Research Progress in the Treatment of Lumbar Intervertebral Disc Herniation Based on the Theory of "the Liver Is in Charge of Tendons and the Kidney Is in Charge of Bones"
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v5i2.2331
Abstract
"Liver is the master of tendon and kidney is the master of bone" is an important theoretical source for the treatment of lumbar disc herniation (LDH) in traditional Chinese medicine (TCM). Most of the patients with LDH are in liver and kidney deficiency, and the treatment of LDH is often based on traditional Chinese medicines that tonify the liver and kidneys. With the development of modern medicine, some progress has been made in recent years on the pathogenesis, diagnostic imaging and therapeutic mechanism of LDH based on the theory of "the liver is in charge of the tendons and the kidney is in charge of the bones", and this article will briefly review these aspects to provide a reference for the better utilization of this theory in the treatment of LDH.
Keywords
lumbar disc herniation; liver masters tendons; kidney masters bones; tonifying liver and kidney
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[17]Song Bohong. Discussion on the relationship between CT imaging indexes of lumbar intervertebral disc herniation and Chinese medicine evidence[J]. Guangming Traditional Chinese Medicine, 2019, 34(23): 3537-3539.
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[20]Xia Song. Clinical observation on the treatment of lumbar disc herniation with sole living parasitic soup[J]. Journal of Liaoning University of Traditional Chinese Medicine, 2013, 15(02): 169-170.
[21]CHENG Wei, GAN Ning, DAI Ying. The effect of Dokou Sangsheng Tang on serum inflammatory cytokines in patients with lumbar intervertebral disc herniation of liver and kidney deficiency type[J]. Traditional Chinese Medicine Information, 2016, 33(01): 88-90.
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[28]Tan XY, Chou J, Chou XZ, et al. Effects of Liver Tonic and Waist Strengthening Formula on NF-κB signalling pathway in rats with lumbar intervertebral disc herniation[J]. Chinese Medicine Herald, 2019, 25(10): 37-39.
[29]Qiu Xiangzhong, Zhu Chengxun, Zhang Xincheng, et al. Effects of Liver Tonic and Waist Strengthening Formula on TNF-α and NFκB expression in intervertebral discs of rats with lumbar intervertebral disc degeneration[J]. Chinese Journal of Traditional Chinese Medicine and Orthopaedics, 2017, 25(9): 9-11, 16.
[30]Qiu Xiangzhong, Liu Dong, Zhang Xincheng, et al. Effects of Liver Tonic and Waist Strengthening Formula on the expression of MMP-3 and TIMP-1 in intervertebral discs of rats with lumbar disc degeneration[J]. Journal of Beijing University of Chinese Medicine, 2017(11): 940-945.
[31]QIU Xiangzhong, ZHU Chengxun, ZHANG Xincheng, et al. Effects of Liver Tonic and Waist Strengthening Formula on the expression of IL-1β and IL-6 in intervertebral discs of rats with lumbar disc degeneration[J]. Chinese Medicine Herald, 2017, 24(24): 57-59.
[32]Zheng Yang. Effects of Liver Tonic and Waist Strengthening Formula on MMP-3, Aggrecan protein and mRNA expression in LDH myeloid cells[D]. Hunan University of Traditional Chinese Medicine,2022.DOI:10.27138/d.cnki.ghuzc.2022.000090.
[33]FANG Peng-Fei, LIU Zong-Wei, WEN Jian-Tao. Efficacy of Duchenne lumbago pill in the treatment of lumbar disc herniation and its effect on inflammatory factors[J]. National Medical Forum, 2022, 37(03): 38-40.
[34]FANG Pengfei, WEN Jiantao, LIU Zongwei. Influence of Duzong lumbago pill on the regulation of inflammatory factors in lumbar disc herniation via NF-κB signalling pathway[J]. China TCM Emergencies, 2020, 29(12): 2097-2099, 2103.
[35]Chen QQ, Ma D, Zhao JR, et al. Study on the effect of Duzong lumbago pill in the treatment of chronic lower limb pain of lumbar intervertebral disc herniation based on network pharmacology and animal experiments[J]. World Science and Technology-Modernisation of Traditional Chinese Medicine, 2023, 25(05): 1702-1713.
[36]WANG Xibin, LI Hu, WAN Ruirong. Progress of analgesic mechanism of natural flavonoids[J]. Right River Medicine, 2022, 50(01): 67-71.
[37]BORGHI S M, MIZOKAMI S S, PINHO-RIBEIRO F A, et al. The flavonoid quercetin inhibits titanium dioxide (tio 2)-induced chronic arthritis in mice[J]. J Nutr Biochem,2018,53:81-95.
[38]MUTO N, MATSUOKA Y, ARAKAWA K, et al. Quercetin attenuates neuropathic pain in rats with spared nerve injury.[J].Acta Med Okayama,2018,72(5):457- 465.
