A Research On The Relationships Between Risk Factors Of Lumbar Disc Herniation And Traditional Chinese Medicine Constitution Typing

Objective To analyze the distribution regulations and characters of Traditional Chinese Medicine constitution typing for the patients with lumbar disc herniation, and to explore the relationship between its risk factors and constitution typing, and to provide the realistic basis for TCM synthesis nursing in the clinical practice and prevention lumbar disc herniation in high-risk populations in terms of Traditional Chinese Medicine constitution.Methods By epidemiological case-control study, selecting300cases of lumbar disc herniation group with150cases and control group with150cases both from inpatient wards and rehabilitation room in orthopedics department of Chinese Medicine Hospital of Zhejiang Province. The questionnaires include general information involving risk factors of lumbar disc herniation, such as, BMI, job nature, working posture, uninterrupted time of univalent work, lumbar load, smoking, diet preference, bed nature, living condition, time of physical exercises, personality, family history of lumbar disc herniation, chronic case history, designed by researcher according to a big amount of reference at home and abroad, and constitution of TCM compiled by Professor Wang Qi. The TCM constitution consisted of nine sub-scales,60-item:Yang-deficiency type,Qi-deficiency type, Yin-deficiency type, Phlegm-wetness type, Blood-stasis type, Wetness-heat type, Special diathesis type, Qi-depression type, Gentleness type. Chi-square test and rank sum test were separately used to analyze this two group sex, different ages, P>0.05, revealing that the comparability between this two groups have not statistical significance differences. The two groups are compared by chi-square test to analyze the TCM constitution typing and the related risk factors, then conclude the factors that have statistical significance. Take the factors again into the logistic regression analysis to explore the correlation between risk factors of lumbar disc herniation and TCM constitution typing.Results①Chi-square test was used to analyze the TCM constitution types ratio between two groups and resulted that there were significant differences in the distributions of Yang-deficiency, Blood-stasis, Phlegm-wetness, Gentleness constitution (P<0.05), but the constituent ratio of other constitution types in two groups had no significant difference (P>0.05). And resulted that the ratios in lumbar disc herniation just as Yang-deficiency (28.0%), Blood-stasis (24.0%), Phlegm-wetness (17.3%), while the ratios in control group were revealed as Gentleness constitution(37.3%).②The two groups were compared by chi-square test to analyze the related risk factors, then conclude the factors that have statistical significance, incorporating the factors into the multi-factor logistic regression analysis, tip:in the.P<0.05level, and ultimately into the regression equation of the eight factors, respectively is:BMI, uninterrupted time of univalent work, lumbar load, diet preference, family history of lumbar disc herniation. Statistical results suggest:BMI for each grade rise, the incidence of lumbar disc herniation increased1.892times; uninterrupted time of univalent work>4hours per day is risk factor of lumbar disc herniation (OR=3.128,95%CI[1.636,5.981]);the larger lumbar load is, the more prone to lumbar disc herniation (OR=2.376,95%CI [1.538,3.670]); partial spicy diet and bland diet (reference category) is statistically significant(P<0.05), and the risk factor; Compared to patients without family history of lumbar disc herniation, those with it is more prone to lumbar disc herniation (OR=15.659).③The correlation between risk factors of lumbar disc herniation and TCM constitution typing was analyzed by multi-factor logistic regression analysis, tip:BMI is protective factor of Yang-deficiency constitution (OR=0.510,95%CI [0.293,0.887]); family history of lumbar disc herniation is risk factor of Yang-deficiency constitution (OR=2.075,95%CI [1.120,3.844]); uninterrupted time of univalent work>4hours per day is risk factor of Blood-stasis constitution (OR=3.053,95%CI[1.623,5.745]); BMI is risk factor of Phlegm-wetness constitution (OR=9.496,95%CI [3.743,24.093]); compared with bland diet (reference category), partial spicy and partial sweet had no significant difference (P>0.05), but partial salty and greasy diet had significant differences (P<0.01) Conclusion①Yang-deficiency, Blood-stasis, Phlegm-wetness constitution were mainly reflected in lumbar disc herniation;②The risk factors positively related to the occurrence of lumbar disc herniation were BMI, uninterrupted time of univalent work, lumbar load, diet preference, family history of lumbar disc herniation;③The impacts of the incidence of lumbar disc herniation risk factors on TCM constitution revealed an objective reality. Thinner body and family history of lumbar disc herniation were risk factors of Yang-deficiency constitution; long time of univalent work posture was risk factor of Blood-stasis constitution; higher BMI, partial salty or greasy diet were risk factors of Phlegm-wetness constitution.