腰椎间盘突出症的中西医治疗述评  

Review of Chinese and Western Medical Therapies for Lumbar Disc Herniation

作　　者：赵泽龙 魏戌[1,2] 银河 张威[1] 于杰 冯敏山[1,2] 孙武[1] 高春雨 尹逊路[1,2] 李路广 肖想玉[1,3] 秦晓宽[1] 齐保玉 杨克新 高景华 孙凯 朱立国 ZHAO Zelong;WEI Xu;YIN He;ZHANG Wei;YU Jie;FENG Minshan;SUN Wu;GAO Chunyu;YIN Xunlu;LI Luguang;XIAO Xiangyu;QIN Xiaokuan;QI Baoyu;YANG Kexin;GAO Jinghua;SUN Kai;ZHU Liguo(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing Key Laboratory of Orthopaedic Technology of Traditional Chinese Medicine,Beijing 100102,China;Shandong University of Traditional Chinese Medicine,Ji′nan 250355,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]中医正骨技术北京市重点实验室,北京100102 [3]山东中医药大学,济南250355

出　　处：《世界中医药》2023年第21期3005-3012,共8页World Chinese Medicine

基　　金：国家重点研发计划项目(2021YFC1712800,2021YFC1712803);国家自然科学基金青年科学基金项目(82205152);中国中医科学院科技创新工程项目(CI2021A02004);中国中医科学院优秀青年科技人才(创新类)项目(ZZ16-YQ-023)。

摘　　要：腰椎间盘突出症(LDH)是一种常见的骨科疾病,显著降低患者的生命质量,已成为影响全球疾病伤残调整寿命年及加重疾病负担的重要原因。LDH治疗一般可分为非手术治疗和手术治疗,非手术治疗方法包括中医或西医药物治疗、手法牵引治疗、物理治疗等,旨在缓解疼痛、减轻炎症反应等,适用于轻、中度LDH患者;手术治疗主要分为微创手术及开放手术,旨在解除脊髓神经压迫等,适用于重度椎间盘突出或脱出的类型。在采取非手术及手术治疗该病时,中西医拥有各自优势特点及局限性。因此,针对该病不同类型及不同阶段,最大程度发挥中西医协同治疗作用,采取中西医结合阶梯化治疗措施,选择优选的治疗方案以提高疗效是治疗本病的关键。本文从LDH的病因及病理机制、病理分型及证候类型、疾病评价等方面着手,系统总结了当前LDH的中西医结合治疗现状,以期为今后该病阶梯化治疗思路及中西医优选治疗方案提供参考。Lumbar disc herniation(LDH),a common orthopedic disease affecting patient′quality of life,has become a major factor affecting global disability-adjusted life years and increasing disease burden.Non-surgical and surgical therapies are available for LDH.Non-surgical therapies include Chinese/Western medicine,manipulation,and physical therapy,with the effects of relieving pain and reducing inflammation.These therapies are suitable for the mild to moderate cases.Surgical therapies mainly include minimally invasive and open surgeries,which can relieve spinal nerve compression,being suitable for severe cases.Chinese and Western medical therapies have their own advantages and limitations in the treatment of LDH.Therefore,for different severities and stages of the disease,it is crucial to maximize the synergistic effect of Chinese and Western medical therapies through a stepwise approach and select the optimal treatment plan to improve efficacy.This article introduces the etiology and pathogenesis,pathological grading,syndromes,and disease evaluation of LDH and systematically summarizes the current status of integrated Chinese and Western medical treatment for LDH.This review aims to provide a reference for the stepwise treatment and the integrated Chinese and Western medical treatment of this disease.

关 键 词：腰椎间盘突出症 中西医结合 治疗现状 阶梯疗法 非手术治疗 手术治疗 治疗思路 述评 

分 类 号：R274.3[医药卫生—中医骨伤科学]