1, should be treated for the cause, lumbar disc prolapse acute rest 1-2 weeks in a hard bed can often make the symptoms stable.
2, symptomatic treatment, pain available paracetamol plus codeine 30mg, 3-4 times / d, and other non-steroidal analgesics, such as isobutyleneacetic acid, naproxen, etc., muscle spasm available Valium 5-10mg orally, 3 times / d; or cyclobenzaprine 10mg orally, 3 times / d, may be effective.
3, severe cases available dexamethasone 10-15mg / d, intravenous drip, 7-10 days; general can be oral prednisone 10mg, 3-4 times a day, 10-14 times for a course of treatment, also available 1%-2% procaine or plus prednisolone each 1ml paravertebral closure, can be combined with acupuncture and physical therapy, conservative therapy can be relieved, poor results can be used pelvic traction or prednisolone epidural Injections, individual ineffective or chronic recurrence cases can be considered surgical treatment.
[Treatment]
I. Bed rest.
Especially in the early stage of disc herniation rest in a hard bed for 3-4 weeks, some patients have their symptoms relieved by themselves.
Second, medication.
Pain relievers, vitamin B, short course of corticosteroids orally can be beneficial to recovery.
Third, physical therapy.
In the acute stage, ultra-short wave therapy and ultraviolet radiation for erythema can be used, and in the chronic stage, short wave therapy and direct current iodine ion introduction can be used.
Traditional Chinese medicine treatment
Sciatica
(I)
Identification】Cold and dampness blockage.
Treatment: Dispersing cold and dampness, relieving paralysis and pain.
Name of formula】Reducing paralysis and relieving pain.
Composition] 10 grams of Radix Chuan Wu, 10 grams of Radix Cao Wu, 6 grams of Radix Sinensis, 15 grams of Radix Achyranthes Bidentata, 12 grams of Atractylodes Macrocephalae, 12 grams of Fructus Atractylodes, 10 grams of Radix Boswelliae, 10 grams of Radix Myrrh, 15 grams of Rhizoma Chuanxiong, 12 grams of Radix Cinnamomi, 6 grams of Glycyrrhiza Uralensis.
Usage】Take 1 dose with water, 2 times a day.
[Source]: Zhou Tian Han Formula.
(II)
[Identification]: Stagnation of wind-cold and dampness and stasis of meridians.
Treatment] Dispelling wind and dampness, dispersing cold and relieving pain.
[Formula name]: Soap Dock with Ginger Soup.
Composition】30g of Soapberry, 9g of Doklam, 9g of Fructus Pulchelli, 6g of Cinnamon, 15g of Turmeric, 15g of Atractylodes Macrocephalae, 30g of Job’s Tear, 9g of Fangji.
Usage】Take 1 dose with water, 2 times a day.
[Source]: Lv Guangzhen Formula.
(III)
Identification】Wind, cold and dampness blocking the meridians, poor flow of Qi and blood, and loss of nourishment of tendons and veins.
Treatment] Relieving tendons and activating collaterals, promoting blood circulation and relieving pain.
[Formula] Shu tendons and invigorating the collaterals drink.
Composition】Duhuo 15 grams, Lingxian 12 grams, Qianxianjian 10 grams, Duzhong 12 grams, Niu Knee 15 grams, Sequoia 12 grams, Papaya 10 grams, Chickweed 30 grams, Safflower 9 grams, Angelica 12 grams, Chuanxiong 9 grams, Di Long 10 grams.
Usage】Take 1 dose with water, 2 times a day.
[Source] Zeng Chong Formula.
(IV)
Identification】Wind, cold and dampness invade the skin and flow into the meridians, causing the dampness to become phlegm, and the phlegm and stagnation to block the channels, resulting in the loss of the flow of Ying and Wei.
Treatment] Dispelling wind and dampness, invigorating blood circulation and resolving blood stasis, cleansing phlegm and clearing the channels.
[Formula name]: Tonifying menstruation and relieving pain.
Composition】Made of Nanxing 10 grams, Angelica dahurica 10 grams, Huangbai 10 grams, Chuanxiong 10 grams, Safflower 10 grams, Qiangwu 10 grams, Weilingxian 25 grams, Cangzhu 15 grams, Tao Ren 15 grams, Fangji 15 grams, Yuanhu 15 grams, Dushu 15 grams, Gentiana 6 grams, Shenqu 12 grams, Gui Zhi 12 grams.
