通讯作者: 孙绍裘, 54sunshaoqiu@163.com

DOI：10.12201/bmr.202603.00126

Clinical and Theoretical Considerations on the Treatment of Lumbar Disc Herniation under the Concept of Emphasizing Both Muscles and Bones

• 摘要：立足“筋骨并重”理论，围绕腰椎间盘突出症的临床实践，从名家视角梳理孙达武教授对本病病因病机及辨证规律的认识，提出“肝脾肾三脏相关、筋骨气血一体失养，湿瘀痰结于腰”的三层病机框架，强调“筋主病、骨主病、筋骨兼病”之分型与“急性激惹期—亚急性整固期—恢复稳固期”之分期相对应。在治法上构建“先松筋、后正骨、继以固本”的综合路径，以健腰养筋汤为核心方药体系，配合针刺、针刀与推拿整复，并辅以功法调摄，实现内外同治、动静相成。通过典型验案论证“筋骨同调、标本兼顾”在缓解症状和改善功能方面的临床优势，为腰椎间盘突出症的中医规范化诊治提供经验借鉴。

  关键词： 腰椎间盘突出症；筋骨并重；肝脾肾同调；名医经验；孙达武; ; ; ; 

   

  Abstract: Grounded in the traditional Chinese medical doctrine of “balancing muscle and bone,” this study articulates Professor Sun Dawu’s clinical reasoning and therapeutic framework for lumbar disc herniation. The pathomechanism is conceptualized as a three-tier structure: functional disequilibrium of the liver–spleen–kidney axis, global malnourishment and imbalance of the myofascial–osseous system, and the entrapment of dampness, phlegm and blood stasis in the lumbar region. On this basis, clinical patterns are further differentiated into muscle-predominant, bone-predominant and combined muscle–bone types, which are dynamically mapped onto an “acute irritative phase–subacute consolidation phase–recovery and stabilization phase” trajectory. Therapeutically, Professor Sun advocates an integrated sequence of “relaxing the muscles, realigning the bones and consolidating the root,” operationalized through a core prescription, Jianyao Yangjin Decoction, for tonifying the liver and kidney, strengthening muscle and bone and resolving dampness and stasis, in combination with acupuncture, needle-knife release and gentle spinal manipulation, supplemented by tailored therapeutic exercises and lifestyle adjustment. Clinical experience suggests that this muscle–bone co-regulation strategy not only alleviates pain and radicular symptoms but also enhances functional recovery and reduces recurrence, thereby offering a structured, reproducible model for the standardized traditional Chinese medicine management of lumbar disc herniation.

  Key words: lumbar disc herniation; “muscle–bone balance” theory; liver–spleen–kidney co-regulation; renowned TCM physician’s clinical experience; Sun Dawu

  提交时间：2026-03-31

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
• html

• 图表

• 王露, 徐王兵, 钟发明, 刘敏, 徐睿, 叶勇祥. 基于络脉理论探讨腰椎间盘突出症伴坐骨神经痛的中医诊疗思路. 2025. doi: 10.12201/bmr.202504.00047

  王龙涛, 秦毅. 腰椎间盘突出症伴Modic改变的研究进展. 2026. doi: 10.12201/bmr.202603.00112

  姜雅亨, 王晔冉, 唐鼎, 徐海鹏, 谢云兴. 基于表面肌电信号分析一次推拿正骨法对腰椎间盘突出的临床效果. 2025. doi: 10.12201/bmr.202511.00020

  汤阳杰, 吴晓锋. 腰椎间盘早期退变的智能诊断方法研究. 2022. doi: 10.12201/bmr.202204.00001

  张珊珊, 田君明, 陆庆旺, 吴文强, 史粮坤. 基于“筋出槽，骨错缝”病机论治退行性腰椎失稳. 2025. doi: 10.12201/bmr.202512.00019

  袁超斌, 沈钦荣. 基于“虚气留滞”论治腰椎间盘突出症. 2025. doi: 10.12201/bmr.202509.00002

  罗敏捷, 陈智龙, 徐卫星. 腰椎Modic改变的机制及对腰椎间盘突出症疗效的影响. 2025. doi: 10.12201/bmr.202504.00011

  罗子琦, 谢春红, 康  佳. 从肾肝脾治疗早发性卵巢功能不全经验. 2025. doi: 10.12201/bmr.202510.00036

  刘涛, 刘晓岚, 谢义松. 基于数据挖掘技术分析腰痹病的临床用药规律. 2025. doi: 10.12201/bmr.202512.00046

  单永改, 范巧真, 齐耿, 李寿皊. 从肝脾相关论治咽喉反流性疾病. 2025. doi: 10.12201/bmr.202502.00015

• 序号	提交日期	编号	操作
  1	2026-02-01	10.12201/bmr.202603.00126V1	下载

• 公开评论  匿名评论  仅发给作者 提交评论