15-40.
[4]邓铁涛.中医诊断学[M].5版.上海:上海科技出版社,1984:6-20.
[5]姚乃礼,朱建贵.中医证候鉴别诊断学[M].2版.北京:人民卫生出版社,2002:37-57.
[6]沈自尹,王文健.中医虚证辨证参考标准[J].中西医结合杂志,1986(10):598.
[7]徐浩,陈可冀.实用血瘀证诊断标准[J].中国中西医结合杂志,2016,36(10):1163.
[8]梁家柱,柳根哲,雷仲民,等.清咽滴丸治疗颈椎前路术后咽痛的临床观察[J].世界中医药,2016,11(9):1761-1765.
[9]钟远鸣,莫日养,梁梓扬,等.脊髓型颈椎病的手术治疗研究进展[J].中国全科医学,2018,21(2):36-40.
[10]关立,汪文龙,海涌,等.颈椎前路非融合术与前路融合术治疗颈椎病的中期疗效比较[J].中华医学杂志,2016,96(25):1991-1996.
[11]项瑜,吴星,郭震浪,等.中西医结合治疗神经根型颈椎病Meta分析[J].辽宁中医药大学学报,2017,19(3):128-132.
[12]孙旗,姜孟家,王淑斌,等.针刺疗法预防肱骨近端骨折内固定术后肩关节功能障碍的临床研究[J].中医正骨,2016,28(4):29-32.
[13]叶华.中西结合治疗老年髋部骨折围手术期并发症及死亡率临床观察[J].新中医,2016,48(4):97-98.
[14]宋建东,李停,李长文,等.脊柱侧凸后路三维矫形术围手术期并发症的危险因素及其预防策略[J].中国中医骨伤科杂志,2017,25(10):38-40.
[15]张建政,高杰,韩力,等.不停用氯吡格雷早期髓内固定治疗老年股骨转子间骨折围手术期的安全性研究[J].中华创伤骨科杂志,2016,18(8):720-724.
[16]苏书栋,李忱,张欣,等.透析患者髋关节置换围手术期的处理[J].中国实验诊断学,2017,21(1):181-184.
[17]刘立云,王璘琳,高书图,等.平乐正骨“破、和、补”三期辨证用药理论在老年股骨颈骨折围手术期中的应用[J].世界中西医结合杂志,2017,12(9):1253-1256,1260.
[18]孙旗,贾育松,陈江,等.养阴利咽汤治疗颈椎前路术后咽痛的临床报道[J].中国中医骨伤科杂志,2015,23(9):41-43.
[19]陈智,黄轩,李凤宁,等.颈椎前路术后吞咽困难的相关因素分析[J].中国脊柱脊髓杂志,2012,22(11):979-983.
[20]黄佳洋,刘会长.气管插管型喉罩在肥胖患者前路颈椎手术中的应用效果[J].实用临床医药杂志,2016,20(1):91-93.
[21]郑梅涧著.郭君双整理.重楼玉玥[M].北京:人民卫生出版社,2006:70-71.
[22]朱宝.中药联合Hybrid术式治疗颈椎病的临床疗效分析[D].北京:北京中医药大学,2016:1-46.