The sciatic nerve is the main nerve trunk supplying the lower limbs. Sciatica refers to pain in the path of the sciatic nerve and its distribution area (buttocks, back of the thigh, posterolateral side of the calf, and outer side of the foot).
Examination: ESR may increase, anti-"O" rheumatoid factor may have abnormalities, spine When necessary, spinal canal angiography can be used to confirm the diagnosis if necessary.
This disease is divided into two categories: primary and secondary.
The cause of primary sciatica (sciatic neuritis) is unknown and is relatively rare clinically.
Secondary sciatica is caused by the compression or stimulation of adjacent lesions, and is divided into radicular and dry sciatica, which respectively refer to whether the compressed part is in the nerve root or the nerve trunk. Root type is more common, and the most common cause is intervertebral disc herniation. Other causes include intraspinal tumors, vertebral body metastasis, lumbar tuberculosis, lumbar spinal stenosis, etc. Dry type can be caused by sacroiliitis, pelvic tumors, pregnancy uterine compression, hip joint inflammation, hip trauma, diabetes, etc.
TCM-related diseases: Bi syndrome.
Most of the causes of sciatica are caused by the invasion of the sciatic nerve by nearby structural lesions along the way of the sciatic nerve. Common ones include lumbar disc herniation caused by trauma, uterine compression due to enlargement in late pregnancy, uterine and adnexitis, improper buttock muscle injection site, and chemical damage to the nerve caused by injecting irritating drugs into the sciatic nerve trunk. A small number of patients can be caused by tumors in the spinal canal, trauma, tuberculosis, inflammation, and tumors of the spine, sacroiliac joints, and hip joints. The above is called secondary sciatica. There are also a few patients who cannot find a clear cause. They often develop the disease after catching cold or living in a humid environment for a long time, which is called primary sciatica or sciatic neuritis.
Main symptoms
Sciatic neuropathy is more common in middle-aged and elderly men, and is more common on one side. The onset of the disease is sudden, with lower back pain and waist stiffness first. Or a few weeks before the onset, you may have brief pain in your lower limbs when walking and exercising. Later, it gradually worsened and developed into severe pain. The pain starts from the waist, buttocks or hips and spreads downward along the back of the thigh, popliteal fossa, outside of the calf and instep. On top of the persistent pain, there are bursts of intensified burning or needle-like pain. Worse at night.
Diagnosis
When the onset of the disease occurs, the patient first feels pain in the lower back and stiffness in the waist. Later, it gradually worsens and develops into severe pain. The pain starts from the waist, buttocks, and hips and goes downwards. The pain spreads to the back of the thigh, popliteal fossa, outer calf and instep, and sometimes there is burning or needle-like pain. The patient likes to lie on the healthy side, with the hip and knee of the lower limb on the diseased side slightly flexed, and the center of gravity shifted to the healthy side. Over time, the muscles in the back of the thighs and calves become weak and weak, which can lead to mild muscle atrophy.
Treatment
If this disease occurs, you should go to the hospital to find out the cause and actively treat the primary disease that causes nerve compression or irritation (such as lumbar disc herniation).
Antipyretic analgesics, such as ibuprofen, diclofenac, etc., can be used for symptomatic treatment.
Auxiliary treatment
When pain attacks, you can apply ice to the affected area for 30-60 minutes, several times a day for two to three days, and then apply a hot water bottle to the affected area at the same intervals. Over-the-counter pain relievers such as indomethacin can be taken.
Use a hot towel or cloth-wrapped hot salt to compress your waist or buttocks every day before going to bed. The temperature should not be too high and should be comfortable.
Dietary care
You can often eat the following foods:
1. 25 grams of Sichuan Duan, 30 grams of Dupu, boiled with 1 pig tail. Season to taste.
2. Boil 15 grams of mulberry and 1 egg until cooked.
3. Stew 6 grams of old mulberry branches with a 500-gram hen and drink the soup.
Notes
When resting on a hard bed, you can insist on doing bed gymnastics.
It is necessary to combine work and rest, have a regular life, and participate in various sports activities appropriately.
