推拿干预腰椎间盘突出症的免疫机制研究进展
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摘要
免疫学机制是腰椎间盘突出症(LDH)三大发病机制之一,虽然发现较晚,却是医学研究的热点和难点。推拿干预疗效确切、无不良反应,在一定条件下可取代部分药物治疗,所以推拿干预的免疫学机制对临床诊疗和推拿科研的意义逐渐增大。随着现代研究的不断深入,LDH的免疫学机制和推拿干预LDH的免疫学机制都取得了新进展,故笔者主要从这两个方面进行阐述并对相关文献进行综述,以期为临床和科研提供参考。
Immunological mechanism is one of the three major pathogenesis of lumbar disc herniation. Although it is discovered late, it is the hot spot and difficulty in medical research. The efficacy of tuina intervention is accurate, non-toxic side effects, which can replace some drug treatments under certain conditions, so the immunological mechanism of tuina intervention is of increasing significance for clinical diagnosis and treatment and scientific research of tuina. With the deepening of modern research, new progress has been made in the immunological mechanism of lumbar disc herniation and the immunological mechanism of tuina intervention in lumbar disc herniation. Therefore, the author mainly elaborates from these two aspects and reviews relevant literature in order to provide references for clinical and scientific research.
Immunological mechanism is one of the three major pathogenesis of lumbar disc herniation. Although it is discovered late, it is the hot spot and difficulty in medical research. The efficacy of tuina intervention is accurate, non-toxic side effects, which can replace some drug treatments under certain conditions, so the immunological mechanism of tuina intervention is of increasing significance for clinical diagnosis and treatment and scientific research of tuina. With the deepening of modern research, new progress has been made in the immunological mechanism of lumbar disc herniation and the immunological mechanism of tuina intervention in lumbar disc herniation. Therefore, the author mainly elaborates from these two aspects and reviews relevant literature in order to provide references for clinical and scientific research.
引文
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[3]林坚,陈水金,洪昆达,等.三步七法推拿治疗腰椎间盘突出症30例.福建中医药,2017,48(1):3-4
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[6]Sutovsky J,Benco M,Sutovska M,et al.Cytokine and chemokine profile changes in patients with lower segment lumbar degenerative spondylolisthesis.International Journal of Surgery,2017(43):163-170
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[9]Yang W,Yu X H,Wang C,et al.Interleukin-1βin intervertebral disk degeneration.Clinica Chimica Acta,2015,450:262-272
[10]Chen B,Yi L,Zhang Y Q,et al.IL-21 is positively associated with intervertebral disc degeneration by interaction with TNF-αthrough the JAK-STAT signaling pathway.Inflammation,2017,40(2):612
