The clinical application of acupuncture therapy is mainly based on the basic theory of traditional Chinese medicine, which has the functions of dredging exterior and interior, connecting up and down, promoting qi and blood circulation and nourishing yin and yang. Acupuncture and moxibustion treatment directly acts on acupoints, and regulates the nutrition, qi and blood and viscera functions of human body through the conduction and reaction of meridians, so as to achieve the purpose of treating diseases. The application of acupuncture and moxibustion in lumbar disc herniation is also based on the understanding of lumbar disc herniation in traditional Chinese medicine, and points are selected along the meridian and treated according to syndrome differentiation, especially by adjusting the Qi, blood, yin and yang of Du Meridian and Foot Taiyang Bladder Meridian, so as to achieve the therapeutic purpose. The common methods of acupuncture and moxibustion for the treatment of lumbar disc herniation are: filiform needle therapy, cupping therapy, electroacupuncture therapy, warm needle therapy, seven-star needle tapping therapy, ear acupuncture therapy, acupoint injection therapy and so on.
needle therapy
Commonly used acupoints are Shenshu, Yaoyangguan, Subversion 17, Huatuo Jiaji, Subjaw, Huantiao, Weizhong, Yanglingquan, Chengshan and Kunlun. Dialectical differentiation of root drama, matching points as appropriate. Leave the needle for 20 minutes, once every other day, ten times as a course of treatment.
auriculotherapy
There are many ways to treat diseases with auricular acupuncture, besides traditional auricular acupuncture and bloodletting, there are also methods such as burying needles, electroacupuncture, magnetic therapy and pill pressing. When treating lumbar disc herniation, the most commonly used method is to bury needles or press pills.
Commonly used ear points: Take kidney, lumbar vertebra, sacrum, Shenmen, sympathetic, subcortical, endocrine, sciatic nerve and buttock, and select 2-3 points at a time.
electro-acupuncture therapy
Electroacupuncture therapy is a combination of electroacupuncture device and filiform needle, which acts on meridians and acupoints of human body to treat various diseases. Its main mechanism of action is to enhance the stimulation of acupuncture on meridian points through the electrification of filiform needles, so as to achieve the purpose of treatment. On the basis of traditional acupuncture points, electroacupuncture therapy also puts forward a method of stimulating according to nerve distribution, which is the development of traditional acupuncture therapy in China.
In the course of treatment, acupuncture points with filiform needles are used to get a sense of acupuncture, and then the wires of electro-acupuncture instrument are connected to the needle handle, and the appropriate frequency is selected. The duration of each treatment was 65438 05 ~ 20 minutes.
For pregnant women, patients with emotional instability or poor general condition, electroacupuncture should not be used.
point injection therapy
Acupoint injection is a method to treat diseases by injecting drugs into a certain part or acupoint of the human body. Under the guidance of the basic theory of traditional Chinese medicine, it combines the stimulating effect of acupuncture on acupoints and meridians with the pharmacological effect of drugs to achieve the purpose of treatment.
For patients with lumbar disc herniation, acupuncture points can be selected according to the principle of syndrome differentiation and treatment, and corresponding body points can be selected in combination with Ashi point; Salvia miltiorrhiza injection, Clematis chinensis injection, paeonol injection, papaya injection, Vitb 1 and Vitb 12 injection can be selected. During treatment, after the needle is inflated, it is injected in several directions according to the principle of multi-directional penetration of one needle, generally 5- 10 ml per point and 2-3 points each time.
Old and infirm people and pregnant women should use water acupuncture therapy with caution when treating lumbar disc herniation.
moxibustion
Moxibustion is an important part of acupuncture therapy. Guided by the theory of meridians and viscera, moxa and other flammable drugs are used to burn at acupoints or affected areas, and the therapeutic purpose is achieved through its warming effect on meridians. Moxibustion can warm meridians, dredge collaterals, dispel cold pathogens, promote qi and blood circulation, dissipate blood stasis and reduce swelling, raise middle qi and lower qi, and has a good therapeutic effect on lumbago and leg pain caused by qi stagnation and blood stasis and wind-cold-dampness arthralgia.
