基于《医学六要》补肝汤辨证加味治疗腰椎间盘突出症回顾分析

目的:分析基于明代医家张三锡《医学六要》补肝汤辨证加味在腰椎间盘突出症中的治疗价值,以此对《医学六要》补肝思想进行继承创新.方法:对湖南省中医药研究院附属医院、湘潭市中医医院、北京中医药大学深圳医院2008年8月一2019年12月采取张三锡补肝汤辨证加味治疗的9 741例腰椎间盘突出症患者,进行回顾性分析.结果:优3 ...

A Retrospective Analysis of Modified Bugan Tang According to Syndrome Differentiationfor Lumbar Disc Herniation Based on Yixue Liuyao

Objective:To analyze the therapeutic value of modified Bugan tang according to syndrome differentiation on the treatment of lumbar disc herniation based on the Yixue Liuyao by ZHANG Sanxi,a Chinese medicine practioner in Ming Dynasty,so as to carry on the inheritance and innovation of the thought of tonifying the liver in this classic book.Methods:A retrospective analysis was performed on 9,741 patients with lumbar disc herniation who were treated with ZHANG Sanxi's modified Bugan tang according to syndrome differentiation from August 2008 to December 2019 in Hunan Academy of Traditional Chinese Medicine Affiliated Hospital,Xiangtan Hospital of Traditional Chinese Medicine and Shenzhen Hospital of Beijing University of Chinese Medicine.Results:There were 3,791 cases of excellent,3,740 cases of good,1,228 cases of normal,982 cases of poor;the total effective rate reached 89.92%.The therapeutic effect of each disease type and Chinese medicine syndrome type was as follows.①Bulging lumbar disc herniation had the best clinical effect,followed by central herniation,and free herniation had the worst effect.②Protrusions in domain A had the best clinical effect,followed by protrusions in domain B,and protrusions in domain D had the worst clinical effect.③The cold and dampness type and blood stasis type had the best clinical effect,and the other types not listed in the Diagnostic Effect Criteria for Chinese Medicine Diseases and Syndromes had the worst effect.④The clinical effect of L5-S1 as the responsible segment was the best,while the effect was the worst in patients with double or multi-segment intervertebral disc protrusion.⑤Patients with symptoms and/or signs of lower extremities had the best effect,followed by those with symptoms and/or signs of waist,and those with symptoms and/or signs of waist and lower extremities had the worst effect.⑥Patients with disease duration for seven days and more than seven days had the best curative effect,while patients with duration for three years and more than three years had the worst curative effect.Based on the Yixue Liuyao,modified Bugan tang according to syndrome differentiation was safe and effective in the treatment of lumbar disc herniation.Conclusion:Based on the Yixue Liuyao,modified Bugan tang according to syndrome differentiation can be used to guide the clinical treatment of lumbar disc herniation,and the thought of tonifying the liver should be further studied,inherited and innovated.