目的 对比三维中等权重压缩感知并行采集序列（3D IW-CS-SENSE）与常规并行采集序列（3D IW-SENSE）在膝关节磁共振成像中的扫描时间、图像质量及诊断效能。方法 前瞻性采集100例膝关节磁共振影像。对比两组三维序列的定量指标、主观评分以及对损伤分级的准确率。结果 IW-CS-SENSE序列扫描时间显著缩短（122.0 ± 28.0 s vs. 221.0 ± 49.0 s，p<0.001）。IW-CS-SENSE序列信噪比、对比噪声比及显示效果评分均低于IW-SENSE序列（p＜0.001），但IW-CS-SENSE序列的SENSE伪影评分更优（5.00 ± 0.00 vs. 4.59 ± 0.62，p<0.001）。两序列对半月板、韧带及软骨损伤分级的准确率均无统计学差异（p值分别为0.33，0.58和0.15）。 结论 3D IW-CS-SENSE序列可显著缩短扫描时间和消除SENSE伪影，同时保持与4倍加速3D IW-SENSE序列相当的诊断效能。
Objective To compare the imaging times, image quality, and diagnostic performance of three-dimensional (3D) intermediate-weighted compressed sensing sensitivity encoding (IW-CS-SENSE) sequence with conventional 3D IW-SENSE sequence in knee MR imaging. Methods MR images of one hundred knees were obtained prospectively. The quantitative indices, qualitative scores, and grading accuracies between the two 3D sequences were compared. Results Imaging times of IW-CS-SENSE sequences were significantly reduced (122.0 ± 28.0 s vs. 221.0 ± 49.0 s, p < 0.001). The signal-to-noise ratios, contrast-to-noise ratios, and visualization scores of IW-CS-SENSE sequences were significantly lower than IW-SENSE sequences (p < 0.001), while scores of SENSE artefact for IW-CS-SENSE sequences were superior (5.00 ± 0.00 vs. 4.59 ± 0.62, p < 0.001). The accuracies in grading meniscal, ACL, and cartilage tears were comparable between the two sequences (p = 0.33, p = 0.58 and p = 0.15, respectively). Conclusion 3D IW-CS-SENSE sequences can reduce scanning time significantly and eliminate SENSE artefacts, while maintaining the same diagnostic performance as the 4-fold accelerated 3D IW-SENSE sequences.
目的 分析改良经脊柱内椎间孔镜系统技术（TESSYS）对腰椎间盘突出症患者疼痛及功能的影响，以期分析该术式优劣，丰富该研究领域。方法 回顾性选取2022年10月—2024年10月医院治疗的80例腰椎间盘突出症患者作为研究对象，根据治疗方式的不同划分为观察组（TESSYS技术治疗）和对照组（经皮椎间孔镜髓核摘除术治疗），每组各40例。观察两组患者疗效、手术时间、术中出血量、住院时间、透视次数、切口长度等情况。比较两组患者术前、术后6 h、术后1天、术后1周、术后1个月VAS评分情况，比较两组患者术前及术后1个月腰椎功能情况，包括Oswestry功能障碍指数（ODI）、腰椎曲度、腰背肌后伸活动度。比较两组患者术前及术后24 h的血清超敏C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6）水平。结果 观察组患者疗效优于对照组（Z=-3.737，P＜0.001）。交互效应下，两组疼痛因不同术式而随着时间增加而有所不同（P＜0.05）；时点效应下，观察组、对照组各组均随着时点增加疼痛随之减少（P＜0.05）；组间效应下，干预前、干预后1个月两组差异不明显，但是观察组疼痛干预后6 h（Z=-2.831，P=0.005）、干预后1天（Z=-3.253，P=0.001）低于对照组。术后1个月，观察组患者的ODI（Z=-4.804，P＜0.001）低于对照组，而腰椎曲度（Z=-6.218，P＜0.001）、腰背肌后伸活动度（Z=-7.014，P=0.001）高于对照组。术后24 h后，观察组患者的hs-CRP（Z=-5.671，P＜0.001）、IL-6（Z=-3.262，P＜0.001）低于对照组。结论 TESSYS相较于经皮椎间孔镜髓核摘除术在治疗腰椎间盘突出症时具有显著优势，可提高疗效，减少出血量，减轻疼痛，减少炎症反应，加快腰椎功能康复，缩短住院时间。
Objective The effect of modified transforaminal endoscopic spine system（TESSYS） on pain and function in patients with lumbar disc herniation was analyzed，so as to analyze the advantages and disadvantages of this procedure and enrich the research field．Methods Retrospectively，80 patients with lumbar disc herniation treated in the hospital from October 2022 to October 2024 were selected as the study subjects．These patients were divided into two groups based on their treatment methods：the observation group（treated with TESSYS technology）and the control group（treated with percutaneous endoscopic discectomy）．Each group consisted of 40 patients．The study evaluated the treatment efficacy，surgical duration，intraoperative bleeding volume，hospital stay fluoroscopy frequency，and incision length for both groups．