D. DAU DAY THAN KINH HONG TO (L4, L5, S 1, S2, S3) 1 Giai phau
3. Cac the lam sang:
a. Dau day than kinh hong mot re:
Thifdng ton re L5 hay S i.
b. Dau day than kinh hong nhieu re:
Dau day than kinh hong khu tru d re L5, S 1, hay L5, L4.
c. Dau day than kinh hong:
The hiem gap hdn. Dau tif mong hay dui, di xuong phia sau trong va mat trifdc ngoai cang chan roi den tat ca ban chan.
d. Dau day than kinh hong gay liet:
Liet tiep theo d giai doan dau, ta cd the phan biet: Thifdng ton re L5: liet cac cd trifdc ngoai cang chan (dang di chan ru, khong the dtfng got chan dtfdc).
Thtfdng ton re S i: liet cac cd sau ckