2 English reference lumbago [Committee of Chinese Medicine Terminology]. Terminology of Traditional Chinese Medicine (2004)]
Lumbago [Terminology Committee of Chinese Medicine]. Terminology of traditional Chinese medicine (20 10)]
3 Summarize lumbago (lumbago [1][2]) as a symptom name [3]. It refers to a disease with low back pain as its main clinical manifestation [1][2]. Huangdi Neijing Lingshu Meridian.
In modern medicine, various kinds of spondylitis, lumbar disc herniation, spinal tumor, proliferative spondylitis, lumbar soft tissue injury, lumbar muscle strain, rheumatoid arthritis, nephroptosis, pyelonephritis, perirenal tissue inflammation, hydronephrosis, renal tuberculosis, kidney calculi, pelvic diseases, etc. , all belong to the category of this disease [4][3].
The etiology and pathogenesis of low back pain are mostly caused by exogenous factors, trauma, fatigue and kidney deficiency.
The waist is a syndrome outside the kidney, and the pulse runs through the kidney and goes around the back [3]. Low back pain is related to the damage of meridians and tendons of kidney and lumbar spine. Therefore, those who are old, chronically ill, tired, emotionally injured, and have irregular atria and ventricles will cause dirty qi and qi failure; Or due to pathogenic factors, trauma, unfavorable waist meridians and poor qi and blood, all can lead to low back pain [3]. Fang Jisheng Lumbago: "The waist is the house of the kidney. If it doesn't turn around, the kidney will be useless. If the experiment says so, we know that the kidney is tied to the waist. Because of excessive greed, kidney meridian injury, kidney qi weakness, cold and dampness, resulting in low back pain. There is also a flash of blood stasis, which is also a backache. "
Cold-dampness low back pain: Low back pain is mostly caused by feeling cold or staying in a cold wetland for a long time, wading in cold, soaking meridians due to the evil of cold water, blocking meridians, and poor blood circulation.
Lumbar muscle strain: due to overwork, falling, damage to meridians, or improper reasons, it leads to qi stagnation and blood stasis, blocked veins and low back pain.
Low back pain due to kidney deficiency: Low back pain is caused by insufficient natural physical endowment, or deficiency of essence and blood in old age, or kidney injury due to house fatigue, failure of essence and kidney qi.
The peripheral muscles of the spine are the power source to drive joint movement and an important factor to strengthen joint stability, and their relationship is easily influenced by external forces and natural environment. Therefore, trauma and inflammation are often the direct pathogenic factors of low back pain, such as improper posture, gravity and violence directly acting on the waist, tearing the ligaments around the small joints of the spine and joint injury, resulting in low back pain.
5 symptoms of low back pain pain on one side or both sides of the waist [2].
When discussing this syndrome in Neijing, we often see symptoms such as "can't roll", "can't throw" and "can't care", and the painful parts can be "spinal pain" and "neck pain", resulting in waist pain (such as "waist pain"); The nature of low back pain is different, such as "low back pain is like a belt, often like bending over", "pain is like a small hammer living in it" and "waist is like a crossbow string" (swelling pain).
The common types of low back pain in clinic are cold-dampness low back pain, strain low back pain, kidney deficiency low back pain and acute sprain low back pain. Cold and dampness, severe back pain, and reduced heat pain are related to the cold and rainy climate [4]. Strain, have a history of chronic diseases, fatigue pain, waist stiffness and pain [4]. Kidney deficiency and low back pain are faint and persistent, with a long course of disease, accompanied by symptoms such as kidney deficiency [4]. Acute sprain, sudden and severe pain in the waist, unable to throw sideways [4].
6 dialectical classification of low back pain "Jingyue Quanshu Miscellaneous Syndrome Mo": "Low back pain syndrome, which is long-lasting and sad, is also kidney deficiency; Those who suffer from heavy rain or sedentary pain are also wet; People who suffer from all kinds of cold, or people who like warmth and hate cold, are also cold; Those who love cold and hate heat are also hot; Depression and pain, qi stagnation; Those who are sad and painful are also qi-deficient; Pain in labor, liver and kidney decline. If you identify it, you can treat it accordingly. "
6. 1 lumbago rheumatism (lumbago with rheumatism syndrome [1]) is the name of the disease [5]. Also known as rheumatic low back pain, it refers to feeling rheumatism, and the back pain is heavier, which is not suitable for sideways; Or fever, aversion to cold, sweating and heavy body; Or edema and sluggish pulse are common symptoms of low back pain syndrome [6]. See Theory of Diseases and Syndrome of Lumbar Back Disease.