Additionally，we compared the VAS scores of both groups before surgery，six hours post-surgery，one day post-surgery，one week post-surgery，and one month post-surgery．We also compared the lumbar function of both groups before surgery and 1 month post-surgery，including the Oswestry Functional Index（ODI），lumbar lordosis，and lumbar back muscle extension activity．Furthermore，we compared the serum levels of high-sensitivity C-reactive protein（hs-CRP）and interleukin-6（IL-6）in both groups before and 24 hours after surgery．Results The therapeutic effect of the observation group was better than that of the control group（Z=-3.737，P＜0.001）．Under the interaction effect，the pain of the two groups varied with time due to different surgical procedures（P＜0.05）．Under the time effect，both the observation group and the control group showed a decrease trend in pain as the time to treatment increased（P＜0.05）．Under the inter group effect，there was no significant difference between the two groups before and 1 month after intervention，but the pain in the observation group was less than that in the control group at 6 hours after intervention（Z=-2.831，P=0.005）and 1 day after intervention（Z=-3.253，P=0.001）．One month after surgery，the ODI（Z=-4.804，P＜0.001）of the observation group patients was lower than that of the control group，while the lumbar curvature（Z=-6.218，P＜0.001）and lumbar back muscle extension activity（Z=-7.014，P=0.001）were higher than those of the control group．Twenty-four hours after surgery，the hs-CRP（Z=-5.671，P＜0.001）and IL-6（Z=-3.262，P＜0.001）levels in the observation group were lower than those in the control group．Conclusions The improved percutaneous transforaminal endoscopic technique has significant advantages over percutaneous transforaminal discectomy in the treatment of lumbar disc herniation．It can improve efficacy，reduce bleeding，alleviate pain，reduce inflammatory reactions，accelerate lumbar functional recovery，and shorten hospitalization time．
目的 探究四子散中药封包药熨在股骨骨折术后疼痛及肿胀中的临床疗效及安全性。方法 选取2024年6月—2025年5月婺源县人民医院骨科收治的60例股骨骨折术后患者, 随机分为观察组（30例,常规治疗+四子散中药封包药熨）与对照组（30例,常规治疗）。比较两组治疗前后疼痛评分（NRS-11）、肿胀程度评分、C反应蛋白（CRP）、白细胞介素-6（IL-6）水平及不良事件发生率。结果 治疗前两组患者疼痛、肿胀评分、CRP、IL-6水平比较差异无统计学意义（P>0.05）; 治疗1周后,观察组疼痛评分为（2.11±0.48）分、肿胀程度为（0.35±0.43）度、CRP为（12.23±3.12）mg/L、IL-6为（16.03±4.01）ng/L,均低于对照组的（3.54±0.56）分、（1.04±0.58）度、（24.31±4.51）mg/L、（23.19±6.75）ng/L,差异有统计学意义（P<0.001）。观察组与对照组均无发生不良事件。结论 四子散中药封包药熨可缓解股骨骨折术后疼痛及肿胀,安全性良好。
Objective To explore the clinical efficacy and safety of Sizi powder pack hot compress in the treatment of pain and swelling after femoral fracture surgery．Methods From June 2024 to May 2025, 60 patients after femoral fracture surgery were admitted to the Orthopedics Department of Wuyuan County People's Hospital and randomly divided into observation group（30 cases, conventional treatment+Sizi power pack hot compress）and control group（30 cases, conventional treatment）． The pain score（NRS-11）, swelling score, CRP,IL-6 levels and incidence of adverse events before and after treatment were compared between the two groups．Results There was no significant difference in pain and swelling scores between the two groups before treatment（P>0.05）．After 1 week of treatment, the pain score（2.11±0.48）, swelling score（0.35±0.43）, CRP（12.23±3.12 mg/L）, IL-6（16.03±4.01 ng/L）levels in the observation group were significantly lower than those in the control group（3.54±0.56, 1.04±0.58, 24.31±4.51 mg/L, 16.03+4.01 ng/L）, and the difference was statistically significant（P<0.001）．There were no adverse events in the observation group or the control group．Conclusions Sizi power pack hot compress can significantly alleviate the pain and swelling after femoral fracture surgery,and with good safety．
目的 观察桂枝加芍药汤个体化干预治疗儿童功能性腹痛的临床疗效。方法 选取2023年100名在广东省妇幼保健院门急诊就诊确诊为儿童功能性腹痛患儿。100名儿童随机分为两组，益生菌组50名、益生菌+中药个体化干预组50名。连续治疗1周。记录两组患儿卧立位心率、卧立位血压、Rutter 儿童行为量表和中医临床症状的改善情况。结果 益生菌+中药个体化干预组患儿治疗后卧立位心率和Rutter儿童行为量表中N行为评分比益生菌组下降，中医临床症状评分的有效率优于益生菌组。结论 桂枝加芍药汤个性化干预治疗儿童功能性腹痛疗效显著。
Objective To observe the clinical efficacy of individualized intervention with Guizhi plus Shaoyao Decoction in children with functional abdominal pain disorders（FAPDs）．Methods A total of 100 children diagnosed with FAPDs at the outpatient and emergency departments of Guangdong Women and Children Hospital were selected．These children were randomly divided into two groups：the probiotics group（50 cases）and the probiotics+traditional Chinese medicine individualized intervention group（50 cases）．Both groups received continuous treatment for 1 week．Parameters including supine/upright heart rates，supine/upright blood pressure，Rutter Children’s Behavior Questionnaire，and improvements in traditional Chinese clinical symptom scores were recorded．Results The probiotics+traditional Chinese medicine individualized intervention group exhibited significantly greater reductions in supine/upright heart rates and N-behavior scores compared to the probiotics group．The effective rate of Chinese clinical symptom scores was also significantly higher in the individualized intervention group．Conclusions Individualized intervention of Guizhi plus Shaoyao Decoction has a remarkable efficacy in treating FAPDs in children．
目的 探讨肌骨超声（MSUS）在慢性肌肉骨骼疼痛（CMP）康复精准化教学中的应用效果。方法 选取在广州市第一人民医院南沙医院康复医学科实习的43名大专及本科学生，对照组进行常规CMP康复精准化教学，MSUS组在常规教学基础上增加MSUS辅助教学。实习结束后，通过专业理论考试和实践考核观察教学效果，并以问卷调查学生对教学形式和效果的满意度。结果 MSUS组的理论考核成绩为（84.62±5.14）分，对照组为（81.45±6.21）分，两组间差异无统计学意义（P＞0.05）。MSUS组的实践考核成绩（4.71±1.06）分高于对照组（3.64±1.14）分（P＜0.05）。问卷调查显示，MSUS组学生的总体满意度（35.24±3.43）高于对照组（32.64±3.98），P＜0.05。其中，对于教学方法的满意度，MSUS组（9.81±0.60）高于对照组（8.82±1.18）（P＜0.05）；对于综合分析与实践能力的满意度，MSUS组（7.43±1.91）高于对照组（6.18±1.62）（P＜0.05）。结论 MSUS教学在夯实学生专业基础知识、深化临床实践、提高综合分析能力和学习积极性方面具有显著优势，为精准化康复教学提供了有效手段。
Objective To explore the application effect of musculoskeletal ultrasound（MSUS）in the precise teaching of chronic musculoskeletal pain（CMP）rehabilitation．Methods Forty-three college and undergraduate students interning in Rehabilitation Medicine Department of Nansha Hospital，Guangzhou First People’s Hospital were selected，control group conducted conventional CMP rehabilitation teaching，and the MSUS group received additional MSUS-assisted teaching on the basis of the conventional teaching．