[1]李 治,覃 杰,陈 锋,等.名中医陈锋从“肝主筋、为罢极之本”论治腰椎间盘突出症经验[J].陕西中医,2024,(2):248-252.[doi:DOI:10.3969/j.issn.1000-7369.2024.02.022]
　LI Zhi,QIN Jie,CHEN Feng,et al.Chen Feng's experiences in treating lumbar disc herniation from the perspective of “liver governs the tendons,the root of fatigue”[J].,2024,(2):248-252.[doi:DOI:10.3969/j.issn.1000-7369.2024.02.022]
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名中医陈锋从“肝主筋、为罢极之本”论治腰椎间盘突出症经验
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年2期
页码:
248-252
栏目:
名中医经验
出版日期:
2024-02-05

文章信息/Info

Title:
Chen Feng's experiences in treating lumbar disc herniation from the perspective of “liver governs the tendons,the root of fatigue”
作者:
李 治1; 覃 杰2; 陈 锋2; 闫 乾2; 刘万祥2; 刘 涛1; 杨元确1
(1.广西中医药大学研究生院,广西 南宁 530004; 2.广西中医药大学附属瑞康医院,广西 南宁530011)
Author(s):
LI Zhi; QIN Jie; CHEN Feng; YAN Qian; LIU Wanxiang; LIU Tao; YANG Yuanque
(Graduate School,Guangxi University of Chinese Medicine,Nanning 530004,China)
关键词:
腰椎间盘突出症;  肝主筋;  罢极之本;  养血荣筋汤;  腰痛
Keywords:
Lumbar disc herniation;  Liver governs the tendons;  The root of fatigue;  Nourishing blood and invigorating tendon decoction;  Lumbar pain
分类号:
R 274.34
DOI:
DOI:10.3969/j.issn.1000-7369.2024.02.022
文献标志码:
A
摘要:
腰椎间盘突出症主要由椎间盘各部分(包括髓核、纤维环及软骨板)出现不同程度的退行性改变,受外力作用的因素下,椎间盘的纤维环破裂,髓核组织从破裂处突出或脱出于后方或椎管内,刺激或压迫相邻脊神经根,产生腰部疼痛,一侧或双侧下肢麻木、疼痛等一系列临床症状。中医学通常把本病归纳在“腰痛”范畴,病因病机以肾虚为本,兼有外感风寒湿热或瘀血邪阻。陈锋教授认为肝脏亦为本病的核心病机之一,提出从“肝主筋,为罢极之本”溯发病之源,以肝不束筋骨致椎间盘退变为始、肝疏泄失司经不络属致腰背筋脉失常为标、肝筋劳损过度罢极不复致腰部筋力涣散为变的核心病机,日久腰背部气血失调、筋骨失衡发为本病。临证善于抓主症、辨主因、守病机,专病专药随症加减化裁,采用补肝养血、行气祛瘀为遣方思路,同时中药内服与外敷结合,注重手法推拿、腰背肌功能锻炼,发挥中医中药的临床价值。
Abstract:
Lumbar disc herniation is characterized by degenerative changes in various components of the intervertebral disc,included the nucleus pulposus,fibrous ring,and cartilaginous endplate.External forces may influence the fibrous ring of the intervertebral disc,leading to its rupture and the subsequent protrusion or extrusion of the nucleus pulposus posteriorly or into the spinal canal.Consequently,this process irritate or compress adjacent spinal nerve roots,resulted in clinical symptoms such as lumbar pain,numbness,and pain in one or both lower extremities.Traditional Chinese medicine classifies this condition under the category of “lumbar pain”,attributed its pathogenesis primarily to kidney deficiency.Simultaneously,external factors such as wind,cold,dampness,heat,or blood stasis are considered contributory factors.Professor Chen Feng believe that the liver is also one of the core pathogenic factors in this disease.He proposes that by tracing the origin of the disease back to the concept of “the liver governs the tendons,which are the root of exhaustion”,the core pathogenesis is as follows:the liver's failure to bind tendons lead to degeneration of the intervertebral discs,served as the starting point.The liver's inability to regulate the meridians causes abnormalities in the muscles and tendons of the lumbar region,represented the hallmark of the disease.Overuse and exhaustion of liver tendons further result in the dispersion of muscle strength in the lumbar region,lead to the transformation of the core pathogenesis.Prolonged imbalances in the qi and blood of the lumbar region,as well as disturbanced in the musculoskeletal system,manifest as the disease.In clinical practice,Professor Chen excels in identifying primary symptoms,distinguishing the primary causes,adhering to the pathogenesis.He customizes treatments by using specific herbal medicines that replenish the liver and nourish the blood,promote qi circulation,and eliminate stasis based on the presentation of symptoms.This approach combines internal and external herbal remedies,along with massage techniques,lumbar muscle strengthening exercises,and health education.It maximizes clinical value of traditional Chinese medicine.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(81960879,82360936); 广西壮族自治区中西医结合骨与关节退行性疾病多学科交叉创新团队项目(GZKJ2310); 陈锋广西名中医传承工作室建设项目(202113)
更新日期/Last Update: 2024-02-07