Usage】Take 1 dose in water, 2 times a day, 3 days for a course of treatment.
[Source] Li Zhi Fang Formula.
(V)
Identification】Cold and dampness blocking the ligaments.
Treatment】Opening up paralysis through Yang, expelling dampness and expelling cold.
[Formula name]: Expelling paralysis.
Composition】6-12 g of Radix et Rhizoma Pinelliae, 6-12 g of Radix Cao Wu, 6-12 g of Radix Chuan Wu, 15 g of Ephedra, 20 g of Niu Kne, 20 g of Papaya, 10 g of Boswellia.
Usage】Take 1 dose in water, 2 times a day, starting with a small amount of Hesperidin and Chuan Cao Wu.
[Source] Li Shuwen Formula.
(VI)
Identification】Wind-cold invasion and obstruction of the veins and ligaments.
Treatment] Dispelling wind and cold, invigorating the blood and clearing the channels.
[Formula name]: Snake and Scorpion Soup.
Composition] 10 g of wuzhi snake, 10 g of fried dilong, 10 g of stiff silkworm, 10 g of cinnamon stick, 10 g of Chuanxiong rhizome, 10 g of licorice, 6 g of whole scorpion, 6 g of Chuanwu, 6 g of Cao Wu, 4 g of centipede.
Usage】Chuan and Cao Wu are first decocted for half an hour to reduce toxicity, then added to other medicines. 300 ml of the liquid is taken, 1 dose daily.
[Source] Wang Jianmin Formula.
(VII)
Identification】Yang deficiency and weakness of Qi, cold and dampness blocking the meridians, and unfavorable flow of Qi and blood.
Treatment] Warming Yang and benefiting Qi, dispersing cold and dispelling dampness, harmonizing blood and promoting circulation.
[Formula] Coix Seeds and Coix Seeds with Paeonia lactiflora and Glycyrrhiza glabra.
Composition】70 grams of Coix Seed, 25 grams of Radix et Rhizoma Polygonati, 30 grams of roasted licorice, 20 grams of Radix Paeoniae Alba, 30 grams of Radix Astragali, 20 grams of Radix Codonopsis Pilosulae, 15 grams of Radix Angelicae Sinensis, 12 grams of Cypress, 10 grams of Mouton, 18 grams of Radix Gentianae Macrophyllae, 10 grams of Radix Hefei, 12 grams of Radix Chrysanthemum, 10 grams of Myrrh, 10 grams of Radix Achyranthes.
Usage】Take one dose with water decoction twice a day.
[Source] Cheng Guangli Formula.
(VIII)
Identification】Cold-heat stasis.
Treatment] Dispersing cold and dispelling dampness, relaxing the tendons and activating the collaterals.
[Formula name]: Sciatic Nerve Formula I with Addition.
Composition】Chuan Niu Knee 60-120 g, Huang Bai 9-12 g, Sheng Ci Ren 30-40 g, Chuan Xiong 10-12 g, Mu Gua 12-18 g, Hosin 4-6 g, Atractylodes 10-15 g, Dou Wu 10-15 g, Turtle Worm 10-15 g, Sang Sang Sang 30 g, Epimedium 30 g, Chicken Blood Vine 30 g, Radix Rehmanniae 30 g, Red Peony 15 g, White Peony 15 g, Radix Rehmanniae 15 g, Radix Rehmanniae 15 g. 15 grams of Radix Rehmanniae, 15 grams of Radix Rehmanniae.
Usage】Take a decoction with water, 1 dose twice a day.
[Source] Song Xinjia Formula.
(IX)
Identification】Deficiency of Qi and Blood, paralysis by cold and dampness.
Treatment] Benefiting Qi and invigorating Blood, soothing tendons and relieving pain.
Name of Formula】Scion Bone Pill.
Composition】60 g of Radix Codonopsis, 60 g of Radix Angelicae Sinensis, 60 g of Papaya, 60 g of Yanhuosuo, 60 g of Licorice, 90 g of Radix Rehmanniae, 30 g of Scorpion, 30 g of Lodder, 30 g of Gangsong, 20 Centipedes, 2 Beehives.
