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| 腰椎間盤突出癥的古籍證據評價及辨證規律探析 |
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陶桃1, 石明鵬1, 張憲帥1, 周國徽1, 于杰2, 銀河2, 莊明輝2, 譚博洋1, 李紹軍3, 朱立國2, 李振華3
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1.長春中醫藥大學, 長春 130117;2.中國中醫科學院望京醫院骨科, 北京 100102;3.長春中醫藥大學附屬醫院骨科, 長春 130117
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| 摘要: |
| [目的] 梳理腰椎間盤突出癥的古籍證據及辨證規律并評價其證據質量，以期對中醫臨床循證醫學的研究提供參考依據。[方法] 檢索《中華醫典》以篩選腰椎間盤突出癥相關的防治證據，應用《中醫古籍防治證據評價分級量表》對每條證據進行評價，并通過“以方測證”的方式為臨床醫生提供經典方劑的辨證規律總結。[結果] 共獲腰椎間盤突出癥的防治證據197條，其中知識類證據192條，案例類證據5條。共涉及136個方劑，古籍共74本。136個方劑中，20個被評為Ⅰ級證據；55個被評為Ⅱ級證據；61個被評為Ⅲ級證據。辨證分型多以腎虛腰痛（55條）、寒濕腰痛（35條），淤血腰痛（9條）、濕熱腰痛（9條）次之。[結論] 中藥方劑治療腰椎間盤突出癥的古籍證據質量不高，中醫古籍的研究仍有待深入探索。古籍證據表明，在腰椎間盤突出癥辨證中以腎虛腰痛、寒濕腰痛常見，治則治法多為補腎壯陽、散寒除濕、溫經通絡、理氣止痛、化痰除濕等。 |
| 關鍵詞: 腰椎間盤突出癥 腰痛 古籍文獻 評價 《中華醫典》 |
| DOI：10.11656/j.issn.1672-1519.2023.05.08 |
| 分類號:R274 |
| 基金項目:國家重點研發計劃項目（2021YFC1712801）；中醫藥循證能力建設項目（2019XZZX-GK005）。 |
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| Evaluation of ancient evidence of lumbar disc herniation and exploration of dialectical rules |
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TAO Tao1, SHI Mingpeng1, ZHANG Xianshuai1, ZHOU Guohui1, YU Jie2, YIN He2, ZHUANG Minghui2, TAN Boyang1, LI Shaojun3, ZHU Liguo2, LI Zhenhua3
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1.Changchun University of Chinese Medicine, Changchun 130117, China;2.Department of Orthopedics, Wangjing Hospital of Chinese Academy of Chinese Medical Sciences, Beijing 100102, China;3.Department of Orthopedics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun 130117, China
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| Abstract: |
| [Objective] To sort out the ancient book evidence and dialectical law of lumbar disc herniation and evaluate its quality of evidence, in order to provide reference for the study of clinical evidence-based medicine in traditional Chinese medicine.[Methods] Search the Chinese medical classics to screen the prevention and treatment evidence related to lumbar disc herniation, evaluate each evidence with the evaluation and grading scale of prevention and treatment evidence of ancient chinese medicine, and provide clinicians with a summary of the syndrome differentiation rules of classic prescriptions through the way of "measuring the syndrome by prescription".[Results] A total of 197 pieces of prevention and treatment evidence of lumbar disc herniation were obtained, including 192 pieces of knowledge evidence and 5 pieces of case evidence. A total of 136 prescriptions and 74 ancient books are involved, in which 136 prescriptions, 20 were rated as Level Ⅰ evidence; 55 were rated as Level Ⅱ evidence; 61 were rated as Level Ⅲ evidence. Most of the dialectical types are kidney deficiency lumbago (55), cold and wet lumbago (35), congested lumbago (9), and damp-heat lumbago (9).[Conclusion] The quality of evidence in ancient books of traditional Chinese medicine for the treatment of lumbar disc herniation is not high, and the research of ancient books of traditional Chinese medicine still needs to be further explored. Evidence from ancient books shows that kidney deficiency lumbago and cold-dampness lumbago are common in the dialectics of lumbar disc herniation, and the treatment principles and methods are mostly kidney tonifying and yang strengthening, dispelling cold and dehumidifying, warming meridians and collaterals, regulating qi to relieve pain, resolving phlegm and dehumidifying, etc. |
| Key words: lumbar disc herniation low back pain ancient literature evaluation Chinese medical classics |