After the internship，the teaching effectiveness was observed through professional theoretical examinations and practical assessments，and a questionnaire survey was conducted to evaluate students’satisfaction with the teaching methods and outcomes．Results The theoretical assessment score of the MSUS group were（84.62±5.14）and（81.45±6.21）of the control group，there was no difference between the two groups（P＞0.05）．The practical assessment scores of the MSUS group（4.71±1.06）were higher than those of the control group（3.64±1.14），and a significant difference was found between the two groups（P＜0.05）．The questionnaire survey showed that the overall satisfaction of the MSUS group students（35.24±3.43）was higher than that of the control group（32.64±3.97）（P＜0.05）．Among them，satisfaction with the teaching method was higher in the MSUS group（9.81±0.60）than in the control group（8.82±1.18）（P＜0.05），satisfaction with comprehensive analysis and practical ability was also higher in the MSUS group（7.43±1.91）than in the control group（6.18±1.62）（P＜0.05）．Conclusions MSUS teaching has significant advantages in consolidating students’basic professional knowledge，deepening clinical practice，improving comprehensive analysis ability and learning enthusiasm．It provides an effective means for precise rehabilitation teaching．
目的 探讨肺癌伴癌性疼痛患者心理僵化现状及其影响因素，为临床制定改善患者心理僵化的针对性干预措施以及提升患者生活质量提供参考依据。方法 采用便利抽样法，选取2023年10月—12月期间焦作市某三级甲等医院收治的肺癌伴癌性疼痛患者为研究对象，采用一般资料调查问卷、疼痛心理僵化量表（PIPS）、简易疾病感知问卷（BIPQ）、家庭功能问卷（APGAR）进行调查，采用Pearson相关性分析肺癌伴癌性疼痛患者心理僵化与疾病感知、家庭功能的关系。采用多元线性回归分析肺癌伴癌性疼痛患者心理僵化的影响因素。结果 本次研究共发放问卷152份，回收有效问卷150份，有效回收率为98.68%。150例肺癌伴癌性疼痛患者心理僵化量表总分为（61.66±2.85）分，回避型经验维度得分为（45.52±1.97）分，认知融合维度得分为（19.74±1.59）分。不同文化程度、家庭人均月收入、疼痛程度的肺癌伴癌性疼痛患者心理僵化得分比较，差异有统计学意义（P＜0.05）。Pearson相关性分析结果显示：肺癌伴癌性疼痛患者心理僵化总分、经验性回避维度得分、认知融合维度得分与疾病感知得分均呈正相关关系（P＜0.001），与家庭功能得分均呈负相关关系（P＜0.001）。多元线性回归结果显示：文化程度、家庭人均月收入、疾病感知、家庭功能是肺癌伴癌性疼痛患者心理僵化的影响因素（P＜0.05），可解释肺癌伴癌性疼痛患者心理僵化43.9%的变异度。结论 肺癌伴癌性疼痛患者心理僵化处于较高水平，且受到文化程度、家庭人均月收入、疾病感知和家庭功能的影响，临床医护人员可从疾病感知、家庭支持等角度出发，采用认知干预、同伴支持等方法，加强对患者的健康教育，以缓解其对疾病的负性认知，从而缓解心理僵化，促进身心健康恢复。
Objective To explore the status and influencing factors of psychological rigidity in patients with lung cancer and cancer pain，and to provide reference for clinical development of targeted interventions to improve patients’psychological rigidity andquality of life．Methods The convenience sampling method was used to select patients with lung cancer and cancer pain who were admitted to a tertiary hospital in Jiaozuo City from October to December 2023 as the research object．The general data questionnaire，Psychological Inflexibility in Pain Scale（PIPS），Brief Illness Perception Questionnaire（BIPQ），and family function questionnaire（APGAR）were used to investigate．Pearson correlation analysis was used to analyze the relationship between psychological rigidity and disease perception and family function in patients with lung cancer and cancer pain．Multivariate linear regression was used to analyze the influencing factors of psychological rigidity in patients with lung cancer and cancer pain．Results A total of 152 questionnaires were distributed in this study，and 150 valid questionnaires were recovered，with an effective recovery rate of 98.68 %．