Usage】Pill made of refined honey, 6 grams per dose, 3 times a day.
Source】Zhangji Gong’s formula.
(X)
Identification】Cold and dampness invasion, poor circulation of Qi and blood.
Treatment] Warming the meridians and clearing the channels, dispelling wind and dispersing cold.
[Formula name]: Painful Paralysis Soup.
Composition】20 g of Ocimum sanctum, 10 g of Yanhuosuo, 10 g of Shenjiang, 25 g of Gymnema sylvestre, 15 g of Niu Knee, 15 g of Danshen, 15 g of Angelica sinensis, 15 g of Paeonia lactiflora, 15 g of roasted licorice, 7.5 g of Boswellia serrata and 7.5 g of Myrrh.
Usage】Take 1 dose with water, 2 times a day.
[Source] Shi Zheng Imitation Formula.
(XI)
[Identification] Wind-cold and dampness paralysis, blocking the meridians.
Treatment] Removing dampness and dispersing cold, and warming the meridians.
[Formula name]: Xin Fang Gui Zhi Tang.
Composition】30-60 g of Cinnamomum cassia, 15-30 g of Paeonia lactiflora, 3-5 slices of ginger, 5-6 g of licorice, 5-10 jujubes, 15-30 g of Astragalus membranaceus, 10-15 g of Radix Angelicae Sinensis, 10-15 g of Chuan Niu Knee, 10-15 g of Dou Wu.
Usage】Take one dose with water decoction twice a day.
[Source] Liu Zhibin Formula.
(XII)
[Identification] Wind-cold and dampness, blocking the meridians.
Treatment] Dispersing cold and dampness, expelling wind and clearing the channels.
[Formula name]: Angelica Sinensis Hui Wei Wei Tang.
Composition】15 g of Radix Angelicae Sinensis, 10 g of Cinnamomum cassiae, 10 g of Paeonia lactiflora in wine, 3 g of Fructus sanguinis, 10 g of Xiaomutong, 12 g of Chuan Niu Knee, 10 g of Xiang Duxiu, 10 g of Xuan Mu Gua, 3 g of Licorice, 10 g of Dried Dilong, 5 g of Scorpion, 3 Sichuan Centipede, 10 g of Fang Ji, 15 g of Chuan Jian.
Usage】Take a decoction with water, 1 dose twice a day.
[Source] Zeng Shaoqiu Formula.
(XIII)
Identification】Cold and dampness, internal transmission to the meridians, stagnation of Qi and blood, and obstruction of the meridians.
Treatment] Dispelling dampness and dispersing cold, warming the meridians, resolving blood stasis and relieving pain.
[Formula name]: Gui Wu Tang with added flavor.
Composition] 12 grams of Cinnamomum cassia, 30 grams of Radix Paeoniae Alba, 30 grams of Salviae Miltiorrhizae, 9 grams of Radix Chuanwu, 9 grams of roasted licorice.
Usage】Take 1 dose in water, 2 times a day.
[Source]: Zhu Hanchen formula.
(XIV)
Identification】Cold condensation and stagnation of Qi, stasis blocking the meridians.
Treatment] Warming Yang and dispersing cold, resolving blood stasis and clearing the channels.
[Formula name]: Add and subtract Yang He Tang.
Composition] 10g of Ephedra, 20g of Radix Rehmanniae, 5g of Oleander, 15g of Atractylodes Macrocephala, 15g of Atractylodes Macrocephala, 50g of Antler Frost, 25g of Xuan Hu, 15g of Peach kernel, 15g of Red Peony, 15g of Poria, 15g of Raw Licorice.
Usage】Take a decoction with water, 1 dose twice daily.
Source】Shang Ershou formula.
(XV)
[Identification] Strain injury to the tendons and veins, lack of qi and blood flow, and blockage of the meridians.
Treatment] Relaxing the tendons and activating the channels, relieving urgency and pain.
[Formula name]: Radix paeoniae and licorice soup.
Composition】50 grams of raw peony, 50 grams of roasted licorice, 15 grams of yuan hu and 15 grams of poppy shell.
Usage】Take one dose in water, two times a day.
[Source] Chen Yuming Formula.