There are many methods of moxibustion. In the treatment of lumbar disc herniation, in addition to warm acupuncture combined with acupuncture, moxa stick moxibustion can also be used alone, and 3-4 acupoints, Shenshu, Dachangshu, Ranjian, Huantiao, Chengfu, Yinmen, Weizhong and Yanglingquan, are selected at each time, and each acupoint is moxibustion for 65,438+05-20 minutes, every other day 1 time.
cupping therapy
It can promote qi and blood circulation, dispel wind and cold, reduce swelling and relieve pain, so it has a certain therapeutic effect on lumbar disc herniation.
In the treatment of waist and leg diseases, cupping can generally be used. For patients with qi stagnation and blood stasis, pricking collaterals and cupping can be used at Shenshu, Dachangshu, Accessory jaw and other acupoints, that is, pricking with triangular needles several times before cupping, and then cupping can make them bleed and strengthen the effect of treating blood and removing blood stasis.
Patients with fever, muscle wasting, eczema and skin injury at the waist, and pregnant women with lumbar disc herniation should not be treated with cupping.
Massage Treatment of Lumbar Disc Herniation
Traditional Chinese medicine believes that the main function of massage therapy is to dredge meridians, promote blood circulation, adjust the function of viscera, relax tendons and activate collaterals, promote blood circulation and remove blood stasis, loosen adhesion and dredge joints. In addition, it can also enhance the disease resistance of human body and achieve the purpose of health care.
Its main mechanism is:
(1) Reduce the pressure inside the intervertebral disc, (2) Increase the pressure outside the intervertebral disc, (3) Restore the protrusion, (4) Retract, (5). (2) changing the position of the protrusion, (6) adjusting the joint disorder and restoring it to position (7), and (8) relieving the nerve root compression. (3) promoting local blood circulation, (9) eliminating inflammatory reaction, (10) relieving adhesion, and (1 1) reducing stimulation to nerve roots. (4) Relaxation of waist and leg muscles, (12) strengthening local blood circulation, (13) promoting the recovery of injured nerve roots (14) and (15) relieving pain.
Treatment of lumbar disc herniation commonly used methods are:
(1) Relieve muscle spasms in the waist and buttocks.
(2) Enlarge the intervertebral space and reduce the pressure in the intervertebral disc.
(3) Increase the pressure outside the intervertebral disc.
(4) Adjust the posterior joint and loosen the adhesion.
(5) Promoting the recovery of injured nerve roots.
When using massage to treat lumbar disc herniation, we should pay attention to the following points: ① In the acute stage or acute attack stage of lumbar disc herniation, nerve roots are seriously congested and edematous, and massage can stimulate nerve roots to aggravate symptoms. Therefore, it is best not to use massage for 3 days before the acute phase. ② For typical central lumbar disc herniation, massage is absolutely forbidden to avoid serious consequences. ③ For some patients with high lumbar disc herniation, the location diagnosis should be made clear, and CT films, nuclear magnetic resonance and other materials should be referred. When the size and position of the protrusion are very clear, massage can be used with caution. ④ For patients with lumbar disc herniation complicated with spinal trauma and symptoms of spinal cord injury, massage therapy can aggravate spinal cord injury and should be banned. ⑤ Lumbar disc herniation is accompanied by fracture, bone and joint tuberculosis, osteomyelitis, tumor and severe senile osteoporosis. Massage therapy can destroy bones and spread infections. ⑥ When lumbar disc herniation is accompanied by systemic diseases such as hypertension, heart disease and diabetes, or there are serious skin diseases and infectious diseases, and tuberculosis and tumor are suspected, massage therapy should be banned. ⑦ Patients with lumbar disc herniation accompanied by bleeding tendency or blood diseases should not be treated with massage, otherwise it may cause local tissue bleeding. (8) Female patients with lumbar disc herniation who are pregnant for more than three months should be prohibited from massage therapy. Massage therapy is not suitable for women during menstrual period.