The total score of PIPS of 150 patients with lung cancer and cancer pain was（61.66±2.85），the score of avoidance experience dimension was（45.52±1.97），and the score of cognitive fusion dimension was（19.74±1.59）．There were statistically significant differences in the scores of psychological rigidity among lung cancer patients with cancer pain with different educational levels，family per capita monthly income，and pain degree（P＜0.05）．The results of Pearson correlation analysis showed that the total score of PIPS，the score of empirical avoidance dimension and the score of cognitive fusion dimension were positively correlated with the score of disease perception（P＜0.001），and negatively correlated with the score of family function（P＜0.001）．The results of multiple linear regression showed that education level，family per capita monthly income，disease perception and family function were the influencing factors of psychological rigidity in patients with lung cancer and cancer pain（P＜0.05 ），which could explain 43.9 % of the variation of psychological rigidity in patients with lung cancer and cancer pain．Conclusions The psychological rigidity of lung cancer patients with cancer pain is at a high level，and is affected by education level，family per capita monthly income，disease perception and family function．Clinical medical staff can use cognitive intervention and peer support from the perspective of disease perception and family support to strengthen the health education of patients，so as to alleviate their negative cognition of the disease，to alleviate the psychological rigidity and promote the recovery of physical and mental health．
目的 研究胸腰椎骨质疏松性椎体压缩性骨折（OVCF）经皮椎体成形术（PVP）后腰背部疼痛缓解情况与骨水泥弥散分布的相关性。方法 选取2021年1月—2023年12月金沙县中医医院和毕节市第三人民医院185例因骨质疏松症导致的胸腰椎OVCF行PVP后的患者,根据术后胸腰椎正侧位X线片显示的骨水泥分布情况分为两组：骨水泥分布充分组（n=101例）和骨水泥分布不良组（n=84）, 两组均行PVP, 均行双侧穿刺入路。统计分析两组患者术前、术后及术后1周、3个月、6个月视觉模拟评分（VAS）、患者起床时间等情况。结果 185例患者术后随访半年, 骨水泥分布充分组101例, 骨水泥分布不良组84 例, 两组术后VAS评分均较前缓解（P<0.05）, 术后及术后1周、3个月、6个月的随访中分布充分组VAS评分分别为（7.17±0.76）（2.11±1.04）（1.4±0.78）（0.36±0.58）（0.05±0.22）分, 优于分布不良组（7.14±0.79）（2.37±0.79）（1.89±0.82）（0.68±0.76）（0.25±0.62）分（P<0.05）。结论 骨水泥的分布在一定程度上决定了PVP后患者腰背部残余痛的程度。尤其是骨水泥在椎体内均匀分布时, 可降低术后腰背疼痛的发生率。
Objective To study the relationship between pain relief situation in the lower back and bone cement distribution after percutaneous vertebroplasty（PVP）of thoracolumbar osteoporotic vertebral compression fracture（OVCF）．Methods A total of 185 patients with thoracolumbar OVCF caused by osteoporosis underwent PVP from January 2021 to December 2023 were selected in Jinsha County Hospital of Traditional Chinese Medicine and the Third People’s Hospital of Bijie City．Based on the distribution of bone cement shown in the anteroposterior and lateral X ray films of the thoracolumbar after the operation, they were divided into the group with adequate bone cement distribution（n=101 cases）and the group with poor bone cement distribution（n=84）．Both groups underwent PVP and bilateral puncture approaches．The Visual Analogue Scale（VAS）scores of the two groups of patients before the operation, after the operation, 1 week, 3 months, and 6 months after the operation, as well as the leaving bed time of the patients,were statistically analyzed．Results A total of 185 patients were followed up for half a year after the operation．