Lumbar disc herniation compresses the sciatic nerve and causes sciatica, mainly due to the nerve roots being stimulated by the products of inflammatory reaction. Therefore, in the early stage of the lesion or when the pain symptoms are heavy, or before and after surgical treatment, the application of intravenous infusion of drugs to relieve nerve root edema, analgesia, anti-inflammatory, antispasmodic, and nerve nutrition is very effective in relieving the condition p restoring nerve function. The methods and drugs of infusion therapy for lumbar disc herniation are briefly described as follows: I. Infusion therapy 1. Dehydration therapy Use 20 mannitol 250-500ml once a day for about 15 days to produce a powerful dehydration effect by rapid sedation. Available 10 glucose 500ml, add tachyphylaxis injection 20mg/2ml, once a day by static drip. 20 Mannitol 250ml tachyphylaxis injection 20 mg/2 ml in an IV once a day. The combination of tachyonuria and mannitol can enhance the efficacy of dehydration. Dehydration is accompanied by oral administration of potassium chloride, sodium chloride and calcium to avoid electrolyte disturbance. The powerful dehydration effect of this drip can dehydrate the herniated nucleus pulposus tissue, reduce its size and make it easy to be returned. At the same time, dehydration decreases the internal pressure of the intervertebral disc, which also facilitates the retraction of the herniated nucleus pulposus. Moreover, the aseptic inflammatory edema around the nerve formed by the spinal nerve root due to compression also decreases with dehydration, resulting in relief of spinal nerve compression [1]. To compare what is the difference in effectiveness of two mannitol intravenous drip modalities in the treatment of lumbar disc herniation. Methods Two methods of rapid manual pressurization and infusion pump controlled drip rate were used for 60 patients: static mannitol manual rapid pressurization group (test group): acute attack patients were treated with intravenous mannitol 250 ml dexamethasone 5 mg, the height of the infusion stand was about 1 m, rehydration was completed in about 15 min, the drip rate was about 330 drops per minute, a total of 200 ml of air was added, first adding air at once 100 ml, and then add air 20 ml every 2 min for a total of 5 times, rehydration bid was carried out for a total of 6 times in 3 days; Infusion pump controlled drip rate group (control group): the infusion pump was used to control the drip rate, which was completed at about 30 min with about 165 drops per minute. The rehydration was carried out BID for a total of 6 times in 3 days. The functional status of the lumbar spine, pain status, and renal function of the patients in both groups were also investigated, and the fluid inside the rehydration skin strips after pressurization was taken for bacterial culture before and after medication. The results of the two different methods before and after medication on the patients’ lumbar spine function recovery, pain reduction difference was not significant, the difference of renal function damage was not significant, and the post-compression rehydration fluid was cultured without bacterial growth. CONCLUSION: Mannitol manual compression intravenous drip was not significantly effective in the treatment of lumbar disc herniation, with increased risk and workload for nurses. It is suggested that it is beneficial for both patients and nurses if rehydration is ensured to be completed without pressure for about 30 min both to ensure the efficacy of the drug and to enable patients to reduce pain, reduce the risk to patients, reduce the workload of nurses, and reduce the possible contamination due to manual pressure [2]. 2. Hormonal anti-inflammatory therapy Flumethasone ivgtt qd 1-3 days 10 mg; 4-6 days 5 mg; 7-9 days 2 mg; 10-12 days discontinued. Dexamethasone inhibits aseptic inflammation, reduces congestion, decreases capillary permeability; inhibits inflammatory infiltration and exudation, thus reducing the swelling of the herniated disc herniated tissue and the tissue around the nerve root canal and relieving the compression and irritation of the nerve [3]. 