推拿治疗不同年龄段患者腰椎间盘突出症的 研究进展

Research Progress on Tuina Treatment for Lumbar Disc Herniation in Patients of Different Age Groups

摘要: 腰椎间盘突出症(LDH)是临床常见病，其发病率随年龄增长呈显著变化，不同年龄段患者在病因病机、病理特点及临床表现上存在差异。推拿作为LDH保守治疗的重要手段，临床应用广泛且取得了一定疗效。本文系统梳理近年来推拿治疗不同年龄段LDH患者的临床研究，从青年期、中年期及老年期分别总结其临床疗效特点，并从抗炎镇痛、缓解肌肉痉挛、神经修复及生物力学调整等角度探讨作用机制。文献回顾表明，推拿治疗对不同年龄段LDH患者均有良好疗效，但手法侧重点和强度应根据年龄特点个体化调整。未来研究应开展针对不同年龄段的大样本、多中心随机对照试验，建立规范化分期分龄诊疗方案，并加强作用机制的深入探索。

Abstract: Lumbar Disc Herniation (LDH) is a common clinical condition, and its incidence varies significantly with age. Patients of different age groups exhibit differences in etiology, pathogenesis, pathological characteristics, and clinical manifestations. As an important conservative treatment for LDH, Tuina (Chinese therapeutic massage) is widely used in clinical practice and has demonstrated reliable therapeutic efficacy. This article systematically reviews recent clinical studies on Tuina treatment for LDH in patients of different age groups, summarizing the clinical efficacy characteristics of adolescents and young adults, middle-aged patients, and elderly patients, respectively. Furthermore, the mechanisms of action are explored from the perspectives of anti-inflammatory and analgesic effects, muscle spasm relief, nerve repair, and biomechanical regulation. Literature review indicates that Tuina is effective for LDH patients across different age groups, but the focus and intensity of manipulation should be individually adjusted according to age-specific characteristics. Future research should conduct large-sample, multicenter randomized controlled trials targeting different age groups, establish standardized staging and age-specific diagnosis and treatment protocols, and further investigate the underlying mechanisms.