Application Of Health Guidance Based On TCM Physique In Patients With Lumbar Intervertebral Disc Herniation

BackgroundLumbar Disc Herniation（LDH）is one of the most common spinal disorders in orthopedics and has become one of the most important causes of disability in both developing and developed countries.The increasing incidence of lumbar disc herniation and its huge social and economic burden make it an urgent problem to strengthen the recognition and treatment of LDH.In recent years,the exploration of the cognitive level of pain disaster in chronic diseases has attracted wide attention,and TCM physique,as an important part of TCM system,has been widely used in chronic disease management.It has been regarded as a new nursing concept of TCM to intervene patients on the theoretical basis of TCM physique.ObjectiveThis study investigated the distribution characteristics and risk factors of TCM constitution in patients with lumbar disc herniation,analyzed the correlation between THE TCM nursing needs of LDH patients and their pain disaster cognition level and emotional state,and gave health guidance to patients after LDH surgery based on the above results combined with the related recuperation content of TCM constitution.To explore the intervention effect of health education guidance based on TCM physique theory on postoperative rehabilitation of patients with lumbar disc herniation,and to provide reference for clinical diversified intervention research.Methods1.A total of 419 LDH patients from 4 level 3 general hospitals in Xinxiang city were surveyed by general information questionnaire,PAIN catastrophization Scale（PCS）,TCM nursing demand questionnaire and positive and negative emotion Scale（PANAS）,and Pearson correlation analysis was performed.To explore the correlation between TCM nursing needs of patients with lumbar intervertebral disc herniation and their cognitive level of pain disaster and emotional state.2.A case-control study design was adopted,including 201 cases of LDH patients as LDH group,and matched 201 cases of people without LDH symptoms as control group.The physical fitness survey scale and influencing factors questionnaire were used to establish Excel database,and SPSS 25.0 software was used to recording and analysis the related risk factors of lumbar disc herniation and various physical susceptibility factors.3.Eighty-four patients with LDH were selected from July to October 2020 in a 2021 hospital in Xinxiang.The patients were divided into observation group and control group by random number table.The Control Group was given routine postoperative guidance,and the Observation Group was given health guidance based on traditional Chinese Medicine Constitution to compare the OSWESTRY disability index,VAS pain score,self-care ability and nursing satisfaction.Results1.A total of 403 valid questionnaires were collected,with total PCS score（29.21±6.91）,dimension score（9.22±2.44）,（5.99±1.96）,（14.00±3.66）.LDH patients have more prominent demands for disease knowledge,rehabilitation sports and psychological rehabilitation nursing guidance.The total emotional state score of LDH patients was（54.70±4.02）,positive emotional score was（21.93±4.73）,negative emotional score was（31.90±4.78）;The pain catastrophizing in LDH patients was positively correlated with TCM nursing needs and negative emotions,and negatively correlated with positive emotions（P<0.01）.2.In the analysis of LDH constitution types,there were statistically significant differences between the four constitutions of phlegm-dampness（24.37%）,blood statis（21.39%）,yang-deficiency（17.91%）and mildness（5.97%）.In the analysis of risk factors,lumbar spine load,family history of LDH,time of exercise,long-term maintenance of a single working position,bed nature,body mass index,and the above four constitutions were all associated with LDH（P<0.05）.LDH phlegm-dampness constitution was related to sex,BMI and smoking history.Whether working in a single position for a long time is related to common working position and blood statis.Yang-deficiency was related to gender,personality（introversion）and Body mass index（P<0.05）.3.Before intervention,all indexes in the two groups were P<0.05,no statistical significance.After intervention,the scores of ODI,VAS and self-care ability in the observation group were（25.93±3.58）points,（4.48±0.92）points and（5.43±2.05）points,while those in the control group were（30.17±3.00）points,（6.02±1.14）points and（7.52±2.73）points.The difference between the two groups was statistically significant（P<0.001）,there was a difference in overall nursing satisfaction between the two groups（P<0.05）.Conclusions1.The catastrophization of pain in LDH patients was at an above medium level,and was significantly correlated with the nursing needs of TCM and emotional state.Therefore,specific TCM nursing for LDH patients can significantly reduce the level of pain disaster by improving the emotional state of patients.2.Most patients with lumbar disc herniation are biased physique,and there are differences between the related influencing factors and physique.Therefore,it is necessary to develop targeted and personalized treatment and nursing measures combined with patients’ physique.3.The application effect of health guidance based on TCM constitution identification in postoperative patients with lumbar disc herniation is significant,which can promote the functional recovery of patients,reduce their pain level,improve their self-care ability and nursing satisfaction.