[39]ZHOU Y S, CUI Y, ZHENG J X, et al. Luteolin relieves lung cancer-induced bone pain by inhibiting NLRP3 inflammasomes and glial activation in the spinal dorsal horn in mice[J]. Phytomedicine,2022,96:153910.
[40]PHAN H T L, KIM H J, JO S, et al. Anti-inflammatory effect of licochalcone A via regulation of ORAI1 and K+ channels in Tlymphocytes. Int J Mol Sci, 2021, 22(19): 10847
[41]HE Xu, LIU Yingfei, WANG Wei, et al. Effects of total saponins of Panax ginseng on learning memory in rats with total cerebral ischaemia and its mechanism of action[J]. Chinese Herbal Medicine, 2019, 50(22): 5521-5526.
[42]WU Qi, LIN Juan, LIU Yaochen, et al. Research on the action mechanism of traditional efficacy of Panax ginseng based on network pharmacology[J]. Chinese Herbal Medicine, 2020, 51(14): 3717-3727.
[43]JIANG Zeng-Hong, ZHOU Min-Ju. Analgesic effect of Cortex Eucommiae polysaccharide on rats with neuropathic pain[J]. Journal of Gannan Medical College, 2019, 39(02): 114-117.
[44]LI Hui, WANG Shunyi, SHI Zhanye. Clinical observation of tonifying kidney and strengthening tendon soup in the treatment of osteoarthritis[J]. Shaanxi Traditional Chinese Medicine, 2016, 37(10): 1368-1369.
[45]Qin Hongzhao, Chen Jing, Li Zhiqiang. Observation on the efficacy of tonifying kidney and strengthening tendon soup combined with acupuncture in treating lumbar intervertebral disc herniation of liver and kidney deficiency type and the effect on NLRP3 expression in monocytes[J]. New Chinese Medicine, 2020, 52(12): 41-44.
[46]QIAN Y, ZENG K W, Ma X L, et al. Resokaempferol-mediated anti-inflammatory effects on activated macrophages via the inhibition of JAK2/STAT3, NF-κB and JNK/p38 MAPK signaling pathways[J]. Int Immunopharmacol,2016,38: 104-114.
[47]Wang Yuanyuan, Zhang Xueqin, Yuan Feifei, et al. Study on the anti-inflammatory immunomodulatory activity of polysaccharides from Sichuan hyssop and Huai hyssop[J]. Journal of Jining Medical College, 2018, 41(02): 132-134.
[2]DEYO R A, MIRZA S K. Herniated lumbar intervertebral disk[J]. N Engl J Med, 2016, 374(18): 1763-1772.
[3]Zhang A S, Xu A, Ansari K, et al. Lumbar Disc Herniation: Diagnosis and Management. Am J Med. 2023 Jul;136(7):645-651.
[4]Jiang QS, Luo CG. Liver, the basis of the strike"[J]. Zhejiang Journal of Traditional Chinese Medicine, 2017,52(10): 711-712.
[5]Zhou Yuming. Experience of treating lumbar intervertebral disc herniation from the theory of "the kidney is the main bone and the liver is the main tendon"[J]. China TCM Emergencies, 2013, 22(02): 337.
[6]Li Xiaoxi, He Jiancheng. Traceability of the theory of liver-kidney homology[J]. Western Chinese Medicine, 2019, 32(09): 45-49.
[7]Huang Wenhao, Chen Bowei, Chen Yuqi, et al. Ruminating on the liver main tendon and the sun main tendon[J]. Chinese Acupuncture and Moxibustion, 2020, 40(09): 989-990.
[8]XU Shao-Ting. Ge Baofeng. Lu Shibi. Practical Orthopaedics[M]. 4th ed. Zhengzhou. Henan Science and Technology Press, 2019: 88, 93.
[9]Cheng Y, Zhang LX, Yang FG. Morphological study of nerve root tissue in an autoimmune model of lumbar disc prolapse in rabbits[J]. Bio-Orthopaedic Materials and Clinical Research, 2005(02): 4-6.
[10]JOHNSON Z I, SCHOEPFLIN Z R, CHOI H, et al. Disc in flames: roles of TNF-α and IL-1β in intervertebral disc degeneration.[J] .Eur Cell Mater, 2015, 30: 104-106.
[11]HOU Guihong, LI Qian, XIE Yan. Study on the relationship between inflammatory factor levels, MMPs/TIMPs expression and lumbar disc herniation in intervertebral disc tissues[J]. Chinese Experimental Diagnostics, 2018, 22(05): 791-794.