Pay attention to protect your waist and affected limbs after exercise. Change your underwear in time after sweating to prevent wet clothes from drying on your body. It is not advisable to take a shower immediately after sweating and wait until you have sweated off before washing. To prevent cold and wind.
During the acute pain period, do not pick up objects weighing more than 10 pounds (1 pound = 0.9072 pounds) and do not use your legs, arms, and back to lift heavy objects. You can push but do not pull heavy objects.
In order to avoid stretching the sciatic nerve and reduce pain, patients often adopt some special pain-relieving postures, such as sleeping on the healthy side and slightly flexing the hip and knee of the lower limb on the diseased side. When sitting, lean on your healthy hip. When standing, the body's center of gravity shifts to the healthy side. When bending to pick up things, the affected limb's knee flexes. Over time, scoliosis occurs, mostly toward the diseased side. Any test that stretches the sciatic nerve can induce or worsen pain. There may be obvious tenderness at various points along the sciatic nerve pathway: such as next to the lumbar vertebrae, equivalent to the ring jump, Weizhong point, below the fibular head on the outside of the ankle joint, and in the center of the sole of the foot. In addition to pain, there are pinpricks and numbness on the outer surface of the calf and the instep. The muscles in the back of the thigh and calf are soft and weak, and mild muscle atrophy may occur over time.
For secondary sciatica, you must first find out the cause, whether there is a history of tuberculosis, trauma, tumors, etc., and go to the hospital for a comprehensive body examination. Women should have a gynecological examination. to find the primary lesion. X-rays are of great significance in identifying the cause of the disease. Lumbar puncture and angiography may be considered for a small number of patients when necessary. The treatment of secondary sciatica starts with removing the cause, such as anti-inflammation and surgical removal of tumors. In the acute stage, you should rest on a hard bed. If the pain is severe, give analgesics and appropriate sedatives. In the early stage of sciatic neuritis, anti-inflammatory analgesics can be given, such as Pyroxicam, indomethacin, etc. Adrenocortical hormones can also be used short-term. Orally or intramuscularly inject B vitamins, keep the affected lower limb warm, and cooperate with acupuncture, physical therapy, body therapy and massage. The pain of sciatic neuritis is most severe within the first 5 to 10 days of the disease, and then relieves and gradually returns to normal after 6 to 8 weeks.
Reference materials:
What is sciatica?
Sciatica is not a disease, but a common clinical symptom. Many diseases can cause sciatica.
What we usually call sciatica refers to pain that occurs along the path of the sciatic nerve and its distribution area. The distribution area of ??the sciatic nerve includes the buttocks, back of the thigh, posterolateral calf, and lateral foot. The pain is mostly obvious at night and can be paroxysmal or persistent. The pain often radiates from the buttocks to the back of the thigh, the outside of the calf and the outside of the instep. Standing and coughing can make the pain worse. The pain can be relieved by bending your knees and hips or lying on your side to rest. The straight leg raise test may be positive.
How many types of sciatica are there?
Sciatica can be divided into two types: primary and secondary.
Primary sciatica is mostly caused by inflammation of the sciatic nerve, and is more common on one side. The main causes are cold and damp and infections from other inflammatory lesions such as tonsillitis, prostatitis, gingivitis, and sinusitis, and some are accompanied by myositis and myofibrotitis.
Secondary sciatica is caused by mechanical compression or adhesion caused by adjacent tissue lesions next to the sciatic nerve pathway. It can occur unilaterally or bilaterally; depending on the area of ??pressure, radiating string pain may occur throughout the entire length, or sciatica may occur at a certain stage.
What are the causes of sciatica?
