脊髓型颈椎病中医证型与脊髓MRI征象相关性研究Study on the Correlation between TCM Syndrome Types and MRI Signs of Cervical Spondylotic Myelopathy
燕文海;谭明生;顾天雯;张坤;唐向盛;
摘要(Abstract):
目的 探讨脊髓型颈椎病(CSM)患者中医证型与脊髓MRI受压征象的相关性。方法 纳入符合标准的CSM患者126例,以MRI显示受压后脊髓形态、信号、脊髓与硬膜的位置关系作为分级依据,分为3级,分别赋0~2分,根据总得分将脊髓受压MRI征象分为Ⅰ、Ⅱ、Ⅲ级。分析CSM中医证型与脊髓受累节段数、脊髓形态、脊髓信号、脊髓与硬膜囊之间的位置关系、脊髓受压分级之间相关性。结果 纳入的CSM患者中,中医证型分布为心脾两虚33例(26.19%),经脉闭阻48例(38.10%),肾阳亏虚45例(35.71%)。按受累节段分为1~2节段组19例(15.08%),3节段组48例(38.10%),4节段组45例(35.71%),5节段组14例(11.11%)。以中医证型分组,3组证型累及节段差异无统计学意义(P> 0.05),肾阳亏虚证型组患者较另两组病程长,JOA评分低、NDI指数高,差异有统计学意义(P <0.05)。3组证型间MRI受压征象在脊髓形态、脊髓信号、脊髓与硬膜关系及受压评级差异均无统计学意义(P> 0.05)。结论 CSM患者中医证型和影像学表现并无相关性,脊髓受压MRI影像学表现不能作为CSM中医证型辨证的参考依据。
关键词(KeyWords): 脊髓型颈椎病;中医证型;MRI征象;相关性;差异
基金项目(Foundation): 国家自然科学基金项目(82074218)
作者(Authors): 燕文海;谭明生;顾天雯;张坤;唐向盛;
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