6. 1. 1 Etiology and pathogenesis are mostly caused by rheumatism and meridian block [5].
6. 1.2 symptoms: severe back pain, not suitable for lateral rotation; Or see fever and aversion to cold, sweating and heavy body; Or see edema, pulse floating astringent [5].
6. 1.3 The treatment should dispel wind and remove dampness. Notopterygium root poison powder, Radix Angelicae Pubescentis Gentiana macrophylla decoction and Cortex Acanthopanacis decoction can be used [5]. This syndrome can be seen in myofibrositis, lumbar muscle strain, rheumatoid spondylitis and other diseases [5].
6.2 Low back pain with wind-cold syndrome (1) is the name of the disease [7]. Also known as wind-cold lumbago, it refers to lumbago syndrome with common symptoms, such as wind-cold, lumbago, or back-joint, or pulling the waist and knees, or cold and heat, cold and warm pain in the waist, thin and white fur and tight pulse [6]. See "Oriental Medical Treasures: Shapes".
6.2. 1 Etiology and Symptoms "On the Etiology and Symptoms of Low Back Diseases": "Five symptoms of low back pain, followed by wind arthralgia and wind-cold pain."
Low back pain caused by wind-cold around the waist is urgent, or even the back, or the knee, or cold and heat, the waist feels cold, the warm pain is relieved, and the pulse is tight [7].
6.2.2 Treatment should disperse cold [7]. Erchaihu decoction, Wuji powder and Jiawei Longhu powder can be used [7].
The syndrome can be seen in fibrositis, proliferative spondylitis, rheumatoid spondylitis, lumbar muscle strain and other diseases [7].
6.3 Low back pain with wind-heat syndrome (1) is the name of the disease [5]. Also known as wind-heat low back pain, it refers to low back pain caused by wind-heat, red urine, or slight sweating due to body heat, dry mouth and thirst, sore throat, red tongue, thin fur and floating pulse. Low back pain [5]. See "Effective Prescription of World Medicine: Miscellaneous Drugs of Big Room and Pulse".
6.3. 1 Pathogenesis is wind-heat invading kidney meridian [5].
6.3.2 Symptoms include low back pain, acute pain, ankle involvement, thirst and constipation, and rapid pulse [5].
6.3.3 Treatment should dispel wind and clear heat. Baidu powder, large and small Bupleurum decoction can be used [5].
6.4 Low back pain with wet phlegm syndrome (low back pain with wet phlegm syndrome [1]) is the name of this disease [8]. Also known as wet phlegm low back pain, it refers to the symptoms of low back pain caused by feeling wet phlegm, such as severe cold pain in the waist, pulling on the back and hypochondrium, heavy rain, or stool, white and greasy fur and slippery pulse [6]. Low back pain [8]. Also known as low back pain due to phlegm injection [8].
6.4. 1 Etiology and Pathogenesis "Treating low back pain caused by internal pulse injury": "Low back pain caused by spleen dampness and phlegm stagnation and water stagnation."
6.4.2 Symptoms include heavy waist depression, back traction, cold pain, even worse cold, slight fever, or loose stool, or swelling of the waist, making it soft and painless, unchanged skin color, and slippery or heavy pulse [9].
6.4.3 Treatment should eliminate phlegm and dampness [9]. Prescriptions such as Nanxing Erchen Decoction, Daotan Decoction, Guigui Pill and Kong Xiandan can be selected [9]. For patients with asthenia, Liujunzi Decoction and Bawei Pill can be used together [9].
6.5 Cold-dampness syndrome of lumbago (cold-dampness syndrome of lumbago [1]) is the name of the disease [10]. Also known as cold-dampness low back pain, it refers to the common symptoms of low back pain, such as cold-dampness ill feeling, severe cold pain in the waist, adverse rollover and gradual aggravation. Whenever it rains or feels cold behind the waist, the pain is warm, the body is tired and weak, or the limbs are not warm, eating less, the tongue is light and heavy, the coating is white and greasy, and the pulse is tight or late [6]. Low back pain [10]. Seeing Danxi Heart Treating Low Back Pain. Also known as damp-cold lumbago [10].
6.5. 1 The etiology and pathogenesis is cold and dampness hurting the waist and kidney [10].
