Objective To explore the relationship between the objective indexes and TCM syndromes of occupational hand arm vibration disease ,and to provide clinical data for the objectification of TCM syndrome differentiation. Methods 101 patients with occupational hand arm vibration disease were collected ,including 24 patients with Xingbi,39 with Tongbi and 38 with Zhuobi,according to the theory of traditional Chinese medicine syndrome differentiation ,the relationship was observed between different TCM Syndrome types and various of parameters,such as 5-and 10-minute rewarming rates in cold water rewarming test,terminal latency,amplitude, conduction velocity ,average time ,average amplitude of abductor pollicis brevis and abductor digiti minimi in electromyography. Results 5-and 10-minute rewarming rate in cold water rewarming test did not differ significantly among the three groups(P > 0.05). Amplitude of median nerve motor conduction differed significantly among the three groups of Xingbi,Tongbi and Zhuobi(χ2 = 6.14,P < 0.05),Further comparison between the groups was made in Xingbi and Tongbi(χ2=0.132,P=0.895),Xingbi and Zhuobi(χ2=2.277,P=0.023),Tongbi and Xingbi (χ2 = 2.172 ,P = 0.030). There were no significant differences among the three groups in latency and conduction velocity of the median nerve motor conduction and latency ,amplitude and conduction velocity of ulnar nerve motor conduction(P>0.05). The differences of conduction velocity and amplitude of median nerve and ulnar nerve sensory conduction,average time and average amplitude of abductor pollicis brevis and abductor muscle among the three groups had no statistical differences(P>0.05). Conclusions The distribution is different in the amplitude of median nerve motor conduction among the three groups of Xingbi,Tongbi and Zhuobi,further analysis shows that the difference is mainly reflected in the Xingbi group. We conclude that the median nerve axonal injury is lighter in Xingbi group than in the other two groups.%目的 探讨职业性手臂振动病的不同中医证型与实验室客观指标间的关系,以为中医辨证分型客观化提供临床支持.方法 筛选已经明确诊断为职业性手臂振动病的患者101例,根据中医理论辨证分型,分为行痹24例、痛痹39例、着痹38例.观察患者冷水复温试验5 min复温率、10 min复温率和神经肌电图检查末端潜伏期、波幅、传导速度及拇短展肌、小指展肌的运动单位平均时限和平均波幅各参数在不同中医证型间分布的异同.结果 冷水复温试验5、10 min复温率在行痹、痛痹、着痹3组间的差异无统计学意义(P>0.05).神经肌电图检查方面,正中神经运动传导波幅在行痹、痛痹、着痹3组间差异有统计学意义(χ2=6.14,P<0.05),进一步组间比较,着痹组与痛痹组比较差异无统计学意义(χ2=0.132,P=0.895),着痹组与行痹组比较差异有统计学意义(χ2=2.277,P=0.023),痛痹组与行痹组比较差异有统计学意义(χ2=2.172,P=0.030).而正中神经运动传导末端潜伏期和传导速度及尺神经运动传导末端潜伏期、波幅和传导速度在3组间差异均无统计学意义(P>0.05).正中神经、尺神经感觉传导波幅和传导速度及拇短展肌、小指展肌运动单位平均时限和平均波幅在3组间差异均无统计学意义(P>0.05).结论 初步认为正中神经运动传导的波幅在行痹、痛痹、着痹3组间的分布有差异,差异主要体现在行痹组与其他两组上,认为行痹组的波幅高于痛痹、着痹组,考虑行痹组正中神经轴索较痛痹、着痹组损伤轻.
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