There were 101 cases in the group with adequate bone cement distribution, and 84 cases in the poor distribution of bone cement group, There was no statistically significant difference in the preoperative general data between the two groups of patients（P>0.05）, and the postoperative VAS scores of both groups were decreased compared with those before operation（P<0.05）．The VAS scores of the adequate distributed group after the operation and in the follow-ups in 1 week, 3 months, and 6 months after the operation were（7.17±0.76）,（2.11±1.04）,（1.4±0.78）,（0.36±0.58） ,and（0.05±0.22）, respectively,better than the poor distribution group （7.14±0.79）,（2.37±0.79）,（1.89±0.82）,（0.68±0.76）,（0.25±0.62）, P<0.05．Conclusions The distribution of bone cement determines to a certain extent the degree of residual pain in the low back of patients after PVP．Especially when the bone cement is evenly distributed within the vertebral body, the incidence of postoperative low back pain can be reduced．
目的 探讨作业疗法结合经皮神经电刺激对脑卒中后肩痛的疗效。方法 选取2020年6月—2023年6月在肇庆市第一人民医院治疗的60例脑卒中后肩痛患者为研究对象,随机分为观察组和对照组各30例。其中,观察组进行作业疗法结合经皮神经电刺激;对照组单纯进行作业疗法。记录患者治疗前及治疗4周后的视觉模拟疼痛评分（VAS）,改良Barthel指数（MBI）和汉密顿抑郁量表评分（HAMD）,并对记录进行检验和t检验。结果 观察组和对照组的治疗效果比较差异有统计学意义（P=0.019）,观察组治疗有效率（93.33%）高于对照组（63.33%）;治疗前两组患者的VAS（P=0.536）和HAMD（P=0.558）分值比较差异无统计学意义,治疗后其VAS（P=0.049）及HAMD（P=0.023）分值均较治疗前下降,且观察组下降幅度分别为（2.23±1.14）分和（4.47±3.06）分,均高于对照组的（1.27±0.98）和（1.33±1.35）,组间比较差异有统计学意义;治疗前两组患者的MBI分值比较差异无统计学意义（P=0.216）,治疗后其MBI分值均较治疗前提高,且观察组提高幅度（21.87±10.25）较对照组（12.00±13.58）更显著,组间比较差异有统计学意义（P=0.003）。结论 作业疗法结合经皮神经电刺激可缓解脑卒中肩痛,改善患者日常生活能力和心理精神状态,减少抑郁的发生。
Objective To explore the therapeutic effect of occupational therapy combined with transcutaneous electrical nerve stimulation（TENS） on shoulder pain after stroke．Methods Sixty patients with post-stroke shoulder pain who were treated in the First People’s Hospital of Zhaoqing from June 2020 to June 2023 were selected as the study subjects and randomly divided into an observation group and a control group,with 30 cases in each group．Among them,the observation group received occupational therapy combined with TENS,while the control group received occupational therapy alone．This study recorded the Visual Analogue Scale（VAS）,modified Barthel Index（MBI）,and Hamilton Depression Rating Scale（HAMD）of patients before and after 4 weeks of treatment,and conducted the and t-test analysis．Results The test analysis showed a significant difference in treatment effectiveness between the observation group and the control group（P=0.019）,with the observation group having a significantly higher treatment effectiveness rate（93.33%）than the control group（63.33%）;t-test analysis showed that there was no statistically significant difference in VAS（P=0.536）and HAMD（P=0.558）indicators between the two groups of patients before treatment．However,after treatment,the VAS（P=0.049）and HAMD（P=0.023）indicators decreased compared to before treatment．The observation group had decreased（2.23±1.14）and（4.47±3.06）,respectively,which were significantly higher than the control group’s（1.27±0.98）and（1.33±1.35）,and the inter group differences were statistically significant;before treatment,there was no statistically significant difference in MBI indicators between the two groups of patients（P=0.216）．