The sciatic nerve is composed of the anterior branches of the lumbar 4-5 nerves and the sacral 1-2 nerves. After emerging from the intervertebral foramen, it runs along the On the back of the pelvis, it exits the pelvis at the lower part of the piriformis muscle and enters the buttocks, between the greater trochanter of the femur and the ischial tubercle, and goes down along the back of the thigh. It is divided into the tibial nerve and the common peroneal nerve at the upper corner of the fossa. The sciatic nerve is the largest nerve in the human body and is easily damaged. Stimulation and compression of the parts above its branches can cause sciatica due to various reasons. Common causes include sciatic neuritis, intervertebral neuritis, sacroiliitis, lumbar disc herniation, lumbar spinal stenosis, spondylolisthesis, spina bifida, lumbar tuberculosis, cauda equina, piriformis injury syndrome, and lumbar sacralization. Or lumbar sacral vertebrae, etc. It should be noted that some gynecological diseases such as adnexitis, uterine fibroids, and late pregnancy can also cause sciatica. Improper injection into the buttocks can cause damage to the sciatic nerve.
How to distinguish dry sciatica from radicular sciatica?
Different pain symptoms can occur depending on the affected part of the sciatic nerve, which are clinically called dry sciatica and radicular sciatica respectively.
Dry sciatica refers to the pain caused by the stimulation or compression of the sciatic nerve trunk (the sciatic nerve segment outside the intervertebral foramen) by various lesions. It is characterized by radiating pain along the sciatic nerve trunk in the affected lower limb, especially It is more common at the distal end of the sciatic nerve. There are tender points below the buttocks along the direction of the sciatic nerve. The pain is not obvious when coughing or other actions that increase abdominal pressure.
Radicular sciatica refers to the pain caused by the lumbosacral nerve root being stimulated or compressed by various lesions inside or outside the spinal canal. It is characterized by obvious channeling pain, mainly in the proximal end of the sciatic nerve, and in the lumbar spine. There are obvious tender points next to the spine and radiate along the entire length of the sciatic nerve to the lower limbs. Coughing and other actions that increase abdominal pressure can aggravate the pain.
How do patients with sciatica exercise?
Patients with sciatica often reduce activities because of fear of pain, which is not conducive to the treatment of the disease. Patients should follow the principle of “exercising moderately within their capabilities” to exercise, especially the exercise of the affected lower limbs. Slow walking, jogging, and ball games can all be done, and special gymnastics are more beneficial.
Lying gymnastics: The patient lies on his back, alternately bending the legs, then taking turns to straighten the legs, and then alternately raising the legs upwards. At the beginning, the lifting angle of the affected lower limb can be smaller than that of the healthy side. After continuous exercise, the lifting angle of the affected lower limb can be gradually increased.
Sitting gymnastics: The patient sits on the edge of the bed or a chair, with his legs hanging on the ground, heels on the ground, toes raised, and hands flat on his legs. After sitting down, slowly bend forward and push your hands towards your feet. When you first practice, your hands may only be able to reach your calves, but after consistent exercise, you can reach the instep and toes.
Standing gymnastics: The patient stands with his hands on his hips. First, he takes turns to lift his straight legs forward, and then stands with his legs spread apart as much as possible. He takes turns to bend the knee joints to make the body bow and squat. At this time, the lower limbs without flexing the knee joint can be traction and stretched.
What is sciatica? What does it have to do with lumbar disc herniation?
The sciatic nerve is composed of the 4th and 5th lumbar nerves and the anterior branches of the 1st, 2nd and 3rd sacral nerves. After exiting the spinal canal from the intervertebral foramen, it runs on the back of the pelvic cavity, exits the buttocks at the lower part of the piriformis muscle, and distributes along the back of the thigh, the posterolateral side of the calf, and the lateral side of the instep. Sciatica usually refers to radiating pain along the course and distribution of the sciatic nerve due to irritation and compression for some reason. The main manifestation is paroxysmal or persistent channeling pain, which is especially obvious at night. The pain mostly radiates from the buttocks to the back of the thigh, the posterolateral side of the calf and the lateral side of the dorsum of the foot. The pain worsens whenever coughing, sneezing or other actions that easily increase abdominal pressure occur. The pain can be relieved by bending the knees and hips or lying on the healthy side to rest, and the straight leg raising test is positive. Sciatica is a clinical symptom, not an independent disease.