[11]Hamamoto H,Miyamoto H,Doita M,et al.Capability of nondegenerated and degenerated discs in producing inflammatory agents with or without macrophage interaction.Spine,2012,37(3):161-167
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[13]魏春,徐杰.腰椎间盘突出症患者外周血白细胞介素-1Β、前列腺素E2及基质金属蛋白酶-3水平变化.新乡医学院学报,2017,34(1):76-78
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[15]赵才勇,何东,刘淼,等.腰椎间盘表观弥散系数与肿瘤坏死因子-Α、白细胞介素-6的相关性研究.功能与分子医学影像学杂志:电子版,2016,5(3):34-37
[16]王飞.血清细胞因子与腰椎间盘突出疼痛的关系研究.中国医药指南,2016,14(2):67
[17]刘路路,郭伟,卫杰,等.腰椎间盘突出症患者血常规变化特征及意义.山东医药,2016,56(25):87-89
[18]曹涌,姚羽,张烽.腰椎间盘突出症与Th细胞、NK细胞的相关性研究.中国脊柱脊髓杂志,2013,23(10):912-915
[19]张海平,张烽,姚羽.腰椎间盘突出髓核的自身免疫性.中国组织工程研究,2012,16(48):8931-8937
[20]Spiliopoulou I,Korovessis P,Konstantinou D,et al.IgG and IgMconcentration in the prolapsed human intervertebral disc and sciatica etiology.Spine,1994,19(12):1320-1323
[21]Akyol S,Hanc?M.TH1 and TH2 cytokines production and NK cell level assessment in peripheral blood of patients with DDH.Indian Journal of Surgery,2013,75(4):294-297
[22]余迪霞,吴建贤,翟志敏,等.腰椎间盘突出症患者外周血T淋巴细胞亚群水平变化及其意义.安徽医学,2013,34(5):537-542
[23]Tian P,Li Z J,Fu X,et al.Role of interleukin-17 in chondrocytes of herniated intervertebral lumbar discs.Experimental&Therapeutic Medicine,2015,10(1):81-87
[24]Cheng L,Fan W,Liu B,et al.Th17 lymphocyte levels are higher in patients with ruptured than non-ruptured lumbar discs,and are correlated with pain intensity.Injury-international Journal of the Care of the Injured,2013,44(12):1805-1810
[25]王葵光,胡有谷.腰椎间盘突出症的自身免疫状态.中华骨科杂志,1994,14(5):258-267
[26]林志刚,蒋诗超,程艳彬,等.探讨《黄帝内经》“筋骨”理论对中医推拿的指导意义.中华中医药杂志,2016,31(7):2491-2493
[27]程艳彬,房敏,王广东,等.以“筋骨失衡,以筋为先”探讨脊柱退化性疾病的推拿治疗.中华中医药杂志,2015,30(10):3470-3473
[28]刘胜.王金贵“通脉松筋易骨”法结合“辨证分期疗法”治疗腰椎间盘突出症思路分析.湖北中医杂志,2013,35(10):35-36
[29]刘德华,张仕年,万兴,等.疏经通督推拿法治疗腰椎间盘突出症30例临床研究.江苏中医药,2013,45(8):51-52
[30]郑兆俭,周倩,陈志瑞,等.从阴引阳法推拿治疗腰椎间盘突出症150例疗效观察.浙江中医药大学学报,2012,36(7):815-817
[31]Crawford C,Boyd C,Paat C F,et al.The impact of massage therapy on function in pain populations:a systematic review and Metaanalysis of randomized controlled trials:part I,patients experiencing pain in the general population.Pain Medicine the Official Journal of the American Academy of Pain Medicine,2016,17(7):1353-1375
[32]朱秀林,朱明,何光远.腰椎间盘突出症针灸推拿治疗进展.中医药临床杂志,2016,28(3):436-438
[33]周楠,房敏,朱清广,等.推拿手法治疗腰椎间盘突出症腰背伸肌群生物力学特性评价研究.中华中医药杂志,2012,27(3):562-566
[34]单衍丽,王道全,王进,等.拔伸斜扳三步推拿法对腰椎间盘突出症椎间盘与神经根比邻关系影响的Mri临床研究.新中医,2014,46(4):172-174
[35]Yang X,Qin Z,Hao X,et al.Spontaneous regression of herniated lumbar discs:Report of one illustrative case and review of the literature.Clinical Neurology&Neurosurgery,2016,143:86
[36]谭丽双,胡晓丽,丁晓伟.推拿疗法结合悬吊运动治疗腰椎间盘突出症临床观察.辽宁中医药大学学报,2017,19(12):149-152
[37]崔瑾,向开维,梁永瑛.头针及推拿治疗腰椎间盘突出症及其对自身免疫水平的影响.中国针灸,2004,24(7):445-448
