眩晕不同中医证候分型颈椎X线表现比较研究
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摘要
目的:探讨眩晕不同中医证候分型颈椎X线摄片的表现。方法:选取2015年1月—2016年12月在河南省中医院门诊就诊和住院治疗的眩晕症患者200例作为研究对象,对所有患者进行中医证候分型,同时为患者提供颈椎五位X线摄片检查,观察不同证型患者检查结果间的差异性,比较统计从而推断颈椎X线摄片对于眩晕不同中医证候分型的应用价值。结果:200例眩晕患者,痰湿中阻证74例,占37.00%;治肝阳上亢证43例,占21.50%;气血亏虚证35例,占17.50%;肾精不足证29例,占14.50%;瘀血阻窍证19例,占0.95%。其中痰湿中阻证患者经颈椎五位X线摄片检查出现了颈椎生理曲度和稳定性改变、韧带骨化等临床症状,且椎体骨质及椎间盘退行性改变出现例数最高,且显著高于其余观察指标出现的次数,差异有统计学意义(P<0.05);与其余各组患者相比较,该类型患者X线特征明显,差异均有统计学意义(P<0.05)。结论:痰湿中阻型眩晕症患者颈椎X线表现具有特征性,可在一定程度上为医者诊断眩晕提供帮助。
Objective: To discuss X-ray manifestation of cervical vertebra in vertigo of different Chinese medicine syndrome differentiation. Methods:Selected 200 cases of patients with vertigo admitted into the outpatient department and hospitalization for treatment in He'nan Province Hospital of TCM from January,2015 to December,2016. Divided them according to Chinese medicine syndrome differentiation,provided X-ray examination of the fifth cervical vertebra for patients at the same time,and observed the differences of examination results among patients with different Chinese medicine syndrome differentiation. Compared and compiled statistics so as to deduce the application value of X-ray for vertigo of different Chinese medicine syndrome differentiation. Results:Among 200 cases of patients with vertigo,there were 74 cases of phlegm-dampness obstructing middle energizer syndrome, accounting for 37.00%; there were 43 cases of upper ascendant hyperactivity of liver yang syndrome, accounting for 21.50%; there were 35 cases of qi-blood depletion syndrome,accounting for 17.50%;there were 29 cases of kidney essence insufficiency syndrome,accounting for 14.50%;there were 19 cases of static blood obstructing orifices syndrome,accounting for 0.95%. In the examination of the fifth cervical vertebra in patients of phlegm-dampness obstructing middle energizer syndrome,there were changes in cervical vertebra physiological curve and its stability,ligament ossification,and other clinical symptoms. The occurrence of vertebral bone and disc degeneration was the most frequent,which was obviously more frequent than that of other observation indexes,the difference being significant(P < 0.05). The X-ray features of this type of patients were more obvious when compared with those in other groups,differences being significant(P < 0.05). Conclusion:The X-ray of the patients with vertigo of phlegm-dampness obstructing middle energizer syndrome has a characteristic manifestation,which can help doctors to diagnose vertigo to some extent.
Objective: To discuss X-ray manifestation of cervical vertebra in vertigo of different Chinese medicine syndrome differentiation. Methods:Selected 200 cases of patients with vertigo admitted into the outpatient department and hospitalization for treatment in He'nan Province Hospital of TCM from January,2015 to December,2016. Divided them according to Chinese medicine syndrome differentiation,provided X-ray examination of the fifth cervical vertebra for patients at the same time,and observed the differences of examination results among patients with different Chinese medicine syndrome differentiation. Compared and compiled statistics so as to deduce the application value of X-ray for vertigo of different Chinese medicine syndrome differentiation. Results:Among 200 cases of patients with vertigo,there were 74 cases of phlegm-dampness obstructing middle energizer syndrome, accounting for 37.00%; there were 43 cases of upper ascendant hyperactivity of liver yang syndrome, accounting for 21.50%; there were 35 cases of qi-blood depletion syndrome,accounting for 17.50%;there were 29 cases of kidney essence insufficiency syndrome,accounting for 14.50%;there were 19 cases of static blood obstructing orifices syndrome,accounting for 0.95%. In the examination of the fifth cervical vertebra in patients of phlegm-dampness obstructing middle energizer syndrome,there were changes in cervical vertebra physiological curve and its stability,ligament ossification,and other clinical symptoms. The occurrence of vertebral bone and disc degeneration was the most frequent,which was obviously more frequent than that of other observation indexes,the difference being significant(P < 0.05). The X-ray features of this type of patients were more obvious when compared with those in other groups,differences being significant(P < 0.05). Conclusion:The X-ray of the patients with vertigo of phlegm-dampness obstructing middle energizer syndrome has a characteristic manifestation,which can help doctors to diagnose vertigo to some extent.
引文
[1]谢建群.中医内科学[M].北京:人民卫生出版社,2013.
[2]国家中医药管理局.ZY/T001.1~001.9-94中医病证诊断疗效标准[S].南京:南京大学出版社,1994:37.
[3]潘福敏,王善金,麻彬,等.颈椎病性眩晕的临床治疗[J].中国矫形外科杂志,2016,24(9):785-788.
