Correlation Between Symptoms And Signs And Imaging Findings Of Lumbar Disc Herniation (liver And Kidney Deficiency Type)

Backround:With the development of society and the accelerating pace of life,the incidence of lumber disc herniation(LDH)is increasing,which seriously affects patients’ health and life,and brings a heavy economic burden to society and families.TCM has unique advantages in the treatment of lumbar disc herniation.In order to improve the diagnosis and treatment rate of TCM,scholars currently mainly discuss the classification of TCM and imaging performance,study the correlation,and observe the different types of syndromes.Between the differences,this type of study only studied the presence or absence of symptoms and signs,but did not take into account its severity,while liver and kidney deficiency was the basic syndrome of lumbar intervertebral disc herniation.However,it is rarely reported.According to the clinical manifestations of the symptoms and signs of a single syndrome,the scores were integrated and quantified.The clinical severity can be objectively and systematically evaluated,combined with imaging findings,and the correlation between the two is studied.The standardization and objectification of research provide the theoretical basis for the diagnosis and treatment of this disease and improve the efficiency of clinical syndrome differentiation in traditional Chinese medicine.Objective:To study the characteristics of the symptoms,signs,integrals and imaging features of patients with lumbar disc herniation(liver-kidney deficiency syndrome)and to explore the correlation between the two characteristics,so as to provide an objective quantitative method for TCM syndrome differentiation and treatment.and provide a clinical reference for integrative medicine therapy.Methods:The basic information of 50 patients who met the clinical inclusion criteria were collected.The clinical severity of the primary and secondary symptoms was assigned to the scores according to the diagnostic criteria.An integral scale of the symptoms and signs was established according to the patient’s lumbar spine X-ray radiographs.CT and MRI imaging data were performed on imaging observations and measurements of lumbar curvature,nucleus protrusion rate(NPR),Modic type of endplate degeneration,and Pfirrmann grade of intervertebral disc degeneration.Analysis the data collected through the software of SPSS20.0,observation of the type of LDH symptoms and signs of integral characteristics,the characteristics of each imaging index that is to explore the correlation between the two.Results:1.The total scores of symptoms and signs in 50 patients ranged from 8 to 23 points,about 15.04±3.76 points on average;There was a correlation between the scores of each main symptom and the total score,and the main symptom 2 was higher than that of the main symptom 1.The significance of the representative is greater,and there is no obvious correlation between the secondary disease and the total score.2.1n the 50 patients,the mean score of the partial yang type was 14.79±3.64,and the mean score of the partial yin type was 15.56±4.01.There was no significant correlation between the positive scores and the total scores of symptoms and signs.3.According to statistics,the lumbar curve range of the 50 patients collected was 10mm-18mm,with an average of 15.26±2.20mm;the central side of the inteivertebral disc protrusion was 13 cases,accounting for 26%;the central protrusion was 21 cases,accounting for 42%,16 cases of lateral type were prominent,accounting for 32%;0 cases of extreme lateral type were prominent,accounting for 0%.The NPR ranged from 10%to 73%;the average protrusion rate was 24.73%± 11.86%;in the Modic classification of the endplate degeneration,there were 2 cases without Modic changes,accounting for 4%;and 0 cases with type Ⅰ,accounting for 0%;Type 1 had 1 case,accounting for 2%;Type Ⅲ had 47 cases,accounting for 94%.According to Pfirrmann grade grading statistics of intervertebral disc degeneration,grade I was 3 cases,accounting for 6%;grade II was 1 case,accounting for 2%;grade Ⅲ was 29 cases,accounting for 58%;grade IV was 15 cases,accounting for 30%;Ⅴ is 2 cases,accounting for 4%.4.Symptoms and signs were correlated with the degree of herniation,the position of herniation,and intervertebral disc degeneration on radiographic findings,and were not significantly correlated with lumbar curvature and endplate degeneration.Conclusions:1.Patients with liver-kidney deficiency type of LDH have typical symptoms and signs,and the symptoms of lumbar pain and lower extremity radiating pain are the most typical in the main symptoms,and the lower limb radiating pain is more representative.Lower extremity numbness and weakness in the legs and knees were used as a reference in diagnosing the syndrome,but the diagnostic value of leg and knee fatigue was higher than that of lower limb numbness.2.There was no significant correlation between yin and yang classification and the total score of symptoms and signs in patients with liver-kidney deficiency type LDH and the severity of their clinical symptoms and signs was not significant.3.Liver and kidney deficiency type of lumbar intervertebral disc herniation in patients with signs and symptoms integral and degeneration degree on the performance of the intervertebral disc protrusion of intervertebral disc,a prominent position and has a certain correlation,no significant correlation with lumbar curvature,endplate degeneration,and the higher the degree of protrusion of the intervertebral disc prominent position as the central herniation and degeneration of the intervertebral disc is heavier,the clinical symptoms and signs of higher performance.