There are many causes of sciatica, including primary and secondary. Pain caused primarily by inflammation of the sciatic nerve is mostly unilateral and can often occur simultaneously with myofibrositis. Secondary lesions of adjacent tissues along the course of the sciatic nerve, resulting in pain caused by mechanical stimulation, compression or adhesion, such as lumbar disc herniation, lumbar spinal stenosis, ligamentum flavum hypertrophy, spondylolisthesis, lumbar sacralization or sacral lumbarization , spina bifida, lumbar tuberculosis, cauda equina neuroma, piriformis syndrome, stimulation of buttock injection drugs, etc. can all cause sciatica.
According to the location where the sciatic nerve is stimulated or compressed, it can be divided into radicular and dry sciatica. Radicular sciatica, the affected part is in the root canal or spinal canal, patients often feel lumbosacral and leg channeling pain, there are obvious tenderness points next to the lumbar spinous process, and radiate along the sciatic nerve to the lower limbs, coughing, sneezing, etc. increase the abdominal pain. Pressure movements can aggravate the pain and produce corresponding sensory disturbances and reflex changes. There were abnormal changes in cerebrospinal fluid examination. In dry sciatica, the affected parts are outside the intervertebral foramen, most commonly at the pelvic outlet. Patients often feel radiating pain along a certain section of the sciatic nerve in the affected limb, often with tender points below the buttocks along the direction of the sciatic nerve. There is no obvious tenderness next to the spinous process. The pain is not obvious when coughing, sneezing and other actions that increase abdominal pressure. Cerebrospinal fluid examination No abnormal changes.
The relationship between sciatica and lumbar disc herniation is extremely close. Lumbar disc herniation can be the cause of sciatica, while sciatica is only a main symptom of lumbar disc herniation. The two are cause and effect of each other. Therefore, clinically, a considerable number of patients with sciatica are diagnosed with lumbar disc herniation; and a considerable number of patients with lumbar disc herniation are diagnosed with sciatica. Sufficient attention should be paid to confusing the two.
Sciatica
(sciatica)
Refers to sciatic nerve disease, which occurs along the path of the sciatic nerve, namely the waist, buttocks, posterior thigh, posterolateral calf and lateral foot Pain symptom cluster.
[Cause]
The sciatic nerve is composed of nerve roots from lumbar 5 to sacral 3. According to the location of the lesion, it is divided into two types: radicular sciatica and dry sciatica. In the former, radicular sciatica lesions are mostly located in the spinal canal. The most common cause is lumbar disc herniation, followed by intraspinal tumors, lumbar tuberculosis, lumbosacral radiculitis, etc. . The lesions of dry sciatica are mainly on the course of the sciatic nerve outside the spinal canal. The causes include sacroarthritis, pelvic tumors, pregnancy uterine compression, buttock trauma, piriformis syndrome, improper gluteal muscle injection, and diabetes.
[Clinical manifestations]
This disease is more common in young and middle-aged men, and is more common on one side. The degree and duration of pain are often related to the cause and onset of the disease.
1. Radicular sciatica
The onset varies with the cause. The most common lumbar disc herniation often occurs acutely or subacutely due to stress, bending, or strenuous activities. A few cases have a chronic onset. The pain often radiates from the waist to one hip, the back of the thigh, the popliteal fossa, the outside of the calf and the foot. It is a burning or knife-like pain. The pain can be aggravated when coughing and exerting force, and is even worse at night. In order to avoid nerve stretch and compression, patients often adopt special pain-relieving postures, such as lying on the healthy side when sleeping, flexing the hips and knees, and focusing on the healthy side when standing. Over time, scoliosis will occur, often bending toward the healthy side. Side, sit with your buttocks tilted toward the healthy side to reduce pressure on the nerve roots. Pulling the sciatic nerve can induce pain or worsen the pain, such as Kernig's sign is positive (the patient lies on his back, first bend the hip and knee to form a right angle, and then lift the calf. Due to flexor muscle spasm, knee extension is limited to less than 130 degrees and there is pain and resistance); the straight leg raising test (Lasegue sign) is positive (the patient is lying on his back, the lower limb is extended, and the affected limb cannot be raised up to 70 degrees, causing leg pain). There may be tenderness along the sciatic nerve pathway, such as the waist points, hip points, national points, ankle points, and plantar points. There is often numbness and decreased sensation on the outer side of the calf and the dorsum of the affected limb. The gluteal muscle tension is relaxed, and the strength of the thumb extensor and thumb flexor muscles is weakened. Achilles tendon reflexes weaken or disappear.
