基于炎性微环境探析推拿干预腰椎间盘突出症的镇痛机理  

Analysis of Analgesic Mechanism of Tuina on the Intervention of Lumbar Disc Herniation based on Inflammatory Microenvironment

作　　者：曹奔 张帅攀 周鑫 朱清广[1] 孔令军[1] 程艳彬[1] 房敏[1,2] CAO Ben;ZHANG Shuaipan;ZHOU Xin;ZHU Qingguang;KONG Lingjun;CHENG Yanbin;FANG Min(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200437;Institute of Acupuncture,Moxibustion and Tuina,Shanghai University of Traditional Chinese Medicine)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海市200437 [2]上海中医药大学针灸推拿学院

出　　处：《中医杂志》2022年第24期2321-2325,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82030121,82004493);国家中医药管理局中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者(2018);国家中医药管理局国家中医药传承创新团队项目(ZYYCXTD-C-202008);科学技术部国家重点研发计划(2018YFC1707800)。

摘　　要：炎症因子被激活,诱发突出物局部炎性微环境浸润,是腰椎间盘突出症(LDH)疼痛产生的重要机制之一。中医学也认识到LDH局部存在“瘀”“沫”聚积,“瘀”与“沫”即腰府“不通”之病理产物,其充斥、浸润于分肉、经筋间隙,进一步又可发展为致痛因素,引发疼痛,与现代医学炎症因子局部浸润导致疼痛的观点相似。中医推拿具有行气活血的作用,可有效改善LDH疼痛症状。结合相关临床研究及动物实验结果,认为推拿还可通过“化瘀消沫”改善腰椎局部的炎性微环境,改善炎症因子指标,在LDH镇痛过程中发挥关键作用。The activation of inflammatory factors and the induction of local “inflammatory microenvironment” infiltration of herniation is one of the important mechanisms of pain in lumbar disc herniation(LDH). In traditional Chinese medicine, it is considered that there is a local accumulation of the pathological products such as “stasis” and “foam” in the “blocked” waist, which may further develop into pain-causing factor that infiltrates local tissues and then cause pain, similar to the viewpoint that local infiltration of inflammatory factors causes pain in modern medicine. Tuina has the function of moving qi and invigorating blood, and can effectively improve the symptom of pain in LDH. According to the relevant clinical and animal studies, it is believed that tuina can improve the local “inflammatory microenvironment” by “dissolving stasis and dispersing foam”, thereby improving the indicators of inflammatory factors, and playing the key role of analgesia in LDH.

关 键 词：腰椎间盘突出症 炎性微环境 疼痛 推拿 

分 类 号：R244.1[医药卫生—针灸推拿学]