[12]LU Changchun, XIAO Navy, XUE Feng. Observation on the efficacy of PLDD combined with lumbar dorsal muscle functional exercise in the treatment of lumbar intervertebral disc herniation and its effect on IL-6 and TNF-α levels[J]. PLA Journal of Preventive Medicine, 2019, 37(04): 81-83.
[13]Wang JZ, Zhou YY, Mei FR. Correlation between IL-1 content in lumbar disc herniation and straight leg raising[J]. Journal of Bone and Joint Injury, 2001(01): 22-23.
[14]Yu J, Zhu LG, Gao JH, et al. Correlation between serum interleukin 1β, interleukin 6 and tumour necrosis factor alpha expression and pain in patients with lumbar disc herniation[J]. Chinese Tissue Engineering Research and Clinical Rehabilitation, 2007, No. 258(02): 301-304.
[15]Zhang Li-Na, Lv Sha-Sha. Analysis of the effect of CT examination and MRI examination in the diagnosis of lumbar intervertebral disc herniation[J]. Imaging Research and Medical Application, 2022, 6(14): 140-142.
[16]DU Jingting, SU Qinglun, CHENG Mingda. MRI-based analysis of the correlation between Chinese medical evidence and pathology of lumbar disc herniation[J]. Chinese Journal of CT and MRI, 2022, 20(09): 175-176, 188.
[17]Song Bohong. Discussion on the relationship between CT imaging indexes of lumbar intervertebral disc herniation and Chinese medicine evidence[J]. Guangming Traditional Chinese Medicine, 2019, 34(23): 3537-3539.
[18]WANG Enjia, ZHANG Hua. Exploring the correlation between Chinese medicine evidence and western medicine pathology of lumbar intervertebral disc herniation based on imaging[J]. Western Traditional Chinese Medicine, 2017, 30(02): 131-133.
[19]FANG Junhua, CHEN Jiahong, GONG Yaling, et al. Analysis of the relationship between CT imaging indexes of lumbar intervertebral disc herniation and Chinese medicine evidence[J]. Asia-Pacific Traditional Medicine, 2015, 11(03): 78-79.
[20]Xia Song. Clinical observation on the treatment of lumbar disc herniation with sole living parasitic soup[J]. Journal of Liaoning University of Traditional Chinese Medicine, 2013, 15(02): 169-170.
[21]CHENG Wei, GAN Ning, DAI Ying. The effect of Dokou Sangsheng Tang on serum inflammatory cytokines in patients with lumbar intervertebral disc herniation of liver and kidney deficiency type[J]. Traditional Chinese Medicine Information, 2016, 33(01): 88-90.
[22]LIU Xian, JIANG Yuzhen, TIAN Lian, et al. Modulation of LPS-induced retinal endothelial cell apoptosis and immune response by Eucommia chlorogenic acid[J]. Chinese Journal of Immunology, 2019, 35(02): 171-175, 180.
[23]BARNES PJ, KARIN M: Nuclear factor-kappa B: a pivotal transcription factor in chronic inflammatory diseases. N Engl J Med 1997, 336: 1066-1071.
[24]ZHANG M, PENG L L, WANG Y, et al. Roles of A20 in autoimmune diseases. Immunol Res. 2016 Apr; 64(2): 337-344.
[25]WANG S L, YU Y L, TANG C L, et al. Effects of TGF-β1 and IL-1β on expression of ADAMTS enzymes and TIMP-3 in human intervertebral disc degeneration. Exp Ther Med. 2013 Dec; 6(6): 1522-1526.
[26]XIE Z H, CHEN J X, XIAO Z J, et al. TNFAIP3 alleviates pain in lumbar disc herniation rats by inhibiting the NF-κB pathway. [J]. Ann Transl Med, 2022, 10(2): 80.
[27]Tan XY, Zhao DM, Chou XZ, et al. Effects of Liver Tonic and Waist Strengthening Formula on neurological function scores and IL-1 expression in a lumbar intervertebral disc herniation model[J]. Chinese Journal of Integrative Medicine and Surgery, 2019, 25(05): 669-673.
[28]Tan XY, Chou J, Chou XZ, et al. Effects of Liver Tonic and Waist Strengthening Formula on NF-κB signalling pathway in rats with lumbar intervertebral disc herniation[J]. Chinese Medicine Herald, 2019, 25(10): 37-39.
[29]Qiu Xiangzhong, Zhu Chengxun, Zhang Xincheng, et al. Effects of Liver Tonic and Waist Strengthening Formula on TNF-α and NFκB expression in intervertebral discs of rats with lumbar intervertebral disc degeneration[J]. Chinese Journal of Traditional Chinese Medicine and Orthopaedics, 2017, 25(9): 9-11, 16.
[30]Qiu Xiangzhong, Liu Dong, Zhang Xincheng, et al. Effects of Liver Tonic and Waist Strengthening Formula on the expression of MMP-3 and TIMP-1 in intervertebral discs of rats with lumbar disc degeneration[J]. Journal of Beijing University of Chinese Medicine, 2017(11): 940-945.