Treatment of lumbar disc herniation with traditional Chinese medicine
According to the basic theory of traditional Chinese medicine, combined with the specific situation of patients, choosing the appropriate formula of traditional Chinese medicine can effectively treat lumbar disc herniation.
(1) For patients with early onset and obvious qi stagnation and blood stasis, drugs such as Xiaohuoluo Pill, Dahuoluo Pill and Kanghyperosteogeny Tablet should be reused.
(2) those with severe cold and dampness should strengthen the spleen and promote diuresis; For patients with severe rheumatism, drugs such as "Duhuo Jisheng Decoction" are added.
(3) For patients with a long course of disease, some drugs for tonifying kidney-yang or kidney-yin can be selected.
In short, no matter how to prescribe drugs, we should take syndrome differentiation and treatment as the most important principle in order to achieve satisfactory curative effect.
External treatment of lumbar disc herniation with traditional Chinese medicine
External treatment of traditional Chinese medicine is one of the traditional Chinese medicine treatments. As early as the time of Neijing, there were records of various external treatments such as external application, medicated ironing, fumigation and washing. External treatment is widely used in orthopedics.
Clinically, it is proved that it is very effective and cheap to use Chinese medicine to relieve symptoms by promoting blood circulation and removing blood stasis, relaxing muscles and tendons and relieving pain. For the convenience of use, many external Chinese medicines have been processed into plaster, pure Chinese medicine powder, tincture, oil and other Chinese medicines.
There are many kinds of traditional Chinese medicines for external use, such as Kanglisha, Huajian ointment, external application of hyperosteogeny, health-care plaster for neck, waist and leg pain, and pain-relieving health-care plaster for hyperosteogeny. The effect is very good and the price is very cheap. This method is simple, convenient and effective. Kanlisha, Huajian Plaster, External Plaster for Hyperplasia, Health Plaster for Neck, Back and Leg Pain and Anting Health Plaster for Hyperplasia are all suitable for elderly patients with aseptic inflammation such as hyperosteogeny, lumbar disc herniation, arthritis, lumbar muscle strain, neck, shoulder, back and leg pain, and also suitable for young and middle-aged patients.
Generally speaking, the external application of traditional Chinese medicine has the following functions: dredging meridians, dispelling cold and removing dampness, dredging orifices and diminishing inflammation, dispersing stagnation and relieving swelling, and relieving pain. Its principle of action: through the skin directly to the focus, dredge obstacles, stimulate the skin to improve microcirculation and stimulate the regulatory function of the human body, and promote the metabolism of cartilage joints to restore balance, thus eliminating the focus and achieving the ideal goal.
stay in bed
The degeneration of the spine is closely related to load bearing. Strict and scientific bed rest, first of all, removes the main factors that further develop lumbar spondylosis and creates the necessary conditions for the recovery of the disease.
Bed rest is the most basic treatment for lumbar disc herniation. Bed rest can reduce the absorption of neurotoxic substances, promote the regression and recovery of inflammation and prevent the occurrence of nerve fiber adhesion. Absolute bed rest is to let the patient lie flat on the hard bed, only allowed to turn over on the bed, not allowed to sit up or stand up, not allowed to stand up when eating or urinating. Generally, bed rest for 3 ~ 4 weeks can be effective. Patients with severe symptoms during acute attack can also consider using traction therapy during bed rest to obtain greater braking effect.
After lying in bed for a period of time, if you combine traditional Chinese medicine external application, massage, acupuncture, physical therapy and other methods for comprehensive treatment, you will get better curative effect.
Waist wear
Waist circumference is one of the commonly used braces in orthopedics, and its main function is braking and protection.