3, regulation of bone metabolism therapy Song Hengping and others reported [4] that 10 ml of refined bone nin was injected intravenously once a day for 7-10 days, and the effect was obvious after three days of medication. This method is suitable for older patients, especially women with lumbar disc herniation combined with osteoporosis. Refined Bone Ning Injection is a polypeptide-rich active substance extracted from the fetal bone of healthy animals, as a sterilized aqueous solution has the ability to regulate bone calcium and phosphorus metabolism, increase bone calcium deposition, increase bone calcium content, and has an important role in the prevention and treatment of osteoporosis. If necessary, then combined with calcium supplementation, relieve bone pain, give oral etidron tablets, wounded bone catcher tablets, etc.. Its efficacy may be related to the fact that bone nin contains peptide active substances, which are involved in the inflammatory regression of herniated disc tissues and have a strong analgesic and anti-inflammatory effect, as well as to its regulation of calcium and phosphorus metabolism and restriction of the release of analgesic substances from mast cells [5]. 4. analgesic therapy 0.25 procaine 200 ml IV (60 drops/min) [6]. The following should be noted: (1) skin test must be done before using the drug; (2) the amount of drug should not be too high and the speed of injection should not be too fast, otherwise it may cause facial flushing, delirium, excitement, and convulsions, and isopentobarbital or sodium phenobarbital can be used to rescue those who have convulsions; (3) it is prohibited for those who have a history of allergy to the drug. Intravenous injection of anesthetic drugs procaine intravenous drip to maintain anesthesia, anesthesia effect is indeed, analgesia perfect. Intravenous infusion of local anesthetics for anesthesia, the domestic early useful procaine anesthesia, but the use of lidocaine is not much. 5, alkalizing blood therapy 5 bicarbonate of soda 200 ml intravenous drip, 100 drops per minute, 30 minutes to finish, once a day, seven times for a course of treatment [7]. Pain can be caused when the tissue ph is lower than 6 due to high lactic acid production in the nucleus pulposus in the case of disc herniation, while the H ionized by lactic acid stimulates the chemoreceptors to produce pain, which in turn causes tissue ischemia and further release of pain-causing substances, producing and aggravating a vicious cycle of pain. This is neutralized by the use of bicarbonate of soda, which alkalizes the blood and raises the ph value, which further reduces the H local pain-causing substances and accelerates pain relief [89]. 6, intervertebral disc atrophy therapy The 1st day onwards starts with 1 mg colchicine intravenously, colchicine 1 mg plus 50 GS 40 ml intravenous drip; the 2nd day follows with tablets orally at a dose of 1 mg/day for 2 weeks – 3 months [10]. In case of nausea and diarrhea, the dose was changed to 0.5 mg twice daily and discontinued in case of severe reactions. Effective against mechanical compression or even obstruction of nerve roots, even if surgery or chemical lysis fails, especially in the acute phase. 1 week mostly has a significant effect, and at the latest within 3 weeks. Atrophic effect on protrusions: Colchicine is also effective on mechanical compression and even obstruction of nerve roots, which cannot be explained by anti-inflammatory effect or anti-microtubular effect. Rash Meck et al. suggested that the intervertebral disc may be atrophied, but the evidence is insufficient and further research is needed. 7.Activating blood circulation and resolving blood stasis therapy Compound Salvia injection 20ml plus 10 glucose solution is given intravenously once a day. Compound Salvia injection has the effect of activating blood circulation, removing blood stasis and relieving pain, and after the static drip can improve the blood circulation of the whole body and the local area, so that the spinal cord and local stasis can be passed and the stagnant ones can be moved, the blood vessels can be opened, the joints can be facilitated, the stasis can be removed and new blood can be generated, the compression of the hematoma and edema inside and outside the spinal cord can be eliminated, so that the spinal cord and cauda equina nerve can be recovered smoothly, and at the same time, the blood flow of the lumbar muscles on both sides is adequate, which can prevent muscle atrophy [11]. 