[38]李华南,王金贵,孙庆,等.整复手法治疗腰椎间盘突出症最佳应用时机的多中心随机对照研究.中医杂志,2013,54(13):1122-1126
[39]张明顺,关斌辉,范宏元,等.腰椎间盘突出症推拿治疗前后血清蛋白质组学分析.中国组织工程研究,2017,21(4):569-573
[40]李静.推拿对腰椎间盘突出症患者机体免疫功能的影响.山东中医药大学学报,2010,34(4):335-336
[41]Major B,Rattazzi L,Brod S,et al.Massage-like stroking boosts the immune system in mice.Sci Rep,2015,5(10913):1-13
[42]Sun Z,Zhang M,Zhao X H,et al.Immune cascades in human intervertebral disc:The pros and cons.Int J Clin Exp Pathol,2013,6(6):1009-1014
[43]王琨,王锋,吴小涛,等.基质细胞衍生因子-1在人正常和退变椎间盘中的表达、分布及意义.中国脊柱脊髓杂志,2013,23(10):916-923
[44]Zhong M,Liu J T,Jiang H,et al.Incidence of spontaneous resorption of lumbar disc herniation:A Meta-analysis.Pain Physician,2017,20(1):E45-E52
[2]Driscoll T,Jacklyn G,Orchard J,et al.The global burden of occupationally related low back pain:Estimates from the Global Burden of Disease 2010 Study.Annals of the Rheumatic Diseases,2014,73(6):975-981
[3]林坚,陈水金,洪昆达,等.三步七法推拿治疗腰椎间盘突出症30例.福建中医药,2017,48(1):3-4
[4]李华南,吴秋君,马永利,等.脏腑推拿干预腰椎间盘突出症合并焦虑状态的临床研究.中华中医药杂志,2019,34(4):1803-1806
[5]Hou S X,Tang J G,Chen H S,et al.Chronic inflammation and compression of the dorsal root contribute to sciatica induced by the intervertebral disc herniation in rats.Pain,2003,105(1-2):255-264
[6]Sutovsky J,Benco M,Sutovska M,et al.Cytokine and chemokine profile changes in patients with lower segment lumbar degenerative spondylolisthesis.International Journal of Surgery,2017(43):163-170
[7]董锡亮,赵宏斌,杨燕琼,等.肿瘤坏死因子Α和白介素1Β在突出椎间盘组织中的表达及意义.中国全科医学,2013,16(36):4276-4278
[8]Johnson Z I,Schoepflin Z R,Choi H,et al.Disc in flames:Roles of TNF-αand IL-1βin intervertebral disc degeneration.European Cells&Materials,2015,30:104
[9]Yang W,Yu X H,Wang C,et al.Interleukin-1βin intervertebral disk degeneration.Clinica Chimica Acta,2015,450:262-272
[10]Chen B,Yi L,Zhang Y Q,et al.IL-21 is positively associated with intervertebral disc degeneration by interaction with TNF-αthrough the JAK-STAT signaling pathway.Inflammation,2017,40(2):612
[11]Hamamoto H,Miyamoto H,Doita M,et al.Capability of nondegenerated and degenerated discs in producing inflammatory agents with or without macrophage interaction.Spine,2012,37(3):161-167
[12]林磊,李般若,王青平,等.腰椎间盘突出物中IL-8、IL-10表达与神经根性疼痛相关性分析.临床军医杂志,2017,45(5):514-516
[13]魏春,徐杰.腰椎间盘突出症患者外周血白细胞介素-1Β、前列腺素E2及基质金属蛋白酶-3水平变化.新乡医学院学报,2017,34(1):76-78
[14]苏世先,刘前前,江美林.脑脊液及血清疼痛物质相关指标与腰椎间盘突出的关系研究.临床和实验医学杂志,2016,15(3):232-234
[15]赵才勇,何东,刘淼,等.腰椎间盘表观弥散系数与肿瘤坏死因子-Α、白细胞介素-6的相关性研究.功能与分子医学影像学杂志:电子版,2016,5(3):34-37
[16]王飞.血清细胞因子与腰椎间盘突出疼痛的关系研究.中国医药指南,2016,14(2):67
[17]刘路路,郭伟,卫杰,等.腰椎间盘突出症患者血常规变化特征及意义.山东医药,2016,56(25):87-89
[18]曹涌,姚羽,张烽.腰椎间盘突出症与Th细胞、NK细胞的相关性研究.中国脊柱脊髓杂志,2013,23(10):912-915
[19]张海平,张烽,姚羽.腰椎间盘突出髓核的自身免疫性.中国组织工程研究,2012,16(48):8931-8937
