推拿伤筋退性行脊椎炎

1、腰椎退性行脊椎炎Retrograde Osteoarthropathy of Lumbar Vertebrae概念 conception脊椎因退变出现椎体边缘唇样增生，小关节肥大性改变而产生腰部酸胀疼痛症状。Lumbago caused by retrograding spine which hyperosteogeny occurs at the border of vertebrae and facet joint.Conception又称脊柱骨关节炎、肥大性关节炎、增生性关节炎等，Spinal osteoarthritis, Osteoarthritis of spineProlifer

2、ation of spineconception是中年以后发生的一种慢性退性行疾病。腰椎发病较高。It is a chronic degenerative disease in the aged.It happens at low back.病因病理由于腰部外伤、劳损和腰部过度活动或长时期负重，致使椎间盘产生退变，弹性软垫作用减弱，使腰椎间隙变窄，同时引起周围韧带松弛，关节出现不稳定，导致椎体两端不断受到牵拉刺激和震荡、冲击，日久形成骨赘。Injury ,sprain , over movement at low back, the disc is degraded ,the ligament

3、s are loosed, facet joints are not sound, both sides of vertebrae are pulled ,stimulated, vibrated, compacted.椎间盘 Disc连接上下椎体，具有弹性垫的作用，缓冲压迫和刺激。Connect upper vertebrae and lower vertebrae together,Elastic pad can reduced the stimulation. Disc degrade椎间盘的水分丢失椎间盘的弹性降低椎间隙变窄The water is loosed inside the

4、disc.The elastic power is reduced.The space between two vertebrae is narrow骨质增生 Hyperosteogeny骨质增生，骨刺，骨赘Spur, spur formation,Osteophytosis , proliferation of osteophyteHyperosteogeny骨质增生是椎体对于压力的反应，是骨组织对压力所产生的代偿性产物，是对脊椎的一种保护性反应。Hyperosteogeny is a reaction of pressure on vertebrae,It is a complementa

5、ry production of bone tissues which be pressed.It is a protective reaction of human spine.hyperosteogeny劳动强度大或肥胖体质容易发生本病。压力和牵拉力是引起骨刺的主要因素。The person who works very hard or very fat (obesity ) is easily got this problem.Spur is mainly produced by pressure and pull force.骨质增生与疼痛H with pain骨刺初发生时，机体有疼痛

6、；骨刺成熟时，机体疼痛消失。椎体后缘骨刺：压迫脊髓。椎体后外缘骨刺（椎间孔附近）：压迫神经根。Spur beginning, too much painSpur formed already , pain disappear.Spur at the posterior of vertebrae can press spinal cord.Spur at the posterior and lateral of vertebrae can press nerves root.中医学对骨刺的认识TCM on spur肾主骨生髓肝藏血，肝主筋脾主运化，脾主肌肉、四肢Kidney dominates

7、bone and produces marrow.Liver stores blood, nourishes the tendon.Spleen transforms food , dominates muscle and branches.TCM on spur人过中年，肾气渐衰，复感风寒湿邪，留滞经络，或因外伤使气血淤阻，血脉凝涩，不能通达，不通则痛。Kidneys qi is weak in the aged,Wind-cold damp evil invade and stay at meridian and collateral.Blood stasis is produced by

8、 injury, blood vessel is stagnated, blood cant flow freely and quickly.TCM on spur寒凝血淤Cold evil dominates constractionCold evil pertains yin evilCold evil produces painCold evil with blood stasis togetherTcm on spur痰淤互结Phlegm is divided into shape( you can see) and without shape (you cant see).Phleg

9、m is produced by spleen ,stored in lung.It is distributed everywhere of the body.Strange diseases are mostly caused by phlegm.Phlegm and blood stasis mixed together.临床表现 Manifestations1，患者多为40岁以上的体质肥胖者，2，长期弯腰劳动和负重，1.obesity, older than 40 years .2. work with bend forward position, or load overweight

10、 for a long timeManifestations3，腰部疼痛发僵，不能久坐久立，晨起症状较重，活动后减轻，劳累后加重，4，腰部俯仰活动不利，但被动运动大多达到正常。3. The patient has pain and stiff sensory at low back, he cant stand and sit for long while. The pain is seriously in the morning, is relieved after movement, is worse when the patient is tired.4. the patient can

11、 flex and extent the low back very well, but passive movement is at normal range.manifestations5，急性发作，腰痛可牵涉到下肢。6，骨赘刺激或压迫马尾神经时，可出现下肢麻木无力，感觉障碍。5. acute onset , lumbago related to lower limb.6. the patients cauda equina is stimulated or pressed , he feels his lower limb numbness and weakness. 检查 signs1

12、.腰椎生理曲度减少或消失。圆背。2.腰部活动受限。3.局部肌张力增高，轻度压痛。有时腰椎棘突有叩击痛。1.Examination shows that the physiological curve of the lumbar vertebrae es flat or reversed, 2.waist movement is limited, 3.pain is felt on the two sides of the lumbar vertebrae upon deep pressing , and hypermyotonia in the lumbar region is noticea

13、ble . signs4.臀上皮神经和股外侧皮神经分布区按之酸痛。5.直腿抬高试验阳性，下肢后伸试验阳性。4.Tender at the area of superior clunial nerve and lateral cutaneous nerve of thigh.5.Backward stretching test of the lower extremities is positive in most cases. Limit is mostly felt in straight-lifting. X filmX片：椎体边缘唇样骨质增生，或骨桥形成，或椎间隙变窄，或骨质疏松。Roe

14、ntgenogram shows spur formation and flatten physiological curve of the lumbar vertebrae. 鉴别诊断脊椎骨质疏松脊椎结核脊椎滑脱Spine osteoporosisTuberculosis of spine (potts disease)spondylolisthesisTreatment principles治则：1.舒筋通络，2.行气活血，3.解痉止痛。1. relax the tendon and dredge mote qi and blood circulation3.

15、 relive spasm and stop painpoints取穴：患部华佗夹脊，肾俞，命门腰阳关，大肠俞，关元俞，居髎，环跳，委中，承山等。huatuojiaji(Extra), shenshu(BL23), mingmen(DU 4),Yaoyangguan(DU3)Dachangshu(BL25)Guanyuanshu(BL26)Juliao(GB29),huantiao(GB30)weizhong(BL40) Chengshan(BL57)manipulations手法：滚、按、揉、点压、弹拨、扳法。Rolling PressingKneadingDigital pressingP

16、lucking Crack Scrubbing操作 manipulations1.滚腰骶部,2.按揉腰骶部，3.按揉上述穴位，1.rolling the low back and sacral region2.palm root or elbow tip pressing and kneading low back and sacral area.3.thumb or elbow tip pressing kneading the points mentioned above.manipulations4.自上而下直推腰椎两侧3050次，5.横推腰骶部30次。4. push flatly wi

17、th the palm the two sides of the lumbar vertebrae from top to bottom for 3050 times ,5. then push flatly the lumbosacral portion from side to side .6.滚下肢后侧和外侧，7.按揉下肢后侧和外侧6.rolling the posterior and lateral side of leg7.pressing kneading the posterior and lateral side of leg. 8.腰椎后伸扳法，9.腰椎斜扳法，8.Stret

18、ching-pulling backwards the thighs so as to help the lumbosacral region return to normal position.9.The patient assumes lateral position. The doctor pulls obliquely the low back.manipulations10.直擦督脉（腰段），横擦腰骶部。以透热为度。10.scrubbing straightly DUMAI low back segment, Scrubbing transversely low back and sacral region.The patient