2. Dry sciatica:
The onset of symptoms also varies with the cause. If it is caused by cold or trauma, the onset of symptoms is often acute. The pain often radiates from the buttocks to the back of the thigh, the posterolateral side of the calf, and the lateral side of the foot. The pain worsens when walking, moving, and pulling the sciatic nerve.
The tenderness point is below the buttock point, Lasegue's sign is positive but Kernig's sign is often negative. Scoliosis usually bends toward the affected side to reduce the traction on the sciatic nerve trunk.
[Diagnosis and Differential Diagnosis]
It is not difficult to diagnose based on the location and radiation direction of pain, factors that aggravate pain, pain relief posture, traction pain and tender points, but it is very difficult to determine the cause. important.
1. Lumbar disc herniation:
Patients often have a long-term history of recurring low back pain or heavy physical labor, and often develop acute symptoms after a waist injury or bending work. In addition to the typical symptoms and signs of radicular sciatica, there are also lumbar muscle spasms, limited lumbar spine movement and loss of forward flexion, and there may be obvious tenderness and radiating pain in the intervertebral space at the site of intervertebral disc herniation. X-rays may show narrowing of the affected vertebrae space, and CT examination can confirm the diagnosis.
2. Cauda equina tumor:
The onset is slow and gradually worsens. The disease often starts with unilateral radicular sciatica and gradually develops into bilateral pain. The pain worsened significantly at night and the course of the disease progressively worsened. Sphincter dysfunction and sellar area hypoesthesia also occur. Lumbar puncture shows subarachnoid obstruction and cerebrospinal fluid protein quantification is significantly increased, and even Froin's sign (cerebrospinal fluid is yellow and solidifies on its own after placement), and spinal cord iodine angiography or MRI can confirm the diagnosis.
3. Lumbar spinal stenosis:
It is more common in middle-aged men. In the early stage, there is often "intermittent claudication". The lower limb pain worsens after walking, but the symptoms disappear after bending down to walk or resting. reduce or disappear. When the nerve root or cauda equina is severely compressed, symptoms and signs of sciatica on one or both sides may also appear, and the course of the disease becomes progressively worse, and treatments such as bed rest or traction are ineffective. Lumbar and sacral X-rays or CT can confirm the diagnosis.
4. Lumbosacral radiculitis:
It occurs due to factors such as infection, poisoning, nutritional and metabolic disorders, strain, cold, etc. Generally, the onset is rapid, and the scope of damage often exceeds the area controlled by the sciatic nerve, manifesting as weakness, pain, and mild muscle atrophy in the entire lower limbs. In addition to the Achilles tendon reflex, the knee tendon reflex is often weakened or disappeared.
In addition, lumbar tuberculosis, vertebral body metastasis cancer, etc. need to be considered. When dry sciatica occurs, attention should be paid to whether there is a history of cold or infection, as well as lesions in the sacroiliac joints, hip joints, pelvis and buttocks. If necessary, in addition to X-rays of the lumbosacral spine, X-rays of the sacroiliac joints can also be taken Take X-rays, anal finger, gynecological examination, and B-ultrasound of pelvic organs to determine the cause.
[Treatment]
1. Bed rest:
Especially in the early stage of intervertebral disc herniation, rest on a hard bed for 3-4 weeks, and some patients' symptoms will relieve themselves.
2. Drug treatment:
Analgesics, B vitamins, and short-term oral corticosteroids can facilitate recovery.
3. Physiotherapy:
In the acute stage, ultrashort wave therapy, erythema-dense ultraviolet irradiation and other treatments can be used. Short-wave therapy and direct current iodine ion introduction can be used in the chronic stage.