After treatment,their MBI indicators increased compared to before treatment,and the observation group（21.87±10.25）showed a more significant improvement compared to the control group（12.00±13.58）．The difference between the groups was statistically significant（P=0.003）．Conclusions Occupational therapy combined with TENS can significantly alleviate shoulder pain after stroke,improve daily living ability and psychological state of patients,and reduce the occurrence of depression．
目的 应用 Python语言对《圣济总录》中腰痛病篇中的中药进行用药规律分析,提取腰痛病治疗方法及用药特色指导临床腰痛病治疗思路。方法 运用 Python语言中的语言提取对《圣济总录》中腰痛篇章中的所有中药方剂识别,提取方剂组成,统计并分析方剂中中药的规律并将其结果可视化呈现。结果 最终共纳入62首方剂,包含药物86味。其中使用频次≥7次、频率≥1.6%的药物共20味,频次频率最高的为桂枝;所用中药四气以温性为主,占56.74%;五味以辛、甘、苦为主,共约占90%,归经以肝肾经为主;药物功效以补虚类为主,占27.13%;关联规则分析显示提升度最高的组合为麻黄-独活,置信度最高的组合为巴戟天-牛膝、牵牛子-牛膝,支持度最高的组合为川芎-当归、川芎-杜仲;通过聚类分析得到3个聚类结果。结论 《圣济总录》治疗腰痛病方面善用通法和补法,强调活血通络,补益肝肾,尤擅长治疗肝肾亏虚或风寒所客等腰痛病证。
Objective Python language was used to analyze the rules of traditional Chinese medicine in the chapter of low back pain in Shengji Zonglu,and to extract the treatment methods and medication characteristics of low back pain to guide the clinical treatment of low back pain．Methods The language extraction in Python language was used to identify all the Chinese medicine prescriptions in the chapter of low back pain in Shengji Zonglu,extract the composition of the prescription,and analyze the rules of Chinese medicine in the prescription to visually present the results．Results A total of 62 prescriptions were included,including 86 drugs．Among them,with there were 20 kinds of drugs,the frequency of use ≥7 times,the frequency ≥1.6%,and cmnamomi Mmulus highest frequency．Four gas used in traditional Chinese medicine is given priority to with warm,accounted for 56.74%．The five flavors were mainly pungent,sweet and bitter,accounting for about 90%,and the liver and kidney meridians were the main meridians．The drug efficacy was mainly deficiency tonic,accounting for 27.13%．The association rule analysis showed that the combination with the highest improvement was Ephedrae Herba- Angelicae Pubescentis Radix,the combination with the highest confidence was Morindae Officinalis Radix- Achyranthis Bidentatae Radix,Pharbitidis Semen- Achyranthis Bidentatae Radix．and the combination with the highest support was Chuanxiong Rhizoma- Angelicae Sinensis Radix,Chuanxiong Rhizoma- Eucommiae Cortex．Three clustering result is obtained by cluster analysis．Conclusions In the treatment of low back pain,Shengji Zonglu is good at using both blocking methods and reinforcing methods,emphasizing circulating blood and unblocking meridians supplementing liver and kidney,especially in the treatment of low back pain syndrome caused by liver and kidney deficiency or wind and cold．