[20]Spiliopoulou I,Korovessis P,Konstantinou D,et al.IgG and IgMconcentration in the prolapsed human intervertebral disc and sciatica etiology.Spine,1994,19(12):1320-1323
[21]Akyol S,Hanc?M.TH1 and TH2 cytokines production and NK cell level assessment in peripheral blood of patients with DDH.Indian Journal of Surgery,2013,75(4):294-297
[22]余迪霞,吴建贤,翟志敏,等.腰椎间盘突出症患者外周血T淋巴细胞亚群水平变化及其意义.安徽医学,2013,34(5):537-542
[23]Tian P,Li Z J,Fu X,et al.Role of interleukin-17 in chondrocytes of herniated intervertebral lumbar discs.Experimental&Therapeutic Medicine,2015,10(1):81-87
[24]Cheng L,Fan W,Liu B,et al.Th17 lymphocyte levels are higher in patients with ruptured than non-ruptured lumbar discs,and are correlated with pain intensity.Injury-international Journal of the Care of the Injured,2013,44(12):1805-1810
[25]王葵光,胡有谷.腰椎间盘突出症的自身免疫状态.中华骨科杂志,1994,14(5):258-267
[26]林志刚,蒋诗超,程艳彬,等.探讨《黄帝内经》“筋骨”理论对中医推拿的指导意义.中华中医药杂志,2016,31(7):2491-2493
[27]程艳彬,房敏,王广东,等.以“筋骨失衡,以筋为先”探讨脊柱退化性疾病的推拿治疗.中华中医药杂志,2015,30(10):3470-3473
[28]刘胜.王金贵“通脉松筋易骨”法结合“辨证分期疗法”治疗腰椎间盘突出症思路分析.湖北中医杂志,2013,35(10):35-36
[29]刘德华,张仕年,万兴,等.疏经通督推拿法治疗腰椎间盘突出症30例临床研究.江苏中医药,2013,45(8):51-52
[30]郑兆俭,周倩,陈志瑞,等.从阴引阳法推拿治疗腰椎间盘突出症150例疗效观察.浙江中医药大学学报,2012,36(7):815-817
[31]Crawford C,Boyd C,Paat C F,et al.The impact of massage therapy on function in pain populations:a systematic review and Metaanalysis of randomized controlled trials:part I,patients experiencing pain in the general population.Pain Medicine the Official Journal of the American Academy of Pain Medicine,2016,17(7):1353-1375
[32]朱秀林,朱明,何光远.腰椎间盘突出症针灸推拿治疗进展.中医药临床杂志,2016,28(3):436-438
[33]周楠,房敏,朱清广,等.推拿手法治疗腰椎间盘突出症腰背伸肌群生物力学特性评价研究.中华中医药杂志,2012,27(3):562-566
[34]单衍丽,王道全,王进,等.拔伸斜扳三步推拿法对腰椎间盘突出症椎间盘与神经根比邻关系影响的Mri临床研究.新中医,2014,46(4):172-174
[35]Yang X,Qin Z,Hao X,et al.Spontaneous regression of herniated lumbar discs:Report of one illustrative case and review of the literature.Clinical Neurology&Neurosurgery,2016,143:86
[36]谭丽双,胡晓丽,丁晓伟.推拿疗法结合悬吊运动治疗腰椎间盘突出症临床观察.辽宁中医药大学学报,2017,19(12):149-152
[37]崔瑾,向开维,梁永瑛.头针及推拿治疗腰椎间盘突出症及其对自身免疫水平的影响.中国针灸,2004,24(7):445-448
[38]李华南,王金贵,孙庆,等.整复手法治疗腰椎间盘突出症最佳应用时机的多中心随机对照研究.中医杂志,2013,54(13):1122-1126
[39]张明顺,关斌辉,范宏元,等.腰椎间盘突出症推拿治疗前后血清蛋白质组学分析.中国组织工程研究,2017,21(4):569-573
[40]李静.推拿对腰椎间盘突出症患者机体免疫功能的影响.山东中医药大学学报,2010,34(4):335-336
[41]Major B,Rattazzi L,Brod S,et al.Massage-like stroking boosts the immune system in mice.Sci Rep,2015,5(10913):1-13
[42]Sun Z,Zhang M,Zhao X H,et al.Immune cascades in human intervertebral disc:The pros and cons.Int J Clin Exp Pathol,2013,6(6):1009-1014
[43]王琨,王锋,吴小涛,等.基质细胞衍生因子-1在人正常和退变椎间盘中的表达、分布及意义.中国脊柱脊髓杂志,2013,23(10):916-923
[44]Zhong M,Liu J T,Jiang H,et al.Incidence of spontaneous resorption of lumbar disc herniation:A Meta-analysis.Pain Physician,2017,20(1):E45-E52