Sciatica
(1)
Syndrome differentiation: cold-damp obstruction.
The treatment method is to dispel cold and remove dampness, relieve numbness and relieve pain.
The prescription is called Juanbi Analgesic Decoction.
It consists of 10 grams of Radix Aconitiformis, 10 grams of Radix Aconi, 6 grams of Asarum, 15 grams of Achyranthes Root, 12 grams of Atractylodes, 12 grams of Fangji, 10 grams of Frankincense, 10 grams of Myrrh, Ligusticum Chuanxiong. 15 grams, 12 grams of cinnamon twig, and 6 grams of licorice.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: Zhou Tianhan Fang.
(2)
Syndrome differentiation: wind, cold and dampness are stagnant and the meridians are blocked by blood stasis.
The treatment method is to dispel wind and dampness, dispel cold and relieve pain.
The famous soap only contains ginger soup.
It consists of 30 grams of Acanthus sinensis, 9 grams of Duhuo, 9 grams of Aconite, 6 grams of cinnamon, 15 grams of Turmeric, 15 grams of Atractylodes, 30 grams of Coix, and 9 grams of Fangji.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: Lu Guangzhenfang.
(3)
Syndrome differentiation: wind, cold, and dampness block the meridians, causing qi and blood to not flow smoothly, and the muscles and veins to lose nourishment.
The treatment method is to relax the muscles and activate the collaterals, promote blood circulation and relieve pain.
The prescription name is Shujin Huoluo Yin.
Composition: 15 grams of Duhuo, 12 grams of Lingxian, 10 grams of Millennium Jian, 12 grams of Eucommia ulmoides, 15 grams of Achyranthes bidentata, 12 grams of Dipsacus, 10 grams of papaya, 30 grams of Millet Spatholobus, and 9 grams of safflower. , Angelica sinensis 12 grams, Chuanxiong 9 grams, Dilong 10 grams.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: Zeng Chongfang.
(4)
Syndrome differentiation: wind-cold dampness invades the skin and flows into the meridians. The dampness condenses into phlegm.
The treatment method is to dispel wind and remove dampness, activate blood circulation and remove blood stasis, clear away phlegm and unblock meridians.
The prescription is called Tongjing Zhitong Decoction.
The composition is 10 grams of Nanxing, 10 grams of Angelica dahurica, 10 grams of Phellodendron, 10 grams of Ligusticum chuanxiong, 10 grams of safflower, 10 grams of Qiang Huo, 25 grams of Clematis, 15 grams of Atractylodes, 15 grams of peach kernel, and 15 grams of Fangji. Grams, 15 grams of Yuanhu, 15 grams of Duhuo, 6 grams of Gentian grass, 12 grams of Shenqu, and 12 grams of Guizhi.
Usage: Decoction in water, 1 dose per day, 2 times a day, 3 days as a course of treatment.
Source: Li Zhifangfang.
(5)
Differentiation of cold and dampness in the collaterals.
The treatment method is to unblock yang and relieve numbness, expel dampness and cold.
The prescription is called Qibi Decoction.
It consists of 6-12 grams of asarum, 6-12 grams of Radix Aconi Radix, 6-12 grams of Radix Sichuan Radix, 15 grams of Ephedra, 20 grams of Achyranthes bidentata, 20 grams of papaya, and 10 grams of frankincense.
Usage: Decoction in water, 1 dose a day, 2 times a day. The dosage of Asarum and Sichuan Radix Aconi should be started from a small amount and gradually increased.
Source: Li Shuwenfang.
(6)
Syndrome differentiation: wind and cold invasion, venation blockage.
The treatment method is to dispel wind and cold, activate blood circulation and unblock meridians.
The famous name is snake and scorpion soup.
Ingredients: 10 grams of Wu Shao Snake, 10 grams of Fried Earthworm, 10 grams of Bombyx mori, 10 grams of Guizhi, 10 grams of Ligusticum Chuanxiong, 10 grams of Licorice, 6 grams of whole scorpion, and 6 grams of prepared Sichuan Wu. 6 grams of Cao Wu and 4 grams of Centipede.
