刘智敏 王艳锋

【摘 要】 腰椎间盘突出症为临床常见病，主要表现为腰痛和下肢坐骨神经放射痛。王艳锋教授将八纲辨证与经络辨证相结合，根据八纲辨证，认为本病总属虚实夹杂证，治应补益肝肾，祛邪通络;根据经络辨证，将本病分为足太阳经型和足少阳经型，治疗时通过调整环跳穴针刺方向使针刺得气，并运用电针，使针感根据经脉循行下传，使气至病所。辅以推拿、穴位注射，综合治疗本病，临床疗效显著。

【关键词】 腰椎间盘突出症;综合疗法;临床经验

Abstract：Lumbar intervertebral disc herniation is a common clinical disease，mainly manifested as low back pain and sciatica.Professor Wang Yanfeng combines the syndrome differentiation of eight principles with the syndrome differentiation of meridians.According to the syndrome differentiation of eight principles，the disease belongs to the syndrome of deficiency and excess，which should be treated by tonifying the liver and kidney，removing pathogenic factors and unblocking collaterals.According to the syndrome differentiation of meridians，the disease can be divided into Foot-Taiyang meridian type and Foot-Shaoyang meridian type.During the treatment，the acupuncture direction of Huantiao acupoint can be adjusted to make the acupuncture Qi，and make the needling sensation pass down according to the circulation of meridians by electroacupuncture，so that the Qi can reach the place where the disease is.Combined with massage and acupoint injection，the clinical effect is significant.

Keywords：Lumbar Intervertebral Disc Herniation;Comprehensive Therapy;Clinical Experience

腰椎间盘突出症（Lumbar Intervertebral Disc Herniation，LIDH），是指在椎间盘退行性变及异常受力等因素的影响下，导致椎间盘纤维环破裂或髓核突出，机械压迫周围神经，并刺激化学物质的释放导致局部非感染性炎症反应的一种综合症。病变部位多发在L4/L5和L5/S1，主要症状为腰痛和下肢坐骨神经放射痛。据统计约20%的腰痛症状是因为腰椎间盘突出引起的，而且本病病程遷延，容易复发，很大程度上影响和降低了患者的生活质量[1]。

王艳锋教授从事临床20余年，对腰椎间盘突出症的诊疗经验丰富，擅用针灸、中药，结合推拿、穴位注射治疗本病，疗效确切。现将其运用综合疗法治疗腰椎间盘突出症的经验介绍如下。

1 八纲辨证

根据腰椎间盘突出症的临床表现，属于中医学“腰痛”“痹证”的范畴。《内经》指出腰痛病位在肾，病理以虚为主，《素问·脉要精微论》云：“腰者，肾之府，转摇不能，肾将惫矣。”《素问·痹论》云：“风寒湿三气杂至，合而为痹”;《诸病源候论》记载：“肾气不足，受风邪之所为也。……