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2023年7月 第38卷 第7期11
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推拿治疗巨大/破裂型腰椎间盘突出症的研究进展

Research progress on tuina for giant/ruptured lumbar disc herniation

来源期刊: 广州医药 | - 发布时间: 收稿时间:2026/6/11 16:10:57 阅读量:18
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推拿;巨大腰椎间盘突出症;破裂型腰椎间盘突出症;髓核重吸收
?tuina; giant lumbar disc herniation; ruptured lumbar disc herniation; nucleus pulposus resorption
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巨大/破裂型腰椎间盘突出症(G/RLDH)是腰椎间盘突出症的严重类型,可致剧烈根性疼痛及神经功能障碍。推拿作为非药物中医疗法,广泛应用于腰椎间盘突出症,但治疗G/RLDH的疗效与安全性尚存争议。近年发现G/RLDH具有较高的椎间盘自然重吸收率,为推拿干预提供了病理基础。本文系统检索相关文献,从中医病机、现代医学机制、临床应用及安全性争议等方面进行综述,旨在指导临床诊治并为未来研究提供参考。
Giant/ruptured lumbar disc herniation (G/RLDH) is a severe type of lumbar disc herniation that can cause intense radicular pain and neurological dysfunction. As a non-pharmacological therapy in traditional Chinese medicine, tuina is widely used for lumbar disc herniation; however, its efficacy and safety in treating G/RLDH remain controversial. Recent studies have revealed a relatively high rate of spontaneous resorption of herniated discs in G/RLDH, which provides a pathological basis for tuina intervention. This article systematically reviews the relevant literature, summarizing the traditional Chinese medicine pathogenesis, modern medical mechanisms, clinical application, and safety controversies, aiming to guide clinical diagnosis and treatment and to provide a reference for future research.
1、[1]胡有谷.腰椎间盘突出症[M].4版.北京: 人民卫生出版社,2011: 185-192. [2]PHW, ASH, BWM, et al. Comparison of Natural Course between Sequestered and Large Central Extruded Disc Herniation Treated Conservatively.. Ann Rehabil Med. 2001;25(3):479-485. [3]Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. J Manipulative Physiol Ther. 2004;27(3):197-210.. [4]Tamburrelli FC, Genitiempo M, Logroscino CA. Cauda equina syndrome and spine manipulation: case report and review of the literature. Eur Spine J. 2011;20 Suppl 1(Suppl 1):S128-S131. [5]张玉璞,吉登军,张炎,等.推拿手法治疗腰椎间盘突出症的作用机制进展[J].中国医药导报, 2022(025):019. [6]黄定权,李树标. 辨证推拿治疗腰椎间盘突出症的研究进展[J].现代中西医结合杂志,2018,27(31): 3523-3525,3534. [7]李智,李静.推拿治疗腰椎间盘突出症机制研究进展[J].中国骨伤,2005,18(1): 62-64. [8]高锋,钱红兵,马智佳,等.基于"络病理论"重用黄芪治疗破裂型腰椎间盘突出症的临床研究[J].中国中医骨伤科杂志, 2021(029-010).. [9]吕子豪,周明旺,吉星.李盛华应用陇中理筋调衡手法治疗“骨错缝、筋出槽”验案举隅[J].中华中医药杂志,2023,38(7): 3180-3183. [10]郭光昕; 朱清广; 孙武权,等. 推拿干预腰椎间盘突出症的免疫机制研究进展[J].中华中医药杂志,2019,34(7): 3132-3135. [11]Splendiani A,Puglielli E,De Amicis R,et al.Spontaneous resolution of lumbar disk herniation: a case report and review of the literature[J].Neuroradiol J,2007,20(1): 57-62. [12]Guinto F C , Hashim H , Stumer M .CT demonstration of disk regression after conservative therapy[J].American Journal of Neuroradiology, 1984, 5(5):632-633. [13]Chiu C C , Chuang T Y , Chang K H ,et al.The probability of spontaneous regression of lumbar herniated disc: a systematic review.[J].Clinical Rehabilitation, 2015, 29(2):184.DOI:10.1177/0269215514540919. [14]Peng-fei Yu, Fang-Da Jiang, Jin-Tao LiuY, et al. Outcomes of conservative treatment for ruptured lumbar disc herniation[J].Acta Orthopaedica Belgica,2013,79(6): 726-730. [15]Tang Z, Li X, Wang Y, et al. Endoscopic Discectomy Versus Nonsurgical Management for Extruded or Sequestrated Lumbar Disc Herniation: A Retrospective Cohort Study With Minimum 2-Year Follow-Up. Global Spine J. 2025 Dec 8:21925682251408374. [16]Zhong M , Liu J T , Jiang H ,et al.Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis[J].Pain Physician, 2017, 20(1):E45. [17]Zou T, Liu XY, Wang PC, et al. Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-analysis. Clinical Spine Surgery. 2024 Jul;37(6):256-269. . [18]冯鸣,姜宏.基于MRI上椎间盘突出程度预测腰椎间盘突出后重吸收的研究进展[J].中医正骨, 2018, 30(11):5. [19]杨博文,马国梁,陈忻,等.非手术治疗巨大型腰椎间盘突出症的临床研究现状[J].世界中医药, 2023, 18(21):3037-3041.DOI:10.3969/j.issn.1673-7202.2023.21.006. [20]叶壮益.手法加牵引治疗巨大型腰椎间盘突出症疗效研究[J].中外医学研究, 2013, 11(25):2. [21]冯伟,冯天有,王飞,等.脊柱定点旋转复位法治疗游离型腰椎间盘突出症[J].中国骨伤, 2008, 21(007):529-531. [22]叶盛,姜超,张宇,等.基于“骨并举”理论的推拿手法治疗“腰曲增大”型腰椎间盘突出症的临床观察[J].山西中医药大学学报, 2024, 25(3):310-313. [23]]谢利民,于银,肖灵,等.腰椎间盘突出症推拿前后CT扫描量化分析[J].中国中医骨伤科, 1994(03)1-4. [24]陈雄,罗建.基于重吸收理论探讨推拿治疗腰椎间盘突出症的作用机制[J].中医学, 2023, 12(10):2852-2858.. [25]Zhou X, Kong L, Ren J, et al. Effect of traditional Chinese exercise combined with massage on pain and disability in patients with lumbar disc herniation: A multi-center, randomized, controlled, assessor-blinded clinical trial. Front Neurol. 2022 Sep 6;13:952346. . [26]Zhao B, Zhao Q, Yin J, et al. Efficacy and safety evaluation of massage combined with traction for lumbar disc herniation: a meta-analysis. Front Med (Lausanne). 2026;13:1762760.. [27]Shen T , Ye Y M , Fan S ,et al.Clinical efficacy of Tuina manipulations for lumbar disc herniation and its influence on posture-associated indicators[J].Journal of Acupuncture and Tuina Science, 2022, 20:213-220. [28]Miao Z, Tong Z, Ye J, et al. Tuina for lumbar disc herniation: A protocol for systematic review and meta analysis. Medicine (Baltimore). 2021;100(1):e24203.. [29]Huang F, Xiao Z, Zhan X, et al. Tuina combined with Adjuvant therapy for lumbar disc herniation: A network meta-analysis. Complement Ther Clin Pract. 2022;49:101627. [30]Mo Z, Li D, Zhang R, et al. Comparisons of the Effectiveness and Safety of Tuina, Acupuncture, Traction, and Chinese Herbs for Lumbar Disc Herniation: A Systematic Review and Network Meta-Analysis. Evid Based Complement Alternat Med. 2019;2019:6821310. [31]]李本澈.韦氏手法治疗肩峰下撞击综合征的临床研究[D].广西中医药大学[2026-05-15]. [32]倪振威.基于辨构论治理论的肩部调衡法治疗肩峰撞击综合征的临床研究[D].长春中医药大学[2026-05-15]. [33]柳文韬.超声引导下注射配合关节松动手法治疗肩峰下撞击综合征的疗效研究[D].上海中医药大学,2020.. [34]王国才,等.推拿手法学[M].北京: 中国中医药出版社,2016: 156-162. [35]张长江,等.脊柱推拿的临床与生物力学研究[J].中国骨伤,2003,16(8): 465-467. [36]曹亚飞,高坤,余伟吉,等.韦贵康国医大师手法治疗腰椎间盘突出症的整体观与康复方案[J].中医药临床杂志, 2021, 33(11):2102-2104.. [37]钟益梁,张弛,蒲张林,等.国医大师韦贵康治疗脊柱相关性疾病经验[J].中医药导报, 2024, 30(2):112-115. [38]房达鸿,张湘黔,雷龙鸣.国医大师韦贵康基于"脊督一体"观调治脊源性亚健康学术经验[J].时珍国医国药, 2025, 36(2):363-367.. [39]龙层花,范德辉 主编.龙氏治脊疗法[M].第2版.广州: 广东科技出版社,2019: 106-110 [40]范德辉,罗孟西,苏美意,等.倒悬推拿疗法治疗腰椎间盘突出症的研究进展[J].按摩与康复医学, 2014, 5(9):3. [41]廖东初,胡寅进,吴志彬,等.倒悬牵引下正骨手法结合体控电疗技术治疗腰椎间盘突出症临床观察[J].中华保健医学杂志, 2023, 25(1):113-114. [42]马智佳,姜宏,俞鹏飞,等.消髓化核汤保守治疗130例巨大型腰椎间盘突出症的疗效分析[J].中国骨伤,2019,32(3):225-230. [43]沈学强,姜宏.巨大破裂型腰椎间盘突出症重吸收30例随访研究[J].中国矫形外科杂志, 2018, 26(21):6.. [44]Thavarajasingam SG, Ramsay DSC, Namireddy SR, et al. Exercise, manipulation and traction physiotherapy in the conservative management of lumbar disc herniation: A systematic review and meta-analysis. Brain Spine. 2025;5:105632. [45]Zhao X Y,Wang Z P,Quan Z,et al.Use self-gravitation traction to treat lumbar disc herniation: study protocol for a double-center,single-blind randomized controlled trial[J].Medicine,2022,101(47): e31759.
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