Usage: Decoct Sichuan and Aconite for half an hour to reduce toxicity, and then add other medicines. Take 300 ml of the medicinal solution, 1 dose per day.
Source: Wang Jianmin Fang.
(7)
The syndrome is Yang deficiency and weak Qi, cold and dampness blocks the meridians, and the movement of Qi and blood is unfavorable.
The treatment method is to warm yang and replenish qi, dispel cold and dampness, harmonize blood and unblock meridians.
The prescription name is Coix, Aconite Powder, Peony and Licorice flavored.
Ingredients: 70g coix seed, 25g aconite (fried first), 30g licorice, 20g red peony root, 30g astragalus, 20g dangshen, 15g angelica, 12g selaginella, 10 grams of Tongtong, 18 grams of Genchi, 10 grams of Sea Breeze Vine, 12 grams of Millet Spatholobus, 10 grams of frankincense, 10 grams of myrrh, and 10 grams of Achyranthes bidentata.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: Cheng Guangli Fang.
(8)
Syndrome differentiation of cold, heat and blood stasis.
The treatment method is to dispel cold and dampness, relax muscles and activate collaterals.
The recipe name is Sciatic Nerve No. 1 recipe with added flavor.
Composition: 60-120 grams of Sichuan Achyranthes, 9-12 grams of Phellodendron, 30-40 grams of raw Yiren, 10-12 grams of Chuanxiong, 12-18 grams of papaya, 4-6 grams of Asarum, 10 grams of Atractylodes. -15 grams, 10-15 grams of solani, 10-15 grams of woodworm, 30 grams of mulberry, 30 grams of epimedium, 30 grams of Spatholobus, 30 grams of Ambrosia, 15 grams of red peony root, 15 grams of white peony root, 15 grams of raw rehmannia and 15 grams of cooked rehmannia.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Origined from Song Xinjiafang.
(9)
Syndrome: Qi and blood deficiency, cold-dampness obstruction.
The treatment method is to replenish qi and activate blood circulation, relax muscles and relieve pain.
The prescription name is Sigu Wan.
Composition: 60 grams of Codonopsis pilosula, 60 grams of Angelica sinensis, 60 grams of papaya, 60 grams of Corydalis corydalis, 60 grams of licorice, 90 grams of Dipsacus bark, 30 grams of whole scorpion, 30 grams of Luoda, 30 grams of spikenard, and 20 grams of centipede. Strips, 2 hives.
Usage: Grind into powder and make honey into pills, take 6 grams each time, 3 times a day.
Source: Zhang Ci Gongfang.
(10)
Syndrome differentiation is caused by the invasion of cold and damp evils, and the flow of Qi and blood is not smooth.
The treatment method is to warm the meridians and unblock collaterals, dispel wind and cold.
The prescription is called Tongbi Decoction.
Composition: 20 grams of black snake, 10 grams of Corydalis, 10 grams of ginger, 25 grams of Spatholobus, 15 grams of achyranthes, 15 grams of salvia, 15 grams of angelica, 15 grams of white peony root, and 15 grams of licorice. , frankincense 7.5 grams, myrrh 7.5 grams.
Usage: Decoction in water, 1 dose per day, 2 times a day.
The source is Shi Zhengfang.
(11)
Differentiation of wind-cold-dampness syndrome blocks the meridians.
The treatment method is to remove dampness and cold, warm and unblock the meridians.
The recipe is called Xinfang Guizhi Decoction.
Composition: 30-60 grams of cassia twig, 15-30 grams of white peony root, 3-5 slices of ginger, 5-6 grams of licorice, 5-10 jujubes, 15-30 grams of astragalus, and 10 pieces of angelica. -15g, Sichuan Achyranthes 10-15g, Sichuan Achyranthes 10-15g.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: Liu Zhibin.
(12)
Differentiation of wind, cold and dampness evil, blocking the meridians.