[31]QIU Xiangzhong, ZHU Chengxun, ZHANG Xincheng, et al. Effects of Liver Tonic and Waist Strengthening Formula on the expression of IL-1β and IL-6 in intervertebral discs of rats with lumbar disc degeneration[J]. Chinese Medicine Herald, 2017, 24(24): 57-59.
[32]Zheng Yang. Effects of Liver Tonic and Waist Strengthening Formula on MMP-3, Aggrecan protein and mRNA expression in LDH myeloid cells[D]. Hunan University of Traditional Chinese Medicine,2022.DOI:10.27138/d.cnki.ghuzc.2022.000090.
[33]FANG Peng-Fei, LIU Zong-Wei, WEN Jian-Tao. Efficacy of Duchenne lumbago pill in the treatment of lumbar disc herniation and its effect on inflammatory factors[J]. National Medical Forum, 2022, 37(03): 38-40.
[34]FANG Pengfei, WEN Jiantao, LIU Zongwei. Influence of Duzong lumbago pill on the regulation of inflammatory factors in lumbar disc herniation via NF-κB signalling pathway[J]. China TCM Emergencies, 2020, 29(12): 2097-2099, 2103.
[35]Chen QQ, Ma D, Zhao JR, et al. Study on the effect of Duzong lumbago pill in the treatment of chronic lower limb pain of lumbar intervertebral disc herniation based on network pharmacology and animal experiments[J]. World Science and Technology-Modernisation of Traditional Chinese Medicine, 2023, 25(05): 1702-1713.
[36]WANG Xibin, LI Hu, WAN Ruirong. Progress of analgesic mechanism of natural flavonoids[J]. Right River Medicine, 2022, 50(01): 67-71.
[37]BORGHI S M, MIZOKAMI S S, PINHO-RIBEIRO F A, et al. The flavonoid quercetin inhibits titanium dioxide (tio 2)-induced chronic arthritis in mice[J]. J Nutr Biochem,2018,53:81-95.
[38]MUTO N, MATSUOKA Y, ARAKAWA K, et al. Quercetin attenuates neuropathic pain in rats with spared nerve injury.[J].Acta Med Okayama,2018,72(5):457- 465.
[39]ZHOU Y S, CUI Y, ZHENG J X, et al. Luteolin relieves lung cancer-induced bone pain by inhibiting NLRP3 inflammasomes and glial activation in the spinal dorsal horn in mice[J]. Phytomedicine,2022,96:153910.
[40]PHAN H T L, KIM H J, JO S, et al. Anti-inflammatory effect of licochalcone A via regulation of ORAI1 and K+ channels in Tlymphocytes. Int J Mol Sci, 2021, 22(19): 10847
[41]HE Xu, LIU Yingfei, WANG Wei, et al. Effects of total saponins of Panax ginseng on learning memory in rats with total cerebral ischaemia and its mechanism of action[J]. Chinese Herbal Medicine, 2019, 50(22): 5521-5526.
[42]WU Qi, LIN Juan, LIU Yaochen, et al. Research on the action mechanism of traditional efficacy of Panax ginseng based on network pharmacology[J]. Chinese Herbal Medicine, 2020, 51(14): 3717-3727.
[43]JIANG Zeng-Hong, ZHOU Min-Ju. Analgesic effect of Cortex Eucommiae polysaccharide on rats with neuropathic pain[J]. Journal of Gannan Medical College, 2019, 39(02): 114-117.
[44]LI Hui, WANG Shunyi, SHI Zhanye. Clinical observation of tonifying kidney and strengthening tendon soup in the treatment of osteoarthritis[J]. Shaanxi Traditional Chinese Medicine, 2016, 37(10): 1368-1369.
[45]Qin Hongzhao, Chen Jing, Li Zhiqiang. Observation on the efficacy of tonifying kidney and strengthening tendon soup combined with acupuncture in treating lumbar intervertebral disc herniation of liver and kidney deficiency type and the effect on NLRP3 expression in monocytes[J]. New Chinese Medicine, 2020, 52(12): 41-44.
[46]QIAN Y, ZENG K W, Ma X L, et al. Resokaempferol-mediated anti-inflammatory effects on activated macrophages via the inhibition of JAK2/STAT3, NF-κB and JNK/p38 MAPK signaling pathways[J]. Int Immunopharmacol,2016,38: 104-114.
[47]Wang Yuanyuan, Zhang Xueqin, Yuan Feifei, et al. Study on the anti-inflammatory immunomodulatory activity of polysaccharides from Sichuan hyssop and Huai hyssop[J]. Journal of Jining Medical College, 2018, 41(02): 132-134.
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