6.5.2 Symptoms and treatment "Introduction to Medicine" Volume 5: "Long-term wet, soaked in rain and dew, wet writing, waist as heavy as stone, cold as water, like hot things with iron. Not thirsty and convenient, eating as usual, decocting with aconite water to tonify the kidney; The water is heavy, the urine is unfavorable, the five products are scattered, and the soup is wet. "
Shufu Decoction, Wuji Powder and Duhuo Atractylodes Decoction can also be used [10]. Mo Yao waizhidan [10].
6.6 Low back pain with damp-heat accumulation syndrome (low back pain with damp-heat accumulation syndrome [1]) is the name of the disease [8]. Low back pain, also known as damp-heat pain, refers to the symptoms of low back pain, which are common symptoms, such as damp-heat, loose waist and buttocks, rapid traction pain accompanied by heat sensation, severe pain on hot days or after waist fever, cold pain, thirst, yellow and red urine, or body heat in the afternoon, slight sweating, red tongue, yellow and greasy fur, thin pulse or thready number [6]. Low back pain [8]. Seeing Danxi Heart Treating Low Back Pain.
6.6. 1 Etiology and pathogenesis are caused by seasonal damp-heat, or the thick taste of damp-heat diet [8].
6.6.2 Symptoms "Pulse Diagnosis and Treatment Method" Volume 1: "Damp-heat lumbago, internal heat annoyance, spontaneous sweating and thirst, red and astringent stool and severe pain." But also waist fever, or edema of limbs, yellow fur, heavy pulse and so on [8].
6.6.3 Treatment should clear away heat and promote diuresis [8]. Prescriptions include Jiawei Ermiao Powder, Daqing Powder Drink and Chaidu Atractylodes Decoction [8]. At the same time, those who are deficient should use Qiwei Pale Powder [8]. This syndrome can be seen in rheumatoid spondylitis, rheumatoid arthritis, acute pyelonephritis, perinephritis and other diseases [8].
6.7 Low back pain with spleen dampness syndrome (low back pain with spleen dampness syndrome [1]), also known as spleen dampness low back pain, refers to the invasion of dampness evil, with low back pain as common symptoms, such as heavy depression, pale complexion, loss of appetite, thin stool, white greasy fur, slippery or wet pulse.
6.8 Low back pain with stagnation of liver-qi (lumbago with stagnation of liver-qi [1]), also known as low back pain with stagnation of liver-qi, abdominal distension and pain, like fullness of qi, sudden accumulation and dispersion, inability to walk for a long time, red tongue, thin fur, thin or heavy pulse, etc.
6.9 Low back pain and blood stasis syndrome (low back pain with static syndrome [1]) is the name of the disease [1 1]. Also known as blood stasis lumbago, it refers to lumbago with prolonged course of disease, often with a history of trauma and strain, with fixed pain, swelling discomfort, or prick-like pain, light day and heavy night, or persistent incomprehension, unfavorable movements, even inability to lean sideways, refusal to press pain, dark face and lips, dark tongue or ecchymosis, and unsmooth or thin pulse [6]. A lumbago [1 1]. See Danxi Heart Method, Volume 4. Also known as hemorrhagic low back pain [1 1].
6.9. 1 The etiology and pathogenesis are mostly caused by falls, chronic low back pain and blood stasis [1 1].
6.9.2 Symptoms are characterized by pain, such as tingling, light day and heavy night, or low back pain with dark stool, reddish yellow or dark urine and unsmooth pulse [1 1].
6.9.3 Treatment should focus on promoting blood circulation and removing blood stasis [1 1]. Use Taoren Honghua Buyin Pill, or Taoren Chengqi Decoction, Chuanxiong Cinnamon Decoction (Li Dongyuan recipe: Notopterygium Rhizoma, Cinnamomum cassia, Chuanxiong Rhizoma, Bupleurum Radix, Angelica, Atractylodes Rhizome, Radix Glycyrrhizae Preparata, Massa Medicata Fermentata, Radix Angelicae Pubescentis, Radix Stephaniae Tetrandrae, Radix Saposhnikoviae, and Taoren). And can be treated with acupuncture and cupping [1 1].
6. 10 lumbago with kidney deficiency syndrome (lumbago with kidney deficiency syndrome [1]) is the name of the disease [12]. Also known as kidney deficiency and lumbago, it refers to deficiency of kidney-qi, weakness of waist and knees, soreness and weakness of waist and knees, which is even worse when you are tired, relieved when you lie down, and often recurs. Yang deficiency is less abdominal tightness, pale face, tepid hands and feet, shortness of breath, weakness, pale tongue and heavy and thin pulse; Yin deficiency leads to anxiety and insomnia, dry mouth and throat, flushed face, fever in hands and feet, red tongue with little coating and thready pulse, all of which are common symptoms of low back pain [6]. Low back pain [12]. See Volume XIX of Emergency. Also known as kidney meridian lumbago [12].
