中医药治疗颈椎间盘源性疼痛研究进展  

Research Progress of Treating Cervical Discogenic Pain with TCM

作　　者：吕晓雅 杨文龙 高磊[1] 仵永旗 张欣[1] 刘方铭[2] LYU Xiao-ya;YANG Wen-long;GAO Lei;WU Yong-qi;ZHANG Xin;LIU Fang-ming(Shandong University of Traditional Chinese Medicine,Ji'nan,Shandong,China,250355;Shandong Provincial Qianfoshan Hospital,Ji'nan,Shandong,China,250014)

机构地区：[1]山东中医药大学,山东济南250355 [2]山东省千佛山医院,山东济南250014

出　　处：《河南中医》2023年第6期962-967,共6页Henan Traditional Chinese Medicine

摘　　要：中医药治疗颈椎间盘源性疼痛(cervical discogenic pain, CDP)方法多样,有中药治疗、针灸治疗、针刀治疗等,中药治疗可补益肝肾,活血行气,舒筋活络,祛风除痹,作用机制为消除炎性因子,减轻炎性反应;针灸基于经络理论,可以通过刺激穴位来达到镇痛效果,机制为控制炎症,降低神经敏化,改善血液循环和缺血缺氧症状,减轻盘内压力;针刀通过松解颈部肌肉、关节、韧带等,依靠调节颈椎动静力平衡系统来恢复颈部的生物力学平衡,从而缓解颈部疼痛。近年来,中医药在治疗CDP方面有着不可替代的作用,但目前的研究仍存在诸多问题:①中医学中只有关于项痹的辨证分型,CDP的辨证分型尚未取得共识;②中医药疗法虽然被广泛应用于临床,但其治疗CDP的相关基础研究比较匮乏,作用机制尚不明确;③中医药尚无规范化的用药标准,其禁忌证及毒副作用也未明确说明。在今后的研究中,应加强以下方面的研究:①对CDP的辨证分型形成专家共识;②开展中医药治疗CDP的实验研究,以明确其作用机制;③制定中医药治疗CDP相关指南。There are many ways to treat cervical discogenic pain(CDP) with TCM,such as Chinese medicinal treatment, acupuncture and moxibustion treatment, acupotomy, etc.Chinese medicinals can benefit the liver and kidney, activate blood and move qi,relax muscles and activate collaterals, dispel wind and arthralgia, and its mechanism is to eliminate inflammatory factors and reduce inflammatory reactions.Acupuncture and moxibustion, based on the meridian theory, can achieve analgesic effect by stimulating acupoints.The mechanism is to control inflammation, reduce nerve sensitization, improve blood circulation, ischemia and hypoxia symptoms, and reduce intradiscal pressure.Acupotomy restores the biomechanical balance of the neck by loosening the neck muscles, joints, ligaments, etc.,and adjusting the cervical dynamic and static balance system to alleviate neck pain.In recent years, TCM has played an irreplaceable role in the treatment of CDP,but there are still many problems in current research:① There is only a consensus on the differentiation and classification of neck arthralgia in TCM,and the differentiation and classification of CDP has not yet been widely recognized;② Although TCM therapy is widely used in clinical practice, there is a lack of basic research on its treatment of CDP,and the mechanism of action is still unclear;③ There is no standardized medication standard for TCM,and its contraindications and toxic side effects are not clearly stated.In future research, the following aspects should be strengthened:① To form expert consensus on the differentiation and classification of CDP;② To conduct experimental research on the treatment of CDP with TCM to clarify its mechanism of action;③ To formulate guidelines for the treatment of CDP with TCM.

关 键 词：颈椎间盘源性疼痛 中药治疗 针灸治疗 针刀治疗 

分 类 号：R274.981.55[医药卫生—中西医结合]