中医治疗腰椎间盘突出症的研究进展

Progress in Traditional Chinese Medicine Treatment of Lumbar Intervertebral Disc Herniation

腰椎间盘突出症(LDH)是一种以腰腿痛、下肢麻木为主要症状的一类疾病,临床上好发于L_(4)/L_(5)和L_(5)/S_(1)椎间盘,严重的神经根麻痹和马尾综合征一般采取手术治疗,其余首选保守治疗,我国人口老龄化进一步加重,腰椎退变、老化的人群增加,越来越多的人采取保守治疗。随着中医治疗方法不断完善和丰富,中医在临床腰椎间盘突出症的保守治疗中疗效显著。尤其是针灸、针刀、推拿,其治疗成本较低且患者接受度高,开展中医治疗的前景非常广阔。现将近5年来中医治疗腰椎间盘突出症的相关研究整理,从中药内服、中药外敷、中药熏洗、推拿正骨、针灸、小针刀、联合疗法7个方面进行概述,以期为临床上中医治疗腰椎间盘突出提供参考和借鉴。其中在中药汤剂内服、中药外敷及中药熏蒸方面要注重个体化,辨证施治,使患者获得更好,更持久的疗效。针灸、小针刀及推拿正骨方面要注重结合影像学、现代解剖学及生物力学研究。在联合疗法方面也应该突出个体化治疗。在临床实践中不但要充分发挥中医整体观念及辨证论治的优势,而且应该更广泛结合现代科学技术来进一步加强药理学和动物试验研究,并在临床研究中增加相应的影像学指标,不断地丰富完善并深入了解中医各种治疗方法的疗效机制。

Lumbar disc herniation(LDH)is a kind of disease with low back and leg pain and numbness of lower limbs as its main symptoms.It is clinically prone to L_(4)/L_(5)and L_(5)/S_(1)intervertebral discs.Severe nerve root palsy and cauda equina syndrome are generally treated by surgery,while the rest are treated conservatively.Nowadays,the aging of the domestic population is further aggravated,and the number of people with lumbar degeneration and aging is increasing.More and more people are taking conservative treatment.With the development of the times,the treatment methods of traditional Chinese medicine have been constantly improved and enriched,and the curative effect of traditional Chinese medicine in the conservative treatment of clinical lumbar disc herniation is significant.In particular,acupuncture,acupotomy and massage have low treatment cost and high patient acceptance,so the prospect of traditional Chinese medicine treatment is very broad.Now,in the past five years,the relevant researches on the treatment of lumbar disc herniation by traditional Chinese medicine are summarized from seven aspects:oral administration of traditional Chinese medicine,external application of traditional Chinese medicine,fumigation and washing of traditional Chinese medicine,massage and bone setting,acupuncture,small needle knife,and combined therapy,with a view to providing reference and reference for the clinical treatment of lumbar disc herniation by traditional Chinese medicine.In the aspects of oral administration of traditional Chinese medicine decoction,external application of traditional Chinese medicine and fumigation of traditional Chinese medicine,we should pay attention to individualization and syndrome differentiation,so that patients can obtain better and more lasting curative effect.Acupuncture,acupotomy and massage bone setting should be combined with imaging,modern anatomy and biomechanics.Individual treatment should also be highlighted in combination therapy.In clinical practice,it is not only necessary to give full play to the overall concept of traditional Chinese medicine and the advantages of syndrome differentiation and treatment,but also to further strengthen pharmacology and animal experimental research by combining modern science and technology more widely,and to add corresponding imaging indicators in clinical research,so as to constantly enrich,improve and deeply understand the therapeutic mechanism of various treatment methods of traditional Chinese medicine.