退行性腰椎不稳症的中医药治疗概况  

Research in theT raditional Chinese MedicineT reatment of Degenerative Lumbar Instability Syndrome

作　　者：来保勇 谢占国 

机构地区：[1]北京中医药大学循证医学中心,北京100029 [2]北京市东城区第一人民医院针灸科,北京100075

出　　处：《医学综述》2017年第13期2666-2670,共5页Medical Recapitulate

基　　金：北京市东城区国家中医药发展改革试验区项目(2015年)

摘　　要：退行性腰椎不稳症的主要症状之一是反复发作性下腰痛,中医药疗法对其有一定的疗效,且在保守疗法中发挥重要作用。其中,中药、针灸、针刀、推拿等疗法可起到疏通经脉、行气活血、除痹止痛的作用。针灸多采用循经取穴,辅以远部辨证取穴的原则;针刀疗法直接作用于十二筋的筋膜层,改善病变部位小血管和挛缩变性组织的微循环,可阻断无菌性炎症反应的恶性循环;推拿疗法促进病变组织微循环,提高局部组织痛阈值,改变肌肉痉挛和挛缩的状态,解除异常牵拉应力,促进椎间关节稳定;中药疗法包括内服与外用,内服多以补肝肾、强筋骨为法,外用包括中药贴敷、中药熏洗及中药离子导入等。虽然这些传统疗法应用于退行性腰椎不稳症具有重要的临床意义,但相关疗效的报道较少且分散。因此,需要对现有的资料报告进行鉴定、整理、综合,从而为临床实践提供线索。A main symptom of degenerative lumbar instability syndrome is low back pain. Traditional Chinese medicine as a conservative therapy has certain effects for treating degenerative lumbar instability syndrome and plays a significant role in the conservative treatment. Traditional Chinese medicine treatments, such as herbal medicine, acupuncture and moxibus- tion, acupetomy, massage and so on, could relieve stagnation and alleviate pain by dredging meridians and activating qi and blood. Acupuncture therapy is performed according to the rule of following meridians and choosing acupeints assisted with remote acupoints selected by syndrome differentiation; acupotomy therapy directly effects on the fascia layer of twelve merid- ians,which can improve microcirculation of the pathological small blood vessels and contracture muscle and soft tissue, and prevent aseptic inflammation. Massage therapy can promote the microcireulation of the lesion tissue, increase the pain threshold of local tissue and change the condition of contracture muscle and spasm, which ultimately promotes the stability of intervertebral joint with removing abnormal pull stress;traditional Chinese medicine therapy includes internal orally and external use, and internal orally use is usually based on the method of tonifying the liver and kidney, strengthening the bones and muscles, while external use includes herbal plaster, herbal fumigation and herb iontophores method etc. Although tradi- tional Chinese medicine is of great significance for treating degenerative lumbar instability syndrome in clinical practice, there is limited and scattered evidence in literature, therefore, we need to verify, so/t and integrate the existing data and report, so as to provide clues for the future clinical practice.

关 键 词：退行性腰椎不稳症 下腰痛 中医药 

分 类 号：R681.5[医药卫生—骨科学]