马尾神经综合征的基础和临床研究概况-临床医学专业毕业论文.docxVIP

PAGE PAGE 1 摘 要 马尾神经综合征（Cauda Equina Syndrome, CES）临床较为常见，为腰椎疾 病中较为严重的并发症之一。它是由于先天或后天的因素导致腰椎管绝对或相对 狭窄，直接或间接地压迫马尾神经，造成神经组织的病理变化，出现以腰痛、下 肢放射痛、鞍区麻木、大小便失禁、性功能障碍等症状为主的一组临床综合症候 群。其治疗效果普遍不理想，因而严重地影响了患者的生活质量，给家庭和社会 带来了沉重的经济负担。 目前国内对马尾神经综合征的基础和临床研究相对于其他骨科疾病来说较 为薄弱。在对其治疗方式的选择上，大多数学者更倾向于手术治疗。本文第一部 分从马尾神经的解剖和病理生理基础、马尾神经综合征的病因病理、临床症状与 体征、诊断、治疗研究进展等方面做了简单的介绍，通过对以上内容的分析，指 出了目前存在的一些问题。针对目前普遍以手术作为本病常规治疗方法的情况， 笔者认为，并不是每一个本病患者都必须接受手术治疗，部分本病患者适于用中 医药治疗。第二部分从中医辩证论治的角度介绍了导师曾一林教授对马尾神经综 合征的认识和运用中医药治疗本病的经验，进一步强调了上面的观点，最后我们 提出了中医药治疗马尾神经综合征的新的治疗理念。 关键词：马尾神经；马尾神经综合征；基础研究；临床研究；手术治疗；非 手术治疗；中医药治疗；临床经验 ABSTRACT CES(Cauda Equina Syndrome) is a common clinical disease belonging to one kind of serious complications of lumbar diseases. It is a clinical syndrome which due to congenital or acquired factors lead to absolute or relative lumbar canal stenosis, directly or indirectly compress cauda equina，cause to it’s pathological changes with the emergence of low back pain, leg redicular pain, saddle anesthesia, incontinence, sexual dysfunction and other symptoms. Because the treatment of CES is generally not ideal, it seriously affects the living quality of patients, gives families and the society a heavy financial burden. Compared to other orthopedic diseases in our country , the basis and clinical studies of CES is relatively weak currently. When facing to the choices of treatment , most scholars support surgical treatment. The first part of this paper includes a brief introduction : the anatomical basis and pathophysiology of cauda equina , the pathophysiology, clinical signs ,symptoms, diagnosis and treatment of CES.According to the analysis of the above elements, we put some exsiting questions. In view of the fact that most scholars take surgry as the contitional treatment of CES, we think that not every patient of CES must be received surgical treatment, some patients are suitable for the treatment of Traditional Chinese medicine. In the second part ,we introduce the experiences of identifying p