[category] Experimental formula
Sciatica refers to pain along the sciatic nerve pathway and its distribution area, divided into two categories: primary and secondary. Clinical pain in the arm, posterior thigh, posterior lateral calf, and lateral foot is the main symptom, and the following three types of evidence are common.
Identification and treatment
Main acupuncture points: lumbar 2-5 jiaoji points, aye-point, ring jump
1. wind-cold dampness paralysis
Diagnosis】Cold pain in the lower back and legs, with up and down movement, inconvenience in flexion and extension, aggravated by rainy and cold weather, or with swelling of the lower limbs; thin white or white greasy moss, floating and tight or sinking pulse.
[Prescription】Chichibian, Yanglingquan, Zhengmen
2. Blood stasis and obstruction
Diagnosis】History of internal contusion of the lumbar region, stabbing pain in the lumbar leg, refusal to press the painful area, stabbing pain released after pressing, pain is worse at night, inability to stoop and elevate, unfavorable rotation; purple tongue or petechiae, stagnant pulse.
Prescription】Yanglingquan, Diayu, Blood Sea, Zhizhong
3. Deficiency of positive energy
[Diagnostic Features] Recurrent pain in the lower back and legs, worse with exertion, atrophy and weakness of the lower extremities, aversion to wind and cold, rubbing and pressing, fatigue and weakness, lack of color; pale tongue with little coating, sunken and thin pulse.
Prescription】Yanglingquan, Zhizhong, Sansili, Sanyinjiao
Other treatments.
Ear acupuncture pressure: sciatic nerve, hip, lumbosacral spine, kidney, pressure points
Skin acupuncture: percussion of the lumbosacral region and bleeding at pressure points, plus fire cupping.
Treatment of sciatica
1. Siwu Tang with flavor
(Zhu Shizeng. Treatment of 1122 cases of sciatica with si wu tang plus flavor. Jilin TCM, 1991<5>: Feng3)
This formula contains 15～20g each of white peony or red peony, rehmannia, and panax notoginseng, 15～25g of angelica, 10～15g of Chuanxiong, 2～3 centipedes, and 10～25g of wuzhang. o Add 10～15g of eucommia and 10～25g of cinnamon for painful paralysis; add 15～20g each of dolichos, gentiana, and 10～15g of fangfeng for walking paralysis; add 15～25g of poria, 15～20g of coix seed, and 10～15g of atractylodes. ～The total effective rate was 93.8%, with 6 cases of apparent effect, 44 cases of effective, and 7 cases of ineffective.
2. Deer and Horse Pill
(Zeng Qingpei. Report of 54 cases of sciatica treated with self-prepared Lu Ma Wan. Journal of Practical Chinese Internal Medicine, 1993(3): 31)
Chuan Niu Knee, Shu Dog Backbone, and Hutia 40g each, 30g of Strychnine, roasted and dried, grinded very finely, 60g of Deer Antler Gum, melted, with appropriate amount of honey, decocted with moderate heat and mixed with the above-mentioned powder, and made into a pill as big as mung bean, 6g daily, 2-3 times orally, lO days as a course of treatment, total effective rate 96.3%.
3. Duluxiaosheng Tang
(Wu Xuewen. Treatment of 93 cases of sciatica with Duluxiaosheng Tang. Heilongjiang TCM, 1994<1>: 34)
Basic formula: Duluxiang, Sangxiangsheng, Eucommia, Niubizi, Hosin, Gentiana, Poria, Cinnamomum, Fangfeng, Chuanxiong, Ginseng, Licorice, Angelicae, Paeoniae, Radix et Rhizoma, and Epimedium; if the pain is severe and the constriction cannot be flexed or extended, Chuanxiong, Paeoniae, Chuanwu, and Scorpion are used again; if the numbness is not benevolent, Chicken Blood Vine is added; if the sinking is heavy, Fangqi is added; if the heat is strong, Hosin and Cinnamommum are removed; if the cold is strong, Radix et Rhizoma is added; if the body is strong, Radix et Rhizoma and Ginseng are reduced. The total efficiency is 96.7%.
