Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China.
Luzhou Longmatan District People's Hospital, Luzhou, Sichuan Province, China.
J Orthop Surg Res. 2023 Jun 16;18(1):436. doi: 10.1186/s13018-023-03869-4.
Intervertebral disc degeneration (IVDD) has become a serious public health problem, placing a heavy burden on society and the healthcare system. Its pathogenesis is not completely clear and may be closely related to mechanical damage, inflammatory factors, oxidative stress and death of nucleus pulposus cells (NPCs). The treatment of IVDD mainly includes conservative treatment and surgery. Conservative treatment is based on hormonal and anti-inflammatory drugs and massage techniques, which can relieve the pain symptoms to a certain extent, but cannot solve the problem from the root cause. Surgical treatment is mainly by removing the herniated nucleus pulposus, but it is more traumatic for IVDD patients, expensive and not suitable for all patients. Therefore, it is extremely important to clarify the pathogenesis of IVDD, to find an effective and convenient treatment and to further elaborate its mechanism of action. The effectiveness of traditional Chinese medicine in the treatment of IVDD has been well demonstrated in clinical medical research. We have been working on the Chinese herbal formula Duhuo Jisheng Decoction, which is a common formula for the treatment of degenerative disc disease. Not only does it have significant clinical effects, but it also has few adverse effects. At present, we found that its mechanism of action mainly involves regulation of inflammatory factors, reduction of apoptosis and pyroptosis of NPCs, inhibition of extracellular matrix degradation, improvement of intestinal flora, etc. However, a few relevant articles have yet comprehensively and systematically summarized the mechanisms by which they exert their effect. Therefore, this paper will comprehensively and systematically explain on it. This is of great clinical significance and social value for elucidating the pathogenesis of IVDD and improving the symptoms of patients, and will provide a theoretical basis and scientific basis for the treatment of IVDD with traditional Chinese medicine.
椎间盘退行性病变(IVDD)已成为严重的公共卫生问题,给社会和医疗体系带来沉重负担。其发病机制尚不完全清楚,可能与机械损伤、炎症因子、氧化应激和髓核细胞(NPC)死亡密切相关。IVDD 的治疗主要包括保守治疗和手术治疗。保守治疗以激素和抗炎药物以及按摩技术为基础,可以在一定程度上缓解疼痛症状,但不能从根本上解决问题。手术治疗主要是通过切除突出的髓核,但对 IVDD 患者创伤较大,费用较高,且不适合所有患者。因此,阐明 IVDD 的发病机制,寻找有效、便捷的治疗方法,并进一步阐述其作用机制极其重要。中药在治疗 IVDD 中的疗效已在临床医学研究中得到充分证明。我们一直在研究中药方剂独活寄生汤,这是一种治疗退行性椎间盘疾病的常用方剂。它不仅具有显著的临床效果,而且不良反应少。目前,我们发现其作用机制主要涉及调节炎症因子、减少 NPC 的凋亡和焦亡、抑制细胞外基质降解、改善肠道菌群等。然而,少数相关文章尚未全面系统地总结其发挥作用的机制。因此,本文将对此进行全面系统地阐述。这对于阐明 IVDD 的发病机制和改善患者症状具有重要的临床意义和社会价值,并将为用中药治疗 IVDD 提供理论依据和科学基础。
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