针灸治疗腰椎间盘突出症近况

本文通过整理文献对针灸治疗腰椎间盘突出症的选穴、操作手法 ,以及配合牵引、推拿、中药的综合疗法作了总结 ,认为针灸治疗本病的疗效是肯定的 ,以夹脊穴为主治疗腰椎间盘突出症是近期的主流 ,可达到消肿、消炎 ,甚至髓核回纳的目的。对急性期病人 ,针灸可以改变腰椎间盘及椎管的位置和形态 ;对已形成退变的椎间盘 ,针灸仍然可以缓解其临床症状。动物实验证明针刺可促进大鼠神经纤维轴突内轴浆运输 ;多次电针可促进大鼠弓状核内POMCmRNA表达的不断增多。在治疗时间上 ,腰椎间盘突出症为越早治疗效果越好

Recent Development on Acupuncture Treatment of Prolapse of Lumbar Intervertebral Disc

In the present paper, the author reviews recent development of acupuncture treatment of prolapse of intervertebral disc from 1) acupuncture treatment including electroacupuncture (EA) therapy, wrist-ankle therapy, combined therapies of EA and cupping, or acupuncture and moxibustion, etc., by choosing body acupoints, scalp-points, abdominal acupoints, etc.; 2) combined treatment of acupuncture and lumbar vertebral traction; 3) combined treatment of acupuncture and massage; and 4) animal experimental study and clinical research on the action mechanism of acupuncture. In regard to acupoint selection, lumbar Jiaji (EX-B 2) is used very often; additionally, some back-shu points and those of the lower limbs are also frequently used in clinic. Results indicate that acupuncture therapy works well in improving clinical symptoms of patients with prolapse of intervertebral disc. Animal experiments display that in nerve-root compression model, acupuncture can relieve demyelination of the compressed nerve fibers and reduce edema of nerve tissue. In sciatica rat model, acupuncture stimulation possesses analgesic effect for which acupuncture induced up-regulation of the expression of prooppiomelanocortin (POMC) of the arcuate nuclei of the hypothalamus may be responsible. CT examination suggests that after acupuncture treatment, the prolapsed pulpiform nucleus recover its normal position, which is identical to the alleviation of clinical symptoms. Ultrasonic examination shows that acupuncture and massage can widen the internal diameter of the vertebral canal and change the position relationship between the prolapsed lumbar intervertebral disc and the compressed nerve root.