Analysis Of Clinical Characteristics Of Nerve Root Sedimentation Syndrome And Observation Of TCM Curative Effect Of Accompanying Symptoms

Objective To explore the clinical characteristics of common concomitant symptoms and TCM syndrome types of patients with positive nerve root sedimentation sign（NRS）,and observe the clinical efficacy of TCM dialectical treatment of patients with positive NRS under the guidance of Qingyang theory.MethodsThis study was retrospective and divided into two parts.Part I: The cases with positive NRS in lumbar MRI images were collected from outpatient department,and the eligible cases were screened out.Excel 2019 software was used to summarize the general and imaging information of each case.The data were preliminarily cleaned,the basic imaging characteristics and the frequency of each symptom were counted.Establish the symptom database,and count the frequency expression of tongue,pulse,symptoms and TCM syndrome types,as well as the distribution of each symptom in syndrome types.Part II: On the basis of the above included cases,patients receiving western medicine or Traditional Chinese medicine were screened out.Divide these cases into group A（spinal stenosis on imaging）and group B（no spinal stenosis on imaging）.Group A and B were further divided into group a1 and b1（western medicine group）and group a2 and b2（Chinese medicine group）.Chinese medicine group（a2,b2）was given Qingyang Tongmai decoction,adding or subtracting according to syndrome differentiation.Western medicine group（a1）was given Nimesulide Capsule combined with Mecobalamine Tablets orally,while group b1 was given Nimesulide Capsule combined with Flupentixol and Melitracen Tablets orally.The treatment lasted for 3 weeks,VAS score,QBPDS score,SAS score and PSQI sleep score were observed before and after treatment.Evaluate the efficacy and safety of TCM treatment for NRS positive patients.Results62 patients were included in study I and all were included in Study II.The most common symptoms of positive NRS are hip discomfort,limb weakness,numbness and stiffness,and abnormal sleep.By comparing the distribution difference of main symptoms in different syndrome types,we find that the common symptoms of liver depression and spleen deficiency syndrome are hip discomfort and limb weakness;The common symptom of heart and liver fire syndrome is discomfort of buttocks and lower limbs;The common symptoms of Qi Yin deficiency syndrome are low back pain and lower limb discomfort;The common syndromes of heart kidney disharmony are limb stiffness and abnormal sleep;Deficiency of spleen and kidney qi is common in limb weakness and lower limb discomfort;Qi stagnation and blood stasis syndrome often has hip discomfort and abnormal sleep.In group a1,there was significant difference between VAS score and QBPDS score before and after treatment（P = 0.007,9 = 0.035,P < 0.05）.There was no significant difference between SAS score and PSQI score before and after treatment（P = 0.13,P = 0.2,P > 0.05）.In group a2,the corresponding P values of the four indexes before and after treatment were < 0.05,indicating that the changes of the four observed indexes were statistically significant.The VAS and QBPDS scores of a1 and a2 groups were compared,which showed that the difference of VAS score was statistically significant,and group a1 was better than group a2;There was no significant difference in QBPDS score（P > 0.05）.In group b1,there was significant difference between VAS score and SAS score before and after treatment（P = 0.005,P = 0.000,P < 0.05）;There was no significant difference between QBPDS score and PSQI score before and after treatment（P = 0.2,P =0.1,P > 0.05）.In group b2,the corresponding P values of the four indexes before and after treatment were 0.18,0.01,0.005 and 0.000 respectively,indicating that among the four observation indexes,except for the change of VAS score（P >0.05）,the other changes were statistically significant（P <0.05）.Comparing the SAS scores of b1 and b2 groups after treatment,it showed that there was no significant difference in SAS scores（P = 0.2,P > 0.05）.Conclusion1.NRS can be classified as "Bi syndrome" in traditional Chinese medicine,which is closely related to liver,kidney,spleen and heart.The medical pathogenesis is liver depression,qi stagnation,blood stasis and liver and kidney deficiency,along with disharmony between liver and spleen.It is based on liver and kidney deficiency,spleen deficiency and Qi deficiency,and marked by heart and liver fire;2.NRS can be seen not only in patients with lumbar spinal stenosis,but also in some patients without obvious spinal stenosis.Its mechanism may be related to spinal canal cerebrospinal fluid circulation;3.For NRS positive patients with obvious lumbar spinal stenosis on MRI,the combination of NSAIDs and Mecobalamin can alleviate their pain and dysfunction,and the effect of relieving pain is better than that of traditional Chinese medicine group,but traditional Chinese medicine has advantages over western medicine in improving anxiety and sleep;4.For NRS positive patients without obvious lumbar spinal stenosis on MRI,NSAIDs combined with anti-anxiety drugs can improve pain and anxiety,but traditional Chinese medicine has more advantages in the treatment of dysfunction and sleep.Both traditional Chinese medicine and Western medicine have good safety.