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[10]刘东钱,尚荣安,胡迪.“解肌通脉、醒神开窍”手法配合颈椎牵引治疗颈性眩晕临床研究[J].中国中医急症,2016,25(6):1100-1102.
[11]于继岗,王明怀,林强,等.葛仙汤治疗椎动脉型颈椎病眩晕患者33例[J].西部中医药,2015,28(12):81-83.
[12]万小林,王俊力,冯莉,等.中医论述眩晕[J].亚太传统医药,2016,12(13):64-65.
[13]李黎,王金玲.从筋骨力学平衡理论探讨林氏颈椎定点旋转扳法治疗急性颈性眩晕的理论来源及诊疗方法[J].中国中医急症,2016,25(9):1714-1716.
[14]单希征.我国眩晕的诊疗现状、发展和策略[J].中国研究型医院,2017,4(1):11-14.
[15]谢玉强.眩晕的中医治疗[J].中国民族民间医药,2012,21(13):92-93.
[16]Mangalgiri AS,Suri AD,Satpathi DK,et al.Study of Origin of Left Vertebral Artery from the Arch of Aorta in Central India and its Clinical Relevance[J].Indian Journal of Forensic Medicine&Toxicology,2014,8(2):161.
[17]Montechiari M,Iadanza A,Falini A,et al.Monolateral type I proatlantal artery with bilateral absence of vertebral arteries:description of a case and review of the literature[J].Surgical&Radiologic Anatomy Sra,2013,35(9):863-865.
[18]Beausanglinder M,Hultcrantz E.Early effects of cervical sympathetic stimulation on cerebral,ocular and cochlear blood flow[J].Acta Physiologica,2010,109(4):433-437.
[19]Linder J.Effects of cervical sympathetic stimulation on cerebral and ocular blood flows during hemorrhagic hypotension and moderate hypoxia[J].Acta Physiologica,2010,114(3):379-386.
[2]国家中医药管理局.ZY/T001.1~001.9-94中医病证诊断疗效标准[S].南京:南京大学出版社,1994:37.
[3]潘福敏,王善金,麻彬,等.颈椎病性眩晕的临床治疗[J].中国矫形外科杂志,2016,24(9):785-788.
[4]童正一,叶洁,许金海,等.颈椎运动负荷试验对不同中医证型颈性眩晕患者血流动力学指标的影响[J].中国中医急症,2015,24(6):981-983.
[5]邓祥春,李贵渝.颈椎病中医证候特点及其与X线特征的相关性研究[J].中医药导报,2016,22(7):88-89.
[6]蓝鋆,姚敏,王晶,等.颈椎病不同中医证候分型的研究概况[J].中国中医骨伤科杂志,2015,23(4):67-70.
[7]王晓东,朱立国,于杰.椎动脉型颈椎病眩晕症状的临床研究概述[J].中国中医骨伤科杂志,2016,24(3):80-82.
[8]胡艳明,杨静茹,李丽娜.椎动脉型颈椎病中医针灸推拿治疗进展[J].河北医学,2015,21(8):1532-1534.
[9]贾峻,沙明波.经方治疗颈椎病眩晕之临床心得[J].中华中医药杂志,2017,32(1):166-168.
[10]刘东钱,尚荣安,胡迪.“解肌通脉、醒神开窍”手法配合颈椎牵引治疗颈性眩晕临床研究[J].中国中医急症,2016,25(6):1100-1102.
[11]于继岗,王明怀,林强,等.葛仙汤治疗椎动脉型颈椎病眩晕患者33例[J].西部中医药,2015,28(12):81-83.
[12]万小林,王俊力,冯莉,等.中医论述眩晕[J].亚太传统医药,2016,12(13):64-65.
[13]李黎,王金玲.从筋骨力学平衡理论探讨林氏颈椎定点旋转扳法治疗急性颈性眩晕的理论来源及诊疗方法[J].中国中医急症,2016,25(9):1714-1716.
[14]单希征.我国眩晕的诊疗现状、发展和策略[J].中国研究型医院,2017,4(1):11-14.
[15]谢玉强.眩晕的中医治疗[J].中国民族民间医药,2012,21(13):92-93.
[16]Mangalgiri AS,Suri AD,Satpathi DK,et al.Study of Origin of Left Vertebral Artery from the Arch of Aorta in Central India and its Clinical Relevance[J].Indian Journal of Forensic Medicine&Toxicology,2014,8(2):161.
[17]Montechiari M,Iadanza A,Falini A,et al.Monolateral type I proatlantal artery with bilateral absence of vertebral arteries:description of a case and review of the literature[J].Surgical&Radiologic Anatomy Sra,2013,35(9):863-865.
[18]Beausanglinder M,Hultcrantz E.Early effects of cervical sympathetic stimulation on cerebral,ocular and cochlear blood flow[J].Acta Physiologica,2010,109(4):433-437.
[19]Linder J.Effects of cervical sympathetic stimulation on cerebral and ocular blood flows during hemorrhagic hypotension and moderate hypoxia[J].Acta Physiologica,2010,114(3):379-386.