The Diagnostic Significance Of Lumbar Lateral X-ray For ASO And Its Correlation With TCM Syndrome

BACKGROUND:Arteriosclerosis obliterans is the most common chronic ischemic disease of the lower extremity arteries in the clinic.Ultrasound of the lower extremity arteries is the most commonly used imaging tool for clinical diagnosis of this disease,while CTA and MRA are mainly used as imaging tools before making surgical plans.The qualitative diagnosis of this disease using X-ray plain films is the result of the research led by Prof.Chen Shu-chang in the 1980s,among which lateral X-ray of the lumbar spine is the most valuable for clinical application.The presence or absence of calcification in the abdominal aorta on lumbar lateral radiographs can determine whether the patient has arteriosclerosis obliterans and the degree of atherosclerosis.Objective:To investigate the diagnostic significance of lateral lumbar spine radiographs for arteriosclerosis obliterans and its correlation with Chinese medical evidence.METHODS:A total of 71 patients with ASO from the outpatient and inpatient departments of the Third Affiliated Hospital to Beijing University of Chinese Medicine,Huguosi Traditional Chinese Medicine Hospital Affiliated to Beijing University of Chinese Medicine,and Beijing Tongrentang Traditional Chinese Medicine Hospital from June 2017 to March 2023 were selected for this study.Patients with ASO were included according to the inclusion and exclusion criteria with reference to the symptoms,signs and tongue and pulse on the first day of enrollment,and were classified by Chinese medical evidence of yin-cold in the vessels,blood-stasis in the vessels,heat-stasis in the vessels,and stagnation and poisonous decay in the vessels.The general data,lumbar lateral radiographic data,and clinical manifestations of the lower extremities were collected,then fill out the "Medical Record Data Collection Form","Chinese Medicine Evidence Determination Form","Quantification of Lower Extremity Symptoms and Signs Scoring Form".All the case data collected during the study were entered into an Excel sheet,summarized and organized,and SPSS 26.0 was applied for statistical analysis.The clinical diagnostic significance of lumbar lateral radiographs for patients with ASO,the correlation between the degree of calcification of the abdominal aorta and the Chinese medical evidence,and the correlation between the pulsation of the dorsalis pedis artery and ASO were investigated.RESULTS:A total of 71 patients with ASO were collected in this study,and a positive rate of 83.1%for calcification of the abdominal aorta on lumbar lateral radiographs was seen.There was a significant positive correlation between the TCM symptoms and Western medical staging in the four groups(P<0.05).There was no significant correlation between the type of abdominal aortic calcification and TCM symptoms(P>0.05);there was no significant correlation between the type of abdominal aortic calcification and Western medical staging(P>0.05);there was no statistical difference between the type of abdominal There was no statistical difference between the type of aortic calcification and limb symptom score and limb sign score(P>0.05).There was a statistical difference between dorsalis pedis artery pulsation and abdominal aortic calcification(P<0.05);there was a statistical difference between dorsalis pedis pulsation in different Western medical stages(P<0.05).There was a statistical difference between the TCM symptoms and the patients’ sleep in the four groups(P<0.05).Conclusions:There is no correlation between the type of calcification in the abdominal aorta and the TCM symptoms of ASO.Although the type of abdominal aortic calcification cannot be used as a reference indicator of TCM symptoms,as the degree of abdominal aortic calcification increases,especially in th ose with tubular calcification,the likelihood that the patient’s condition will progress to stagnant venous stasis and toxic decay evidence increases significantly.The accurate determination of the TCM symptoms of ASO can help in prescribing medication,and in combination with the calcification of the abdominal aorta,can further predict the risk of further progression of the patient’s disease.There was no significant correlation between the degree of calcification of the abdominal aorta and the staging of the clinical manifestations of the patient’s limbs.The degree of calcification of the abdominal aorta on lateral lumbar radiographs can be used as a primary screening test for atherosclerotic occlusive disease.