Study On TCM Syndrome Elements Of Liver And Kidney Deficiency Lumbar Intervertebral Disc Protrusion Based On Imaging And Biochemical Indexes

Objective: To compare imaging and serum biochemical indicators of patients with liver and kidney deficiency type lumbar disc herniation with non-hepatic kidney deficiency type,analyze the differences between the two groups,and explore the detection of liver and kidney deficiency in traditional Chinese medicine under modern medical technology The characteristics of syndrome type of lumbar disc herniation provide objective basis for TCM syndrome differentiation of liver and kidney deficiency,and provide new ideas for TCM syndrome research.Methods:1.According to the inclusion criteria,the patients who were hospitalized in spinal surgery in our hospital from October 2018 to September2019 were selected as the research subjects.40 patients with liver and kidney deficiency type were included in the experimental group,and 40 patients with non-liver and kidney deficiency type were included in the control group.2.Measure the lumbar vertebral body height,the thickness of the intervertebral disc,the thickness of the ligamentum flavum,the area of the erector spinae and multifidus muscles and their signal intensity,the distance between the articular processes and the signal intensity of the articular processes,the intervertebral disc,facet joint,and paravertebrae based on the imaging system The degeneration grades of muscle and vertebral endplates were assigned and the degree of degeneration was assigned.Metabolite indicators such as TCM syndrome distribution and serology were collected in two groups.3.Compare the differences of imaging,serology and other metabolites and TCMsyndrome characteristics between the two groups,analyze the correlation between liver and kidney deficiency syndrome and degeneration of vertebral body and paravertebral appendages,and preliminary analysis of metabolic indicators for liver and kidney deficiency Impact of Syndrome.Results: 1.Most of the liver and kidney deficiency groups were over 60 years old,and those without liver and kidney deficiency were basically under 38 years old.The liver and kidney deficiency group had a significantly longer course of disease.2.Imaging: the liver and kidney deficiency group is mainly bulging,and the non-hepatic and kidney deficiency group is mainly protruding;the two groups in the protruding position are mainly central in cross section,and the sagittal liver and kidney deficiency group is prominent All in the intervertebral space,there is a small amount of protrusion free from the dural sac in the non-hepatic and kidney deficiency group;the distribution of the protruding segments in the liver and kidney deficiency group is more balanced,and the L4/5,L5/S1 is Main;most of the liver and kidney deficiency groups are protruding in more than 3 segments,and the number of non-liver and kidney deficiency groups is more than 3;the most severe and responsible segments are L4/5 and L5/S1.the Lord.Vertebral body and paravertebral attachment comparison: the height of the vertebral body in the liver and kidney deficiency group was significantly lower than that in the control group,and the signal intensity in the liver and kidney deficiency group was higher than that in the control group.The kidney deficiency group is lower than the control group,and the signal intensity liver and kidney deficiency group is higher than the control group.The thickness of the ligamentum flavum as a whole is lower in the liver and kidney deficiency group than in the control group,and the signal intensity of the liver and kidney deficiency group is significantly higher than that in the control group.The paravertebral muscle area of ??the liver and kidney deficiency group was lower than that of the control group,and the multifidus muscle was more obvious.The signal strength of the erector spinae and multifidus muscles were higher than that of the control group;Smaller,with L3/4,L4/5 segments more obvious,the signal strength of upper and lower articular processes in liver-kidney deficiency group was higher than that in non-liver-kidney deficiency group.Pfirrmann intervertebral disc degeneration,Fujiwara facet joint degeneration,and Goutallier muscle fat infiltration were significantly different between the two groups.The degeneration of the liver and kidney deficiency group was significantly higher than that of the control group;Modic vertebral endplate degeneration existed in all groups except L4 The difference,liver and kidney deficiency group is also higher than the control group.3.Syndrome distribution: The disease in the liver-kidney deficiency group is mainly liver,kidney,meridians,bones,skin,and the disease is mainly blood stasis,yin deficiency,qi deficiency,Jin deficiency,Jing deficiency;non-liver kidney Symptoms and signs of the deficiency group are relatively simple.The main diseases are muscles,bones,meridians,and the main diseases are qi stagnation and blood stasis.A small number of patients have phlegm,drinking,dampness,and cold.Liver and kidney deficiency syndrome scores are positively correlated with vertebral body and paravertebral attachment degeneration in imaging.4.A total of 81 metabolic indicators were detected in the metabolites,of which 29 were statistically significant,24 were metabolites with a frequency of greater than 10,and 13 had abnormal values ??exceeding 10 and 13 were statistically significant:blood Regular white blood cells,red blood cells,hemoglobin;total protein in blood biochemistry,high-density lipoprotein,apolipoprotein A,?2 globulin,lipoprotein ?;white blood cell count,red blood cell count in urine routine;thrombin in coagulation function Original activity,fibrinogen,D-dimer.Among the different metabolites,only total protein and ?2 globulin content were correlated with liver and kidney deficiency syndrome scores.Conclusions:1.The imaging of lumbar disc herniation with liver-kidney deficiency type is mainly degenerative changes.The main realizations are loss of vertebral height and changes in signal intensity,reduction in height of the intervertebral disc and ligamentum flavum,and changes in signal intensity.Decreased area of ??the paramus,muscle fat infiltration,and changes in signal intensity.The facet joints of the lumbar spine mainly manifested as a decrease in joint space and a change in signal intensity of the facet joints.2.Liver and kidney deficiency syndrome does not exist alone,liver and kidney deficiency is actually the liver,spleen and kidney deficiency.The symptoms of non-liver and kidney deficiency patients are mostly qi stagnation and blood stasis.3.Liver and kidney deficiency syndrome scores were positively correlated with degeneration of vertebral bodies and paravertebral appendages.The more severe the liver and kidney deficiency,the more severe the degeneration of the vertebrae and paravertebral joints,ligaments,and muscles.4.Only total protein and ?2 globulin in differential metabolites of patients with liver and kidney deficiency type lumbar disc herniation were correlated with liver and kidney deficiency syndrome scores.Metabolites may reveal the nature of liver and kidney deficiency and require further study.