(1) braking function. When wearing the waist line, it will limit the activities of the lumbar spine, especially the flexion activities, so that the local tissues of the lumbar spine can get a relatively full rest, relieve muscle spasm, promote the recovery of blood supply, dissipate pain-causing substances, and alleviate or disappear the inflammatory reaction around nerve roots and intervertebral joints.
(2) protection. Waist circumference can strengthen the stability of lumbar spine. Therefore, when patients with lumbar disc herniation start to move on the ground after lying in bed or traction, wearing waist circumference can strengthen protection, limit the range and amplitude of lumbar movement to a certain extent, and consolidate the effect of early treatment.
Waist circumference is widely used in the treatment of lumbar disc herniation, but it is not optional to wear and use it. Generally wear a waistline for 4 ~ 6 weeks, and the longest is not more than 3 months. The waist size should be suitable for the patient's body shape.
Nursing care of patients with lumbar disc herniation?
In the acute stage, you should sleep on a hard bed and stay in bed for 3 weeks.
Avoid coughing and sneezing to prevent constipation.
If the symptoms are obviously improved, you can gradually exercise your back muscles and do light activities in the wild under the protection of your waistline.
Prevention of recurrence of lumbar disc herniation
After treatment and rest, patients with lumbar disc herniation can be relieved or cured, but the recurrence rate of the disease is quite high, because:
(1) After treatment, although the symptoms of lumbar disc herniation basically disappeared and the nucleus pulposus of many patients was not completely restored, the compression degree of nerve roots was reduced or the adhesion with nerve roots was relieved.
(2) Although the condition of patients with lumbar disc herniation has been stable or healed, in a short time, once they are tired or sprained, the nucleus pulposus will protrude again, leading to the recurrence of the disease.
(3) Failing to keep warm in the cold and humid season, wind, cold and humidity invade the diseased parts of human body, and fatigue can easily induce the recurrence of the disease.
(4) Liver and kidney loss failed to be replenished in time. Chinese medicine believes that kidney stores essence and governs bone; Liver stores blood, main reinforcement. Sufficient kidney essence and full liver blood make the bones and muscles strong and the joints flexible. From people to middle-aged and elderly people, physiological function declines, and liver and kidney essence and blood are insufficient, which leads to malnutrition of bones and muscles. Over time, osteoarthropathy is prone to occur.
(5) Although the nucleus pulposus of this segment has been removed, the stability of the upper and lower vertebrae in this segment is not good after operation, and the intervertebral discs in the upper and lower segments of the surgical segment are easy to prolapse, which leads to the recurrence of lumbar disc herniation.
In daily life, study and work, people need different postures and form their own habits, which have an important influence on the human body. Therefore, we are required to pay attention to the rationality of standing posture, sitting posture, working posture and sleeping posture, correct bad posture and habits, strengthen exercise, strengthen physical fitness, especially the functional exercise of back muscles, so as to play a good role in treatment and prevention.
The role of functional exercise in the prevention and treatment of lumbar disc herniation
Functional exercise, also known as acrobatic therapy, was called "introduction" in ancient China. It is an indispensable part of the prevention and treatment of lumbar disc herniation, and it is also a self-exercise method in the rehabilitation process of lumbar disc herniation, which occupies the same important position as manual therapy, drug therapy and physical therapy.
The biggest feature of functional exercise is that patients can actively participate in the treatment process, which is conducive to mobilizing patients' subjective initiative in treatment and enhancing their confidence in overcoming diseases. It plays an important role in the prevention and treatment of lumbar disc herniation.
(1) In the acute episode of lumbar disc herniation, functional exercise mainly adopts physical exercise combining adaptive traction exercise with relaxation exercise to relieve lumbar muscle spasm.
(2) In the remission stage of lumbar disc herniation, functional exercise is mainly to strengthen the strength of lumbar muscles and improve the function of waist and legs.
(3) Local acrobatic therapy can strengthen muscle contraction ability through autonomous activities, thus achieving the effect of treating and preventing muscle atrophy.
(4) Functional exercise plays an important auxiliary role in the treatment of lumbar disc herniation with other methods.