8. anti-swelling and anti-inflammatory therapy β-heptaosaponin sodium 25 mg NS 250 ml rapid intravenous drip (within 30 minutes) once a day. In the acute phase of lumbar disc herniation, because the nerve roots are stuck, there will be obvious local aseptic inflammation, manifested as congestion, swelling, and increased exudate of the nerve root tissue. β-Hepta saponin sodium is a terpene saponin sodium extracted from the dried mature fruit of the Chinese herbal medicine Boraginaceae [12], which has strong swelling elimination, anti-exudation, and anti-inflammatory, improving microcirculation functions, and can significantly play a role in eliminating nerve root inflammation and reduce nerve root swelling, congestion and exudation [13.14]. In addition, β-heptaosaponin sodium has the ability to increase venous tone [14], which plays a positive role in reducing venous stasis in the spinal canal and reducing intervertebral disc adhesions. Jia Tianming et al [15] compared the efficacy of β-heptaosaponin sodium and mannitol in the treatment of acute radicular sciatica, 56 clinically typical patients were then divided into two groups: the treatment group was l rapid intravenous drip of β-heptaosaponin sodium 25mgNS250m; the control group was rapid intravenous drip of 20 mannitol 250ml and the simultaneous application of dexamethasone 10mg, the treatment group was superior to the control group, with significant difference (p<0.01). 9, improve microcirculation therapy Yan Yacheng et al. reported [16] 654-2 20mg intravenous drip for 7 days and dexamethasone 10mg intravenous drip for 7 days as a control group, the results: 654-2 can effectively treat nerve root pain, the effect is similar to the dexamethasone group, there is no significant difference between the two groups, except that the dexamethasone group can be effective quickly, 1-2 days, while the 654-2 group often takes 2-3 days to be effective. The effects of 654-2 on blood circulation include: (1) regulating the microcirculation diameter, in addition to significantly relieving vasospasm, it can also maintain a certain tension in vessels with reduced resistance, showing a biphasic regulating effect; (2) reducing microvascular permeability and reducing exudation; (3) improving blood flow metamorphosis; (4) increasing microvascular autoregulatory movements. It is through this mechanism that 654-2 opens the closed small nerve arteries and unblocks the tiny veins, eliminating nerve root edema and hypoxia thus relieving nerve root pain. It has also been reported [17] that if there is spastic pain in the limb, 5GS 250ml plus 654-2 injection 10mg intravenously once daily to relieve muscle spasm for 5 days as a course of treatment. 10, antibiotic therapy physiological saline or 10G.S250ml plus vanguardomycin V or VI 4~6g, intravenous drip, lower limb scurrying pain over the knee and the recent aggravation of lumbar and leg pain symptoms, static drip for 7 days, generally static drip for 3-5 days. When the affected limb traction radiating pain with intravenous penicillin (about 6.4 million U), plus dexamethasone 5mg, 5 sugar saline 250ml (penicillin must be tested by skin) in about 35-40min after the drip, then the efficacy is better. So far there is no basis to believe that the inflammation caused by lumbar disc herniation is caused by bacterial infection, and it is recognized that it is aseptic inflammation due to local stasis and ischemia and hypoxia caused by edema of nerve roots. However, in our clinical observations, a large number of patients had their lower limb soreness quickly reduced after the addition of intravenous antibiotics, especially cephalosporin antibiotics. Bacterial infection starts from impaired systemic and local immune mechanisms, the release of inflammatory mediators, resulting in reduced local tissue resistance, bacteria take advantage of the opportunity to enter, cephalosporins and other antibiotics in the treatment of lumbar intervertebral disc herniation, in addition to antibacterial sterilization, may also have the function of blocking the release of inflammatory mediators. Among inpatients with symptoms that did not decrease after using penicillin, symptoms were significantly reduced after switching to cephalosporins [18]. 11, nutritional neurotherapy (energy metabolic therapy) Drugs: ① cytidyl phosphate 500mg-750mg10GS250ml ivgtt qd. ② energy combination 2 10GS500ml ivgtt qd energy combination specific dosing: adenosine triphosphate (ATP) 40mg, coenzyme A100 units, add 500ml10 of glucose, intravenous drip (iii) saline 250 ml is added to the dose of ATP, and the dose of ATP is added to the dose of glucose. (iii) Saline 250 ml is added to neurotolepin 7.2 U (2 doses) intravenously, which is suitable for use when, in addition to pain, there is also coldness and numbness in the limbs [19.20]. The energy combination has a nutritive function on the compressed nerve roots and contributes to the recovery of damaged nerves. Energy combinations with neurotrophic drugs have the ability to regulate and improve nerve conduction and promote recovery of nerve function. Insulin accelerates glycogen utilization thus further eliminating edema. 