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腰椎间盘突出症的吸收:临床表现、机制及保守治疗综述

Lumbar disc herniation reabsorption: a review of clinical manifestations, mechanisms, and conservative treatments.

作者信息

Chai Yuan, Shen Xuyu, Wang Zixin, Zhang Xiaoyun, Wang Zhiqiang, Zuo Xinchen, Liu Jintao

机构信息

Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, Jiangsu, China.

Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.

出版信息

Front Med (Lausanne). 2025 Jul 28;12:1633762. doi: 10.3389/fmed.2025.1633762. eCollection 2025.

Abstract

Lumbar disc herniation (LDH) is a common and frequently occurring condition primarily caused by lumbar intervertebral disc degeneration (LIVDD) and protrusion of the nucleus pulposus (NP), with low back pain and lower limb pain as the main clinical manifestations. It is characterized by a prolonged disease course and a high recurrence rate, with patients often experiencing long-term suffering, significantly impairing their quality of life and mental health. Studies have found that some LDH patients, without undergoing surgery or chemonucleolysis, experience spontaneous shrinkage and resorption of the intervertebral disc (IVD) tissue, along with relief of back and leg pain-a phenomenon referred to as LDH reabsorption. Modern medical research suggests that this reabsorption process is closely related to factors such as inflammatory responses, macrophage activation, extracellular matrix enzyme balance, neovascularization, ferroptosis, mitochondrial function, oxidative stress, and cellular autophagy. However, the precise mechanisms of LDH reabsorption and commonly used clinical therapies remain unclear, leading to suboptimal treatment outcomes. This study systematically reviews the relevant literature on LDH reabsorption, focusing on clinical diagnosis, underlying mechanisms, and common therapeutic strategies, aiming to summarize recent research progress and provide theoretical references for future clinical prevention and treatment of LDH.

摘要

腰椎间盘突出症(LDH)是一种常见且多发的病症,主要由腰椎间盘退变(LIVDD)和髓核(NP)突出引起,以腰背痛和下肢疼痛为主要临床表现。其特点是病程长、复发率高,患者常长期受苦,严重损害其生活质量和心理健康。研究发现,一些未经手术或化学溶核治疗的LDH患者,椎间盘(IVD)组织会自发缩小和吸收,同时腰腿痛缓解——这种现象被称为LDH吸收。现代医学研究表明,这种吸收过程与炎症反应、巨噬细胞活化、细胞外基质酶平衡、新生血管形成、铁死亡、线粒体功能、氧化应激和细胞自噬等因素密切相关。然而,LDH吸收的确切机制和常用的临床治疗方法仍不明确,导致治疗效果欠佳。本研究系统回顾了关于LDH吸收的相关文献,重点关注临床诊断、潜在机制和常见治疗策略,旨在总结近期研究进展,为未来LDH的临床预防和治疗提供理论参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb5/12336140/0bc92c25e541/fmed-12-1633762-g001.jpg

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