Advances in the Study of Chinese Medical Syndrome of Cervical Radiculopathy
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摘要: 证候规范化与客观化是中医药现代化的重要研究内容。从辨证分型、临床疗效评价、证候基础研究方面综述了神经根型颈椎病(CR)中医证候的研究现状，认为目前该病中医证候研究方面存在证候诊断标准不统一、疗效评价欠规范、证候基础研究缺乏系统性等问题。通过比较现有的国家标准与行业标准，提出可优先参考中华中医药学会颁布的《神经根型颈椎病中医诊疗指南》作为证候诊断标准；关于疗效评价建议遵循国际研究规范，至少选择1项公认的疾病疗效评价指标，根据证候特点选择合适的评价量表；建立公认的CR病证结合动物模型，从动物、组织、细胞层面运用系统生物学技术对中医药干预措施的作用机制进行说明，比较CR不同证候患者临床特征与生化指标等表达差异。Abstract: The standardization and objectification of syndrome is an important research element in the modernization of Chinese medicine. The current research status of Chinese medical syndrome of cervical radiculopathy (CR) was reviewed in terms of syndrome differentiation and classification, clinical efficacy evaluation, as well as syndrome-based research, and it was concluded that the current research on Chinese medical syndrome of CR was characterized by the lack of uniform diagnostic criteria, standardized efficacy evaluation, and systematically syndrome-based research. By comparing the existing national standards and industry standards, it is suggested that the Guidelines for the diagnosis and treatment of cervical radiculopathy promulgated by the Chinese Association of Chinese Medicine can be preferred as the diagnostic criteria for the syndromes. In addition, it is recommended to follow the international research standards, select at least one recognized disease efficacy evaluation index, choose a suitable evaluation scale according to the characteristics of the syndromes, establish a recognized animal model for the combination of CR diseases and syndromes, use systems biology techniques to explain the mechanism of action of Chinese medicine interventions at the animal, tissue and cellular levels, and compare the differences between the expression of clinical characteristics and biochemical criterions in patients with different syndromes of CR.
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表 1 不同神经根型颈椎病中医证候诊断标准
证候名称 诊断标准 出现频次 气滞血瘀证/血瘀气滞证 《中医病证诊断疗效标准(骨伤科)》
《中药新药临床研究指导原则(试行)》
《22个专业95个病种中医诊疗方案》
《中医循证临床实践指南·专科专病》
《神经根型颈椎病中医诊疗指南》5 气血不足证/气血亏虚证 《中医病证诊断疗效标准(骨伤科)》
《中药新药临床研究指导原则(试行)》
《22个专业95个病种中医诊疗方案》
《中医循证临床实践指南·专科专病》
《神经根型颈椎病中医诊疗指南》5 肝肾不足证/肝肾亏虚证 《中医病证诊断疗效标准(骨伤科)》
《22个专业95个病种中医诊疗方案》
《中医循证临床实践指南·专科专病》
《神经根型颈椎病中医诊疗指南》4 风寒阻络证/风寒痹阻证 《中药新药临床研究指导原则(试行)》
《22个专业95个病种中医诊疗方案》
《中医循证临床实践指南·专科专病》
《神经根型颈椎病中医诊疗指南》4 寒湿阻络证 《中医循证临床实践指南·专科专病》
《神经根型颈椎病中医诊疗指南》2 痰湿阻络证 《中医病证诊断疗效标准(骨伤科)》
《22个专业95个病种中医诊疗方案》2 风寒湿证 《中医病证诊断疗效标准(骨伤科)》 1 肝阳上亢证 《中药新药临床研究指导原则(试行)》 1 
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