目的 研究慢性非特异性腰痛患者腰椎正侧位X线中腰椎侧弯、L1-5棘突偏歪和椎体滑脱情况,总结规律,为慢性非特异性腰痛患者治疗提供依据。方法 选取164例慢性非特异性腰痛患者,观察并记录每例患者腰椎正侧位X线中腰椎侧弯、L1~L5棘突偏歪和椎体滑脱情况。用统计学软件分析腰椎侧弯、棘突偏歪和椎体滑脱情况。结果 共有59例发生腰椎侧弯,占35.98%,其中Cobb角5°~10 °有47例,占28.66%;Cobb角>10°有12例,占7.32%。腰椎侧弯发病以L4为下端椎为主。以L3为下端椎有12例患者,占20.34%;以L4为下端椎有37例患者,占62.71%;以L5为发椎有10例患者,占16.95%。共119例发生棘突偏歪,占总例数的72.56%。L5棘突偏歪最常见,发生率为57.93%;L4次之,发生率为48.17%。L5棘突偏歪率与L1~L3棘突偏歪率比较差异均有统计学意义（χ2分别为14.580,11.771,7.484,P分别为<0.001,0.001,0.006）,但与L4棘突偏歪率比较差异无统计学意义（χ2=3.124,P=0.077）。共30例患者存在椎体滑脱,占18.29%。L5最常发生滑脱,发生率为8.54%;L4次之,发生率为7.93%。L4与L5椎体滑脱率比较差异无统计学意义（χ2=0.040,P=0.841）;L4分别与L1,L2,L3以及L5分别与L1,L2,L3椎体滑脱率差异均有统计学意义（L5与L1、L2、L3：χ2分别为14.580、11.771、7.484,P分别为<0.001、<0.001、<0.006;L4与L1、L2、L3：χ2分别为13.495、10.712、6.550,P分别为<0.001、<0.001、<0.010）。结论 慢性非特异性腰痛患者较常发生腰椎侧弯,侧弯以L4为下端椎为主;慢性非特异性腰痛患者较常发生棘突偏歪,L5棘突偏歪最常见,L4次之;L5和L4是慢性非特异性腰痛患者最常发生滑脱的椎体。在治疗慢性非特异性腰痛患者时,与L5和L4相关的肌肉、筋膜等软组织损伤以及关节退行性变或紊乱应引起重点关注。
Objective To study the lumbar scoliosis,L1-5 spinous process deviation and spondylolisthesis in spine X-ray of patients with chronic non-specific low back pain（CNLBP）,and summarizing the existing rules,so as to provide imaging theoretical support for the treatment of CNLBP．Methods A total of 164 patients with CNLBP were selected．The lumbar scoliosis,L1-5 spinous process deviation and spondylolisthesis were observed and recorded in the anteroposterior and lateral X-ray films of each patient．The lumbar scoliosis,spinous process deviation and spondylolisthesis were statistically analyzed by statistical software．Results A total of 59 people had lumbar scoliosis,accounting for 35.98%．There were 47 patients with 5°-10°Cobb angle,accounting for 28.66%．There were 12 patients with Cobb angle >10°,accounting for 7.32%．L4 was the main lower apical vertebra of lumbar scoliosis．There were 12 patients with L3 as the lower apical vertebra,accounting for 20.34%;37 patients with L4 as the lower apical vertebra,accounting for 62.71%;10 patients with L5 as the lower apical vertebra,accounting for 16.95%．A total of 119 people appeared spinous process deviation,accounting for 72.56%．L5 spinous process deviation was the most common,with proportion of 57.93%,and L4 was the second,with proportion of 48.17%．The results of chi-square test showed that there were significant differences between L5 and L1-L3 spinous process deviation（χ2 were 14.580,11.771,7.484,and P values were <0.001,0.001,0.006 respectively）,but no significant difference between L5 and L4 spinous process（χ2=3.124,P=0.077）．A total of 30 patients had spondylolisthesis,accounting for 18.29%．L5 was the most common of spondylolisthesis,with an occurrence rate of 8.54%．L4 was the second,with an occurrence rate of 7.93%．There was no significant difference in spondylolisthesis rate between L4 and L5（χ2=0.040,P=0.841）．The spondylolisthesis rates of L4 and L5 were significantly different from those of L1,L2 and L3（L5 and L1,L2,L3：χ2 were 14.580,11.771,7.484,and P values were <0.001,0.001,0.006 respectively;L4 and L1,L2,L3：χ2 was 13.495,10.712,6.550,P values was <0.001,0.001,0.010 respectively）．Conclusions Lumbar scoliosis is more common in patients with CNLBP,and L4 is the main lower apical vertebra of lumbar scoliosis．Patients with CNLBP often have spinous process deviation,and the most common is L5 spinous process deviation,followed by L4．L5 and L4 are the most common vertebrae with spondylolisthesis in patients with CNLBP．The soft injury and joint degeneration or disorder related to L5 and L4 should be paid more attention in the treatment of patients with CNLBP．