4. Saponaria decoction
(Liu Xizhen. Soapberry decoction for the treatment of 117 cases of sciatica. Journal of Beijing University of Traditional Chinese Medicine, 1994<4>: 21)
The decoction of 20~40g of Saponaria spinosae, 300ml of water decoction, divided into 2 doses, wind-cold type with Fenghuang, Hsiang Xin, Coix Seed, Fructus Pseudostellariae, Cinnamon, Papaya, Qiang Wu, liver and kidney deficiency type with Sequoia, Eucommia, Fructus Lycii, Cornu Cervi Pantotrichum, Sang Sang Sang, stagnant veins and veins type with Chuan Niu Knee, Wang Bu Liuxing, Boswellia, Myrrh, Gynostemma, Andrographis, damp-heat type with Fang Qi, Huang Bai, Tu Fu Ling, all with this decoction, clinical recovery 62.4%, basic control 17.1%, improvement 15.4%, ineffective 5.1%.
5. Four worms remitting paralysis soup
(Zheng Yuejin. Treatment of 124 cases of dry sciatica with Siworm Releasing Palsy Tang. New Chinese Medicine, 1990<12>: 39)
This formula contains whole scorpion, centipede, ground turtle worm, ground dragon, tianma, angelica, bupleurum, cow knee, coix seed, gerbera, deer’s tongue, rehmannia, white peony, in case of cold, add shuanwu and cao wu, in case of stasis of blood, add frankincense and myrrh, in case of damp-heat, add lian dong teng, tu fu ling and huang cypress. 124 cases were treated, 72 cases were cured, 36 cases showed efficacy, ll cases were effective, and 3 cases were ineffective.
6. Strong tendons and bones pill
(Cui Lianguang, Wang Xiaoping. Treatment of 86 cases of lumbar discogenic lumbar and leg pain with Zhuangjianshoubiaowan. Shandong Journal of Traditional Chinese Medicine, 1995<8>: 351-352)
Composition: Radix Angelicae Sinensis, fried Eucommia Ulmoides, Chuan Gui, Gynostemma lucidum, Salviae Miltiorrhiza, Dilong, etc.
Indications: Lumbar discogenic lumbar and leg pain.
How to use: Take orally in the morning and evening every day, 5g each time with warm yellow wine, 12 days for a course of treatment, stop for 3 days and continue with the next course of treatment.
7. Paralysis and Pain Relief Soup
(Liu Yuanmian, Guo Qiaoling, Liu Jialei, et al. Treatment of 23.6 cases of sciatica with Paralysis Removal and Pain Determination Tang. Journal of Gansu College of Traditional Chinese Medicine, 1995<2>: 19-20)
Composition: Dou Wu 5g, Angelica Sinensis 15g, Sang Sang Sang 30g, Salviae Miltiorrhiza 30g, Wang Bu Liu Xing 30g, Gymnema Sylvestre 30g, Chuan Niu Knee 30g, Du Zhong 15g, Wei Ling Xian 15g, Fang Qi 15g, Fang Feng 15g, Bulbus Fritillariae 10g, Hossein 10g, Radix et Rhizoma Polygonati 10g, Glycyrrhiza Glabra 6g.
Effects: Tonifying the kidney, nourishing the blood, invigorating the blood, warming the menstruation, dispersing cold, dispelling wind and dampness, resolving blood stasis and relieving pain.
Indication: Sciatica, with a cure rate of 51.3% and an overall efficiency of 96.2%.
8. Water centipede combination
(Fan Tan. 32 cases of primary sciatic neuritis treated with water centipede combination. Zhejiang Journal of Traditional Chinese Medicine, 1989(7): 306)
Composition: Fresh (or dried 150g) water centipede, ginger (cut into pieces), brown sugar, 250g each, add 2,000ml of water, decoct to 500ml with civil and military fire, and take in 2 warm doses.
Main treatment: primary sciatic neuritis, total efficiency 100%.
9. Sawtooth mackerel cartilage powder
(Japan and other developed countries commonly used this method,)
Composition: Sawtooth mackerel cartilage powder 7.5g, divided into three times with warm water.
Treatment: Sciatica caused by lumbar intervertebral disc disease, sciatica is mostly radioactive pain, and sawtooth shark cartilage powder for the lumbar spine, so the effect of the resulting reflex sciatica is extremely obvious, and from the root of the problem, the cure rate is 100%, the total efficiency rate of 100%.