nav emailalert searchbtn searchbox tablepage yinyongbenwen piczone journalimg journalInfo journalinfonormal searchdiv searchzone qikanlogo popupnotification paper paperNew
2023, 10, v.42 1122-1127
中西医结合治疗腰椎椎管内脊膜瘤个案报道
基金项目(Foundation): 国家自然科学基金面上项目(编号:82174410); 山东省自然科学基金面上项目(编号:ZR2020KH01)
邮箱(Email): xzw6001@163.com;
DOI: 10.16295/j.cnki.0257-358x.2023.10.019
发布时间: 2023-10-05
出版时间: 2023-10-05
移动端阅读
摘要:

报道一例运用独活寄生汤加针刺结合脊柱外科椎管减压术治疗腰椎椎管内脊膜瘤的病案。腰椎椎管内脊膜瘤属于良性肿瘤,极少出现恶性变,以神经根受压的临床症状为典型表现,与诸多腰椎疾患症状相似,易发生漏诊、误诊。目前西医治疗一般采用椎管减压术,即切除肿瘤,解除对脊髓的压迫,在此基础上予以消炎止痛、消肿、营养神经等对症治疗。该病归属于中医学腰腿痛范畴,应用中药、针刺等治疗措施代替西药对症治疗,不仅能显著降低其不良反应,还有利于改善患者临床症状,提高疗效。

Abstract:

A case of lumbar intraspinal meningioma treated with spinal canal decompression and combination of administration of Duhu Jisheng Decoction(独活寄生汤 ) and acupuncture is reported. Lumbar intraspinal meningioma is a benign tumor,rarely with malignant mutation. The typical manifestations are mainly clinical symptoms of nerve root compression,similar to symptoms of other lumbar spine diseases,and therefore missed diagnosis and misdiagnosis are common. At present,western medicine treatment such as spinal canal decompression,that is,removing the tumor and relieving the compression of the spinal cord is usually applied,combined with symptomatic treatment such as anti-inflammation and relieving pain,resolving swelling and nourishing nerve. From the perspective of traditional Chinese medicine(TCM),this disease pertains to the category of lumbar and knee pain,and TCM treatment such as Chinese medicinals and acupuncture should be applied to replace the symptomatic treatment by western medicine,for TCM treatment can not only significantly reduce the side effects caused by western medicine,but also relieve the clinical symptoms of patients and improve the clinical efficacy.

参考文献

[1]王忠试.王忠诚神经外科学[M]. 2版.武汉:湖北科学技术出版社,2015:950-953.

[2] KOELLER K K,ROSENBLUM R S,MORRISON A L.Neoplasms of the spinal cord and filum terminale:radiologic-pathologic correlation[J]. Radiographics,2000,20(6):1721-1749.

[3] BUETOW M P,BUETOW P C,SMIRNIOTOPOULOS J G. Typical,atypical,and misleading features in meningioma[J]. Radiographics,1991,11(6):1087-1106.

[4] RADEK M,GROCHAL M,TOMASIK B,et al. The anterolateral approach with corpectomy in the management of the ventral meningioma of the spinal canal[J]. Neurol Neurochir Pol,2016,50(3):226-230.

[5] WESTWICK H J,YUH S J,SHAMJI M F. Complication avoidance in the resection of spinal meningiomas[J].World Neurosurg,2015,83(4):627-634.

[6] MAIURI F,DE CARO M L,DE DIVITIIS O,et al. Spinal meningiomas:age-related features[J]. Clin Neurol Neurosurg,2011,113(1):34-38.

[7] JU C I,HIDA K,YAMAUCHI T,et al. Totally ossified metaplastic spinal meningioma[J]. J Korean Neurosurg Soc,2013,54(3):257-260.

[8] RACO A,PESCE A,TOCCACELI G,et al. Factors leading to a poor functional outcome in spinal meningioma surgery:remarks on 173 cases[J]. Neurosurgery,2017,80(4):602-609.

[9]赵兰锋,王正阁,马国华,等.椎管内非典型神经鞘瘤和非典型脊膜瘤的MRI鉴别诊断[J].现代肿瘤医学,2023,31(5):912-915.

[10]刘彬,王振宇,谢京诚,等.后正中入路治疗胸椎管内脊膜瘤41例报告[J].中国微创外科杂志,2014,14(11):1011-1014,1027.

[11]徐宝占,初明,卫永旭,等.脊膜瘤手术中切除硬脊膜内层的临床疗效分析[J].中华神经外科杂志,2015,31(11):1141-1145.

[12]董伟杰,苏洛希,刘馨蔓,等.显微手术切除椎管内脊膜瘤的技巧和效果[J].中华显微外科杂志,2022,45(6):639-642.

[13]金掌,曲春.独活寄生汤对退变性腰椎管狭窄症患者腰椎功能及血液流变学、炎性因子的影响[J].中药材,2022,45(9):2264-2266.

[14]贾松涛,郑丽娅,武佐元,等.调督理筋针法联合独活寄生汤治疗寒湿痹阻型腰椎间盘突出症的疗效及对血清PGE2、IL-6和TNF-α水平影响[J].中华中医药学刊,2021,39(12):167-171.

[15]侯成志,李秋月,魏戌,等.独活寄生汤治疗膝骨关节炎的研究[J].中国中医基础医学杂志,2021,27(11):1843-1846.

[16]张绍峰,徐世杰,李冀.段富津应用独活寄生汤治疗风湿久痹经验[J].中国中医基础医学杂志,2017,23(9):1317-1318,1320.

[17]吴豫云,周倩仪,崔家康,等.独活寄生汤联合化学药治疗强直性脊柱炎疗效的Meta分析[J].中国药房,2016,27(21):2945-2947.

[18]马永胜,杨豪.独活寄生汤治疗腰椎融合术后遗留症状的疗效观察[J].中药药理与临床,2015,31(2):214-215.

[19]冯雪,郭晓明,孙旭,等.针灸治疗腰椎管狭窄症术后下肢麻痛的效果分析[J].双足与保健,2019,28(21):37-38.

[20]娄洁,张冠锋,董梦真.腰椎间盘突出症术后应用针灸及康复训练对腰椎关节活动度及疼痛的影响[J].实用中医药杂志,2021,37(1):125-127.

[21] ZHANG W D,LIU H,LE X Z,et al. Acupuncture for postoperative pain of lumbar disc herniation:a systematic review and meta-analysis[J]. Medicine(Baltimore),2022,101(49):e32016.

基本信息:

DOI:10.16295/j.cnki.0257-358x.2023.10.019

中图分类号:R739.42

引用信息:

[1]齐朋朋,徐展望,王卫国,等.中西医结合治疗腰椎椎管内脊膜瘤个案报道[J].山东中医杂志,2023,42(10):1122-1127.DOI:10.16295/j.cnki.0257-358x.2023.10.019.

基金信息:

国家自然科学基金面上项目(编号:82174410); 山东省自然科学基金面上项目(编号:ZR2020KH01)

发布时间:

2023-10-05

出版时间:

2023-10-05

检 索 高级检索