12, anti-free radical therapy Some people [21] reported Vitc 54g into liquid ivgtt qd. clinical use Vitc2~5g into liquid ivgtt qd. mannitol, βD sodium heptaerythroside are powerful dehydrating drugs, also a free radical eliminator, play a protective role on ischemic nerves. Vitamin C is a proven free radical scavenger as it reduces lipid peroxidation in cells, thereby reducing damage to biofilms[22] . Combined medication 1. 20 mannitol 250 ml is added to 20 ml of salvia injection for rapid sedation (finished within 20 min), once a day in the morning and once in the evening, and applied continuously for 7 days as a course of treatment. The effect is not significant when you can add 1 course, if the effect is still not obvious after 2 courses, consider stopping the use of Gandan liquid, and closely observe the efficacy during the use of the drug, stop using other analgesics [23.24]. 2, Dan magnesium infusion therapy Method:Using 10% glucose or 0.9% saline 450ml plus Dan Shen injection 20ml 25% magnesium sulfate injection 20ml IV once a day for 7 days. Result:The total efficiency of Dan-Magnesium infusion therapy for lumbar disc herniation was 95.8%. Conclusion:Dan magnesium combination can improve microcirculation to reduce nerve root edema descending paper inflammatory response:stabilize cell membrane regulation neurotransmitter protection nerve [25]. 3, diglycerin infusion therapy 20% mannitol 250ml and dexamethasone 5mg mixed IV, the treatment of lumbar disc herniation in the acute phase of patients, some people [3] called "diglycerin infusion therapy" mannitol rapid IV is the main role of cell dehydration, and dexamethasone has "membrane stabilization effect". The duration of the dehydrating effect of mannitol can be prolonged. 4. Free radical scavenger infusion therapy [26] 20 Mannitol 250 ml Flumethasone 5 mg Vitamin C 2.0 once daily for 3-5 times. Free radical scavengers improve tissue pathological lipid peroxidation reaction and alleviate inflammatory lesions of the spine. 5, comprehensive formula author's own formula 10GS500ml energy combination 2 Vitc 5g 654-2 10mg flumethasone 10mg ivgtt, qd. where flumethasone ivgtt usage: 1-3 days 10mg; 4-6 days 5 mg; 7-9 days 2 mg; 10-12 days discontinued. Every three days a course of treatment a total of four courses of treatment with excellent results and few side effects. 6.Intravenous grouping of combined medication Dehydration:20 mannitol 125ml plus dexamethasone 10mg, 2 times a day for the first 3-4 days of sedation, and once a day for the next 3-4 days. Mannitol alone in patients with diabetes and gastric ulcer. For more serious cases, add β-heptaosaponin sodium 20mg plus saline 250ml rapid drip daily (30min drip). Anti-inflammatory:Saline 250ml plus 2-3g of Vanguardomycin V, IV, once a day for 3-5 days. Vasodilatation and microcirculation medication:5 glucose 250ml, compound salvia 12ml, 654-210mg, once a day. Neurotrophic and free radical counteracting medication:5 glucose 250ml, cytidine 0.5g, vitamin C 3.0g, vitamin B 6 200mg, once a day. The aim is to reverse or reduce aseptic inflammatory edema of nerve roots, improve local blood circulation, improve stasis, ischemia and hypoxia of nerve roots blocking further damage to tissues by inflammatory mediators and reducing sensitivity of nerve roots [27]. III.Summary In recent years, pharmacological treatment of lumbar disc herniation has greatly improved the prognosis and efficacy, which is a significant progress in the pharmacological treatment of lumbar disc herniation. Currently, erythropoietinEPO [28.29], methylprednisolone [29], neurotrophic factor [30], nitric oxide synthase inhibitor L-NNA [31], Panax ginseng total saponin, Chuanxiongzin, ginsenoside, Ganoderma lucidum spores, and Astragalus membranaceus [32] have achieved exciting results for the treatment of spinal cord injury, but for herniated lumbar discs still lacks boldness and requires further clinical research. It is necessary to pay attention to both the standardized research of drug monomers and follow the research idea of multi-stage and multi-mechanism combined therapy to give full play to the advantages of drug multi-target therapy, only in this way can the efficacy of drug therapy be improved and a revolutionary leap be made in the drug therapy of lumbar disc herniation.