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从‘湿’论治腰椎间盘突出症

A Study of Treatments for Prolapse of Lumbar Intervertebral Disc from ‘Dampness’

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초록

本文的目的在于,整理和归纳中医学中‘湿’理论与腰椎间盘突出症(LDH)的相关性,从中医学的角度,结合现代医学对LDH的治疗法进行理论假设,在此基础上通过针药结合的临床治疗,为腰间盘突出症的治疗提供一种新的思路。为此,笔者一方面在‘知网’、‘万方’等中文数据库通过“腰椎间盘突出症”、“湿邪”、“津液”等关键词检索、研读和整理相关的文献资料,另一方面采取临床观察和专家走访、病案分析法,用尽可能详尽的数据验证理论假设,为研究结果提供更为完善的参考依据。笔者在查阅与腰椎间盘突出症、湿邪相关的文献时发现腰椎间盘突出症作为临床上常见病和多发病,其发病机制和治疗等认识与中医学中的‘湿邪’相关,而湿邪可通过针与药结合治疗。因此,笔者假设LDH可通过针与药结合治‘湿’见效,认为在腰椎间盘突出症的保守疗法中,针药结合是一种安全有效的方法。此外,中医古籍中记载腰椎间盘突出症的发病机制和治疗等认识与中医湿邪相关,而针对寒、热不同湿邪证型,拟用甘姜苓术汤或四妙丸为底,配合远端针刺、局部经筋排刺,针药结合以利水化湿、通络止痛,对比治疗前后的症状,疗效颇佳。研究结果初步显示,湿邪为腰椎间盘突出症的发病核心,以利水化湿、通络止痛为治疗原则,针药结合治疗腰椎间盘突出症能够缓解症状、修复结构并防止复发,故而值得临床推广。

Abstract

The purpose of this paper is to sort out and summarize the correlation between the ‘Wet’ theory and protrusion of the Lumbar Intervertebral Disc, Providing a new idea for the treatment of Lumbar Disc Herniation (LDH) through a theoretical hypothesis from which the point of view in Traditional Chinese Medicine (TMC), with the combination of acupuncture and medicine clinical treatment. The Lumbar Disc Herniation (LDH), which is a common and frequently- occurring disease in clinics, is believed related to ‘Dampness’ from the point of TMC. To verify this point of view, I have collated and summarized the relevant literature on protrusions of the intervertebral disc and dampness pathogens in Chinese databases such as ‘Zhiwang’ and ‘Wanfang’, found that the combination of acupuncture and medicine is a safe and effective method in the conservative treatment of protrusion of intervertebral discs. In addition, the pathogenesis and treatment of lumbar protrusions of intervertebral disc recorded in ancient TCM books are related to dampness and pathogenic factors of TCM. According to different syndromes of cold and heat, Chinese medicine intends to use Ganjianglingzhu Decoction or Simiao Pills as the base, as well as the method of distal acupuncture, and local Meridian Drainage, Acupuncture which is combined with drugs to achieve the goal of melting the dampness and stopping pain by activating meridians. Compare with the treatment for these symptoms before, the effect is quite good. The results showed that dampness was the core of protrusions of the intervertebral disc, and the combination of acupuncture and medicine based on the principle of melting the dampness and stopping pain by activating meridians could relieve the symptoms, repair the structure and prevent the recurrence, which is worth to be popularized.

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