The treatment method is to dispel cold and dampness, expel wind and dredge collaterals.
The prescription name is Danggui Huini Tang.
Composition: 15 grams of Angelica sinensis, 10 grams of tender cinnamon twigs, 10 grams of Chinese peony root, 3 grams of Asarum, 10 grams of Akebia, 12 grams of Sichuan Achyranthes, 10 grams of Xiang Duhuo, and 10 grams of Xuan Papaya. Grams, 3 grams of raw licorice, 10 grams of dried earthworm, 5 grams of whole scorpion, 3 centipedes, 10 grams of fangji, and 15 grams of cuttlefish.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: Zeng Shao Qiufang.
(13)
Differentiation of the evil of cold and dampness, internal transmission of meridians, qi and blood stasis, and obstruction of menstruation.
The treatment method is to dispel dampness and cold, warm the meridians, remove blood stasis and relieve pain.
The recipe is called Flavored Guiwu Soup.
It consists of 12 grams of cassia twig, 30 grams of white peony root, 30 grams of salvia miltiorrhiza, 9 grams of Sichuan black root and 9 grams of licorice root.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: I wish Han Chenfang.
(14)
Syndrome differentiation: cold coagulation and qi stagnation, blood stasis blocking the meridians.
The treatment method is to warm yang and dispel cold, remove blood stasis and unblock collaterals.
The prescription name is Jiamin Yanghe Tang.
Composition: 10 grams of ephedra, 20 grams of rehmannia glutinosa, 5 grams of osmanthus, 15 grams of white mustard seeds, 15 grams of atractylodes, 50 grams of antler cream, 25 grams of xuanhu, 15 grams of peach kernels, and 15 grams of red peony root. 15 grams of Poria cocos and 15 grams of raw licorice.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: Shang Ershou Fang.
(15)
Syndrome analysis shows that the muscles and veins are injured due to strain, the Qi and blood are not flowing, and the menstrual flow is blocked.
The treatment method is to relax muscles and activate collaterals, relieve pain and relieve pain.
The recipe is called Flavored Peony and Licorice Decoction.
It consists of 50 grams of raw white peony root, 50 grams of roasted licorice, 15 grams of Yuanhu, and 15 grams of poppy shell.
Usage: Decoction in water, 1 dose per day, 2 times a day.
Source: Chen Yumingfang.
Category Prescriptions
Sciatica refers to pain along the sciatic nerve pathway and its distribution area. Divided into two categories: primary and secondary. The main clinical symptoms are pain in the arms, the back of the thigh, the posterolateral side of the calf, and the outer side of the foot. The following three syndrome types are common.
Syndrome differentiation treatment
Main points: Jiaji point, Ashi point, Huantiao point on waist 2-5
1. Diagnosis of wind-cold-dampness paralysis
Diagnostic key points include cold pain in the waist and legs, walking up and down, inconvenience in flexion and extension, aggravated by rainy and cold weather, or accompanied by swelling of the lower limbs; thin white or greasy fur, floating, tight or heavy pulse.
Prescription Zhinbian, Yanglingquan, Mingmen
2. Blood stagnation
Diagnostic key points include a history of contusion in the waist, tingling in the waist and legs, refusal to press the painful area, and dissipated pain when pressed, severe pain at night, inability to tilt, difficulty turning sideways; dark purple tongue or swollen tongue Ecchymosis, stagnant pulse.
Prescription Yanglingquan, Geshu, Xuehai, Weizhong
3. Insufficient righteousness
Diagnostic key points include dull pain in waist and legs, which recurs repeatedly, especially when exerted, weak lower limbs, aversion to wind and cold, fond of rubbing and pressing, feeling tired and weak, dull complexion; pale tongue with few coatings, weak pulse Serious.
Prescription Yanglingquan, Weizhong, Zusanli, Sanyinjiao
Other therapies:
Auricular point sticking: sciatic nerve, buttocks, lumbosacral vertebrae, kidney, Tender points
Skin acupuncture: Tap on the lumbosacral area and prick the tender points for bleeding, plus cupping.