Distribution Law Of The Lumbar Disc Herniation Tender Points

Lumbar disc herniaion (LDH) is a common disease and frequently-occurring disease in acupuncture; it is the most common cause of low back pain. The incidence of the disease showed an increasing trend in the current, lead to the public a tremendous physical and psychological harm, and greatly reduces the overall quality of life of society.TCM regards that clinical manifestations of LDH are similar with the characteristics of disease of muscle regions (JING JIN). Its morbidity are closest with kidney, regardless of the external or internal disease factors, they always base on deficiency of the kidney, contusion, dampness and damp heat are inducements. The disease is located in the waist,it's pathogenesis are deficiency of the kidney Qi, dystrophy of muscles and bones, obstruction of channels, impede circulation of Qi and blood, It get pain because of the obstruction or malnutrition. LDH also have closely relationship with liver, meridian of foot-shaoyin, meridian of foot-shaoyang, meridian of foot-tai yang, Du meridian, Ren meridian and Dai meridian and so on.Modern medicine regards that the intervertebral disc degeneration is the inner pathogenesis of LDH. As age Increasing, water in intervertebral discs tissue are declining, and factors of the abnormal force which act on the spine, spinal deformation, physical activity, smoking, vascular disease and diabetes etc., cause less blood supply, and accelerate the degeneration process of intervertebral discs. Trauma, overloading and cold always lead to the occurrence of this disease, besides it is closely related with careers too. L4,5 and L5S1 disc have the highest incidence. As to the mechanisms of pain located in the lesion parts of LDH, Now many scholars believe that have relationship with mechanical stimulation of the peripheral nerve caused by prominence, the chemical factors of the chemical reaction of inflammation induced by prominence and autoimmunity etc., Chemical Factors mainly are PLA2, IL-6, IL-1, TNFa, NO and immune globulin. LDH may cause abnormality of the blood-supply and metabolism of tissue such as the muscles, tendons or soft tissue etc. in some way, and then Tender points are produced.At present, under the guidance of muscle meridian, treat LDH by choosing acupoints which combining the methods of identifying diferentiation of syndromes of acupuncture and of pain-point needling (ashi point) together, it make less pain, and have good effect, so acupuncture become the first choice for many patients with LDH. But few detailed descriptions on the principle of the distribution of tender points, only general description of treatment in the tender point, for clinical practice, it's hard to be prevail because that the complexity of the exam proceeding and incomplete procedures were done in a short time. It is critical for treatment of LDH to find the tender point.The problems mentioned above which encountered in this study,under the guidance of the theory of meridians, by examining 110 patients with LDH detailed physical, to find related tender points and make the corresponding record, and finally normalized integration analysis, summarized distribution of tender point in patients with LDH:The waist:(1)The occurrence rate of tender point Under the spinous process is lower than the one beside the corresponding spinous process;(2) The occurrence rates of tender points beside the spinous process of L4,5 are higher than the one beside the other three spinous processes;(3) Tender point of transverse process of L3 rank top with 81.8%.The buttocks and lower extremities:(1) Tender points always locate in the Starting point and ending point of the muscle, shape punctation;(2) At the edge between Two or more long belly of muscle or tendon of muscle tender points were linear;(3) Tender points In the large tendon of muscle become flaky. Tender points mostly lie in foot—tai yang muscle meridian,foot—Shaoyang muscle meridian, and in the parts of the three yin mridians of foot pass by or coross over. especially in the places—ankle, knee and hip where muscle meridian get together,and muscles attach in. And intersection of two muscle meridians or three muscle meridians reach a high rate of tenderness. Sum up the regular rule of tender points of LDH, when choose the acupoints to treat LDH,it could be more convenient, fast and accurate,and can improve the efficacy of clinical.