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1、影像监控下腰椎间盘突出症(血瘀证)针刀治疗机制和定位操作探讨唐峰,吕武宾,邓军,姜兴鹏(重庆三峡医药高等专科学校,重庆,万州,404000)[作者简介]唐峰(1978~),主治医师,主要从事颈肩腰腿痛临床治疗。联系地址:重庆市万州区白岩路398号重庆三峡医药高等专科学校附属中医医院针灸科,邮编404000,电话13896995881。[摘要]腰椎间盘突出症临床分型较多,其中血瘀证是主要证型之一。由于外伤或自身变性,髓核或纤维环向椎管内或椎间孔内突出,突出部分挤压神经根,引起出血,水肿或变性等炎症反应变化,造成慢性粘连、纤维组织增生、变性与肌挛缩,新陈代
2、谢障碍而出现疼痛和神经压迫症状。我们通过临床研究,以C臂X光机为辅助,对针刀定点进行简化,通过四点定位,规范实际针刀操作手法,在影像监控下准确进行针刀操作手法。针刀治疗较常规针灸保守治疗在治疗血瘀证腰腿痛方面,能有效对局部病变组织处进行松解、剥离、铲削,可减轻炎症区域内压,阻断其对神经血管的恶性刺激,促使局部毛细血管扩张,改善血液循环,缓解或纠正缺血、缺氧状态,有利于致痛物质吸收代谢和炎症消退,改变组织的病理反应和恢复脊柱的动态生理平衡,从而达到治疗本病目的。[关键词]针刀;腰椎间盘突出症;腰腿痛;[abstract]lumbarinterverteb
3、raldiscclinicalclassificationismore,Bloodstasissyndromewhichisthemaintypeofcard.Duetotraumaortheirowndegeneration,Pulpnuclearorfibertoringinthespinalcanalorbetweenvertebraholeisoutstanding,Prominentpartextrusionnerveroot,thebleeding,edema,ordegenerationofinflammationchange,Cause
4、chronicadhesion,fibrehyperplasia,degenerationandmusclespasm,Metabolismobstaclesandtheoccurrenceofpainandnervecompressionsymptoms.Wethroughtheclinicalresearch,InCarmX-raymachineforauxiliary,Acupotomologytosimplifythedot,Throughthefourpositioning,regulatingtheactualacupotomologyop
5、erationskill,Intheimagemonitoringforacupotomologyunderaccurateoperationskill.acupotomologythantraditionalacupuncturetreatmentofconservativetreatmentinthetreatmentofbloodstasissyndromebacklegpain,Caneffectivelytolocallesiononloosesolution,peelbegins,theshovelcut,Toreduceinflammat
6、ionpressureinsidethearea,toblockthevesselsandnervesmalignantstimulation,Makelocalbloodcapillarydilate,improvebloodcirculation,relieveorcorrectischemiaandhypoxiastate,Tocausepainmaterialabsorbmetabolismandinflammationsubsidise,changetheorganization'spathologicalresponseandrecover
7、yofthespinedynamicphysiologicalbalance,soastoachievethepurposethetreatmentofthisdisease.[keywords]Acupotomology;lumbarintervertebraldisc;Backlegpain;腰椎间盘突出症是临床常见病和多发病,临床分型主要有血瘀证,肝肾亏虚证,寒湿证,湿热证;其中血瘀证临床常见证型。《素问·刺腰痛》云:“衡络之脉,令人腰痛,不可以俯仰,仰则恐仆,得之举重伤腰”;又曰:“肉里之脉令人腰痛,不可以咳,咳则筋缩急;厥阴之脉令人腰痛,腰中
8、如张弓弩弦”。《医学心悟》中:“腰痛拘急,牵引脚足”,这些所描述的症状与腰椎间盘突出症相似。古