| Objective:This study was conducted to compare the characteristics of different TCM syndrome of degenerative lumbar spinal stenosis and the degeneration degree of the triple joint complex of the lower lumbar spine,and to analyze their potential correlation,so as to provide a realistic and feasible reference basis for the objectification and standardization of TCM syndrome,as well as for the combined clinical diagnosis and treatment of degenerative lumbar spinal stenosis by Chinese and Western medicine.Methods:90 patients with DLSS(single segment)who attended the Second Department of Spine of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2021 to January 2022 were screened according to the nadir criteria,and the general data(evidence type,gender,age,disease duration)of each patient were collected through the electronic medical record system,and the MRI and CT data of lumbar spine were collected and evaluated through the PACS electronic imaging system(degree of degeneration of stenotic segments,responsible discs and small joints).Data were entered in Microsoft Excel,and data analysis was performed in SPSS 22.0 using the corresponding statistical methods to investigate the correlation between the TCM syndrome and the degree of degeneration of the triple joint complex of the lower lumbar spine.Results:1.A total of 90 patients were included in this study,including 51 males and 39 females,with a male to female ratio of 1.5:1.The age distribution ranged from 45 to 78 years,with an average age of 60.49±8.68 years,and the disease duration ranged from 3 to 72 months,with an average disease duration of 21.47±16.75 months.There were 16 cases(17.78%)in L3/4,55 cases(61.11%)in L4/5,and 19 cases(21.10%)in L5/S1.The syndrome type distribution was as follows: 23 cases(25.56%)of wind-cold obstruction syndrome group,26 cases(28.89%)of qi deficiency and blood stasis syndrome group,41 cases(45.56%)of liver and kidney deficiency syndrome group.2.There was statistically significant difference in the course of disease between the syndrome type groups(P=0.000).After pair-comparison,the difference mainly came from wind-cold obstruction syndrome and qi deficiency and blood stasis syndrome(P=0.005),qi deficiency and blood stasis syndrome and liver and kidney deficiency syndrome(P=0.000).There were no significant differences in gender(P=0.373)and age(P=0.063).3.Pfirrmann grade difference between syndrome type groups(P=0.001)was statistically significant,and the difference after pin-pinal comparison was mainly caused by wind-cold obstruction syndrome and liver and kidney deficiency syndrome(P=0.000).Weishaupt grading(P=0.039)showed statistically significant difference,and the difference after pairto-pair-comparison was mainly caused by wind-cold obstruction syndrome and liver and kidney deficiency syndrome(P=0.040).There was no significant difference in narrow segments(P=0.586).4.Spearman correlation analysis showed that there was no linear correlation between age,stenosis and TCM syndrome type(ALL P > 0.05),while there was a linear correlation between disease course,degree of disc degeneration and degree of facet degeneration and TCM syndrome type(course r=0.431,P=0.000;Degree of disc degeneration r=0.398,P=0.000;Degree of facet degeneration r=0.239,P=0.000).Conclusion:1.TCM syndrome types of DLSS are correlated with the degree of degeneration of the threejoint complex.Pfirrmann and Weishaupt classification can provide objective reference for TCM syndrome differentiation and classification.2.The TCM syndrome type of DLSS is correlated with the course of disease,but there is no correlation between gender,age,narrow segment and TCM syndrome type.3.The TCM syndromes of DLSS ranged from wind-cold obstruction syndrome to qi deficiency and blood stasis syndrome,and then to liver and kidney deficiency syndrome.The course of disease was prolonged successively,and the degeneration degree of the three-joint complex was intensified successively. |
