中西医结合治疗腰椎间盘突出症100例

Traditional Chinese medicine (Acupuncture) and western medicine combined to treat 100 patients with Lumbar Intervertebral Disc Herniation and Protrusion

Dr. Xiu Wei

1089 Budapest, Vajda Peter u, 43a

摘要 Abstract

  腰椎间盘突出症是腰腿痛最常见的原因之一。亦属中医“痹症”范畴。腰椎间盘突出症中以L4-5、L5—S1 间隙发病率最高，约占90%。多个间隙同时发病者仅占5%~22%。目前治疗此症的方法主要有非手术治疗和手术治疗。笔者采用传统针灸疗法加穴位注射同时配合医疗练功等治疗腰椎间盘突出症100例,取得了满意的疗效,总有效率达92%。现报告如下。     Lumbar Intervertebral Disc Herniation and Protrusion is one of the most common causes of low back and lower extremities pain. L4-5, L5-S1 are the highest incidence of lumbar disc herniation and protusion,  and accounted for a more than 90%. The multiple Intervertebral gap incidence, onlyabout 20%. Currently, the treatment of this disease is mainly non-surgical treatment and surgical treatment. I use traditional Chinese acupuncture(akupunktura) and acupunctural injection with medical drugs, also let the patients to do medical gymnastics etc, to treat 100 cases of lumbar disc herniation and protrusion to achieve satisfactory effect, the total effective rate of 92%.  Report as following.   临床资料 本组100例中男性68例,女性32例;年龄最小者1 9岁,最大者80岁;病程最长者1 2年,最短者半个月。病史长、年龄长者多伴有椎管狭窄。超过70%的患者是在经过了几个星期到几个月的传统西医治疗后无明显效果而来我处就诊。约10%的患者在别处经过传统的针灸疗法无明显效果而来我处。全部病例均有腰腿疼痛、很多患者有下肢麻木等症状,均经CT或核磁共振明确诊断。 Clinical data The group of 100 patients with 68 cases of males, 32 females; the youngest patient was 19 years old, the oldest was 80 years old; The longest history was 12 years, the shortest was two weeks. Long history with old ages usually associated with spinal stenosis. Over 70% of patients who came to me already had traditional Western medical treatment from a few weeks to a few months, but had no obvious effects. Also about 10% of patients after only having acupuncture treatments, but had no significant effect who come to my office. All patients had lumbar and leg pain, many patients hadnumbness in their leg or foot, all patients were examined by CT or MRI to confirm the diagnosis.   治疗方法 Method   治疗效果 疗效评定标准: 临床治愈: 腰腿痛症状消失，腰部活动正常，直腿抬高70°以上，,能够进行正常工作活动； 好转：腰腿痛明显减轻，腰部活动功能改善； 无效：症状、体征无改善。 治疗后随访的患者2个月-3年。 本组治愈77例,占77% ,好转15例,占15% ,无效8例,占8%。总有效率92%，一般经1.5～2个疗程即可治愈。 治疗无效的病人主要原因是腰间盘突出的过大，或年龄大病史长伴有严重的或广泛的椎管狭窄的病人。大量的临床实践经验证实，除了约10% 的患者须行手术治疗外，中西医结合的综合治疗方法已取得了很好的疗效，得到临床认可和发展.   Result Evaluation standard: Excellent: low back and extremities pain disappear,  the normal body activities, Lasegue sign more than 70 degree, be able to do the normal work and activities. Better: low back and extremities pain are reduced, body activities are improved. No effective: nearly no improvement in symptoms and signs. Follow-up after treatment of patients 2 months to 3 years. 77 cases were cured, 77%, improved in 15 cases (15%), 8 cases (8%).Total efficiency of 92%, one of the most courses can be cured, individual 1.5-2 courses.

For the patients with no effective the main reason are the lumbar disc herniation is too large, or the older patient with long history associated with severe spinal stenosis. Except approximately 10% of patients required surgical treatment, A lof of Clinical practice and experience confirmed that, the treatment methods of using traditional Chinese medicine (acupuncture) and Western medicine achieved very good clinical results.