6. 10. 1 The etiology and symptoms are caused by atrioventricular node and kidney essence injury caused by overwork [12].
"synopsis of the golden chamber lumbago": "those with kidney deficiency and lumbago have insufficient essence and yin. ..... Its symptoms are shortness of breath, inability to stand up and lack of rest. There is no great pain, but it is long and sad, and it is repeated. "
6. 10.2 There is a difference between yang deficiency and yin deficiency [12].
Kidney-yang deficiency is characterized by cold pain in the waist, tepid hands and feet, pale complexion, thin stool, pale tongue, heavy and thin pulse or weakness [12]. Treatment should be warming yang and tonifying kidney [12]. Bawei Pill, Erzhi Pill, Gui You Pill and Tonifying Pill can be selected [12].
Kidney yin deficiency is characterized by low back pain, dull complexion, dizziness and tinnitus, and dry throat and mouth [12]. People with excessive fire due to yin deficiency are more likely to see Rise of the Legend, upset by excessive internal heat, Huang Chi in urine, red tongue and rapid pulse, which may cause weakness [12]. Treatment should be nourishing yin and tonifying kidney [12]. Zuogui Pill, Danggui Dihuang Drink and Dabuyin Pill are all acceptable [12].
This syndrome can be seen in chronic nephritis, nephroptosis, lumbar muscle strain, spinal tuberculosis and other diseases [12].
The treatment of low back pain is mostly caused by exogenous pathogens and trauma, especially acute low back pain. Chronic low back pain is more common in internal injuries, and the treatment is mainly to tonify kidney and strengthen tendons [3].
Acupuncture has a good effect on low back pain, but low back pain caused by spinal tuberculosis and tumor is not within the scope of acupuncture treatment.
Rubbing the waist with the palm at ordinary times, morning and evening 1 time, each time 10min, can relieve and prevent the onset of low back pain.
This paper mainly discusses the methods of acupuncture and moxibustion in treating lumbago due to cold and dampness, lumbar muscle strain and lumbago due to kidney deficiency, which can be used as a reference for the treatment of other lumbago.
7. 1 Acupuncture mainly selects Shenshu, Dachangshu, Weizhong, Jiaji and Ashi points [4]. Cold-dampness lumbago plus Guanyuanshu and Dachangshu; Strain and low back pain plus secondary jaw diaphragmatic relaxation; Kidney deficiency and lumbago plus Zhi Zhi, Mingmen and Taixi; Acute sprained low back pain plus middle low back pain point, intermediate bleeding [4].
Rules? Eliminating dampness and cold, invigorating kidney and qi, dredging menstruation and relieving pain.
Prescription? Shenshu Yao Yan Committee
Fang Yi? The waist is the house of the kidney, and Shenshu is the place where the kidney meridian regulates qi, so it can tonify kidney qi, and moxibustion can dispel dampness and dispel cold; The waist and eyes dredge local tendons, dredge meridians and relieve pain; The Committee regulates the qi of the sun meridians, dredges the meridians, and promotes blood circulation to relieve pain.
Matching points with certificates? Severe cold and dampness-waist and yangguan, blood stasis-ditch, kidney deficiency-Mingmen, Sanyinjiao.
Operation? Millimeter acupuncture, tonic or catharsis, moxibustion or cupping as appropriate according to the actual situation of the disease, 1 time a day, 30 minutes each time,1time as a course of treatment.
7.2 Ear acupoint selection? Lumbosacral renal hilum
Method? After acupuncture, the patient is required to move his waist, keep the needle for 30 minutes each time,/kloc-0 times a day, or press the needle to bury the needle or keep the seed to press the needle.
7.3 acupoint injection? Mainly the pain point.
Method? The mixture of 5ml dexamethasone and 2ml procaine was strictly sterilized and injected into the pain point. Push the liquid medicine after no blood return, and inject 0.5 ~ 1 ml into each point every time, once a day or every other day.
7.4 Puncture and cupping mainly choose tenderness points, lightly bleed again with a skin needle, and add cupping [4]. Suitable for low back pain caused by cold and dampness, strain and acute sprain [4].
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