独活寄生汤治疗神经根型颈椎病作用机制和临床应用研究进展

Research Progress on the Mechanism and Clinical Application of Duhuo Jisheng Decoction(独活寄生汤)in the Treatment of Cervical Spondylotic Radiculopathy

颈椎病已成为我国乃至全球临床实践中一大顽疾。神经根型颈椎病患者占有最多比例,其发病机制较为复杂,尚未形成统一共识。中医学将神经根型颈椎病辨病为“痹证”范畴,其主要病机为肝肾、荣卫亏虚,外受邪气、过劳、外伤,内外相攻所致。独活寄生汤作为药王孙思邈的经典名方,已普遍用于骨伤科疾病的治疗之中,但针对神经根型颈椎病未见广泛临床应用。因此,根据近年独活寄生汤的相关文献归纳总结,此方治疗神经根型颈椎病的作用机制可能与以下4个方面相关:降低炎症物质水平,改善血供,延缓颈椎退变,改善神经功能。文章对独活寄生汤治疗神经根型颈椎病的作用机制、单味药现代药理学研究、现阶段临床应用进行综述,以期为神经根型颈椎病的中西医临床治疗提供相应的理论基础和参考价值。

Cervical spondylosis has become a major stubborn disease in clinical practice in China and even in the world.Cervical spondylotic radiculopathy accounts for the largest proportion of patients,and its pathogenesis is more complex,and no unified consensus has been reached.Cervical spondylotic radiculopathy is classified as arthralgia in traditional Chinese medicine.The main pathogenesis is liver and kidney,deficiency of Rong and Wei,external evil,overwork,trauma,and internal and external attack.As a classic prescription of SUN Simiao,Duhuo Jisheng Decoction(独活寄生汤)has been widely used in the treatment of orthopedic diseases,but it has not been widely used in clinical application of cervical spondylotic radiculopathy.Therefore,according to the relevant literature of Duhuo Jisheng Decoction in recent years,it is summarized.The mechanism of this prescription in the treatment of cervical spondylotic radiculopathy may be related to the following four aspects:reducing the level of inflammatory substances,improving blood supply,delaying cervical degeneration,and improving neurological function.This article reviews the mechanism of Duhuo Jisheng Decoction in the treatment of cervical spondylosis of nerve root type,the modern pharmacological research of single herb,and the current clinical application,in order to provide the corresponding theoretical basis and reference value for the clinical treatment of cervical spondylosis of nerve root type.