    典型病例 男性患者，33岁，牙科医生。因左侧腰4-5间盘脱出，腰5骶1间盘膨出，左侧腰腿痛伴左下肢小腿和足麻木，用西医疗法综合治疗1个半月，疗效轻微。只能站立几分钟，走几步，无法自己开车。当然更无法工作，天天卧床在家。来我处就医。使用上述中西医结合疗法治疗6-7次后，症状明显减轻，开始回诊所少量工作，继续巩固3-4次，共治疗1个半月，疼痛症状消失，麻木基本消失，恢复工作。   Case report Male patient, 33-year-old dentist. The left L 4-5 intervertebral disc herniation, L5-S1 disc protrusion(MRI confirmed), left low back and leg pain with cruris and foot numbness, traditional western medical treatment 1 and a half months, a slight effect. He still has pain only can stand a few minutes, walking few steps, unable to drive car, Of course, unable to work. Only has to lying in the bed at home. Come to my office for medical treatment. After 6-7 times treatment, the symptoms significantly reduced, he began to return to the work for a few hours a day, continue to treat 3-4 times, totally about one and half months treatment, the pain disappeared, numbness was almost disappeared, he returns to work. 讨论 腰椎间盘突出症是腰椎间盘变性，纤维环破坏，髓核突出，或纤维坏完整但和髓核一起突出压迫或刺激椎间盘周围神经根及软组织, 产生炎症、水肿、粘连，从而产生腰部及下肢放射性疼痛或麻木。腰椎间盘突出症在某种程度上属于自限性或自愈性疾病，约80～90%的患者通过非手术治疗可获得满意疗效，只有10～15%的患者需手术治疗。除马尾神经损害持续加重的患者外，腰椎间盘突出症均以非手术治疗为首选。 腰椎间盘突出症属中医学痹证范畴，系风、寒、湿三气杂至而成。寒属阴，其性收引；湿性重浊黏滞，易阻塞气机。当寒湿之邪侵入人体后，可引起气血瘀阻，血流不畅，不 通则痛。主穴腰椎夹脊穴，介于督脉和膀胱经之间，能扶督脉之阳，助膀胱之气，针刺时实施强刺激可振奋一身之阳气，驱逐风寒湿邪，行气活血。辅以秩边、环 跳、委中、阳陵泉、悬钟、昆仑等穴位治疗，加强疏经、活血、镇痛作用。西药穴位注射能够抗炎、消肿、解痉止痛、扩张血管、改善微循环、促进神经营养作用. 迅速激发经气，疏经活血，并且可使针刺和药物的作用明显增强，因而可在短时间内显示明显的止痛效果。辅以功能锻炼和牵引这些传统的西医疗法，把各家之长灵活巧妙的运用，从而达到更好的效果。   Disscusion Lumbar disc herniation and protrusion is intervertebral disc degeneration, the fibrous annulus destructed and the nucleus herniated or the intact fibrous annulus with nucleus protruded and oppression or stimulate the nerve root and soft tissue induced inflammation, edema, adhesions, resulting in lower back and lower extremity radiating pain or numbness. In general, about 80 – 90% of patients with satisfactory results can be treated with non-surgical treatment, only 10 -15% of patients required surgical treatment. Lumbar disc herniation and protrusion are belong to Arthralgia areas in traditional Chinese medicine, consist of 3 chi: wind, cold and wet. Cold chi belongs to yin, wet chi is heavy and muddy viscous, easily blocked human body meridian. When these bad chi invading the human body, the good chi(energy) can not go through in the meridian, then the meridian is blocked. When the meridian is blocked, the problems appear in the body, such as pain etc.. The acupuncture(akupunktura) stimulate the stations in the meridians, to solve the block and let the chi in meridians go through, then the people is healthy. Acupunctural(akupunkturas) injection with medical drugs can make anti-inflammatory, reduce swelling, pain, dilate blood vessels, improve microcirculation and nutrition the nerves. The acupuncture and drugs injection together can significantly enhanced treatment result, thus in a short period of time shows analgesic effect. Combined by doing medical gymnastics and other traditional Western Medicine, using these methods to achieve better results.