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已发表论文
腰椎间盘突出症患者同期症状的网络分析及核心症状的识别
Authors Lu H, Shi H, Chen Y, Zhang C, Chen X, Zhang X, Yin X
Received 7 June 2025
Accepted for publication 23 December 2025
Published 30 December 2025 Volume 2025:18 Pages 7233—7244
DOI https://doi.org/10.2147/JPR.S545433
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor King Hei Stanley Lam
Hongping Lu,1,2,* Haoke Shi,1,* Yao Chen,1 Chun Zhang,3 Xi Chen,3 Xiaohong Zhang,4 Xinhong Yin1
1School of Nursing, University of South China, Hengyang, Hunan, People’s Republic of China; 2Department of Pain Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, People’s Republic of China; 3Department of Orthopaedics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, People’s Republic of China; 4Department of Nursing, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xinhong Yin; Xiaohong Zhang, Email 2018000091@usc.edu.cn; 1239702016@qq.com
Objective: To construct a contemporaneous symptom co-occurrence network of patients with lumbar disc herniation (LDH) to extract symptom clusters and identify core and bridge symptoms using network analysis.
Methods: A questionnaire was administered to 312 LDH patients hospitalized in a tertiary-level hospital in Hubei Province from September 21, 2024, to March 31, 2025, using convenience sampling. Instruments included a general information questionnaire, the Japanese Orthopaedic Association’s Low Back Pain Assessment Scale (JOA), the Visual Analogue Scale (VAS), and the Self-Rating Anxiety Scale (SAS). Symptomatic data were collected and downscaled using exploratory factor analysis to reduce dimensionality and extract symptom clusters with intrinsic associations. The symptom network was constructed using R, relationships between symptoms were analyzed, and centrality indices were calculated to identify key symptom nodes.
Results: Exploratory factor analysis extracted four symptom clusters. They were the symptom cluster of limited lumbar mobility function, the symptom cluster of limited lower extremity mobility function, the symptom cluster of abnormal distal limb sensation, and the symptom cluster of lower extremity motor coordination disorder. The top three symptoms for node strength were Difficulty standing (rs = 5.72), Difficulty walking (rs = 5.43), and Difficulty turning over (rs = 5.35); the top three for bridge strength were Difficulty standing (rs = 4.58), walking ability (rs = 4.49), and Difficulty walking (rs = 4.37).
Conclusion: Difficulty standing, Difficulty walking, and Difficulty turning are the most central symptoms in LDH patients, while Difficulty standing, walking ability, and Difficulty walking are bridge symptoms.
Keywords: lumbar disc herniation, intervertebral disc degeneration, low back pain, network analysis, contemporaneous network, core symptoms, nursing
1School of Nursing, University of South China, Hengyang, Hunan, People’s Republic of China; 2Department of Pain Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, People’s Republic of China; 3Department of Orthopaedics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, People’s Republic of China; 4Department of Nursing, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xinhong Yin; Xiaohong Zhang, Email 2018000091@usc.edu.cn; 1239702016@qq.com
Objective: To construct a contemporaneous symptom co-occurrence network of patients with lumbar disc herniation (LDH) to extract symptom clusters and identify core and bridge symptoms using network analysis.
Methods: A questionnaire was administered to 312 LDH patients hospitalized in a tertiary-level hospital in Hubei Province from September 21, 2024, to March 31, 2025, using convenience sampling. Instruments included a general information questionnaire, the Japanese Orthopaedic Association’s Low Back Pain Assessment Scale (JOA), the Visual Analogue Scale (VAS), and the Self-Rating Anxiety Scale (SAS). Symptomatic data were collected and downscaled using exploratory factor analysis to reduce dimensionality and extract symptom clusters with intrinsic associations. The symptom network was constructed using R, relationships between symptoms were analyzed, and centrality indices were calculated to identify key symptom nodes.
Results: Exploratory factor analysis extracted four symptom clusters. They were the symptom cluster of limited lumbar mobility function, the symptom cluster of limited lower extremity mobility function, the symptom cluster of abnormal distal limb sensation, and the symptom cluster of lower extremity motor coordination disorder. The top three symptoms for node strength were Difficulty standing (rs = 5.72), Difficulty walking (rs = 5.43), and Difficulty turning over (rs = 5.35); the top three for bridge strength were Difficulty standing (rs = 4.58), walking ability (rs = 4.49), and Difficulty walking (rs = 4.37).
Conclusion: Difficulty standing, Difficulty walking, and Difficulty turning are the most central symptoms in LDH patients, while Difficulty standing, walking ability, and Difficulty walking are bridge symptoms.
Keywords: lumbar disc herniation, intervertebral disc degeneration, low back pain, network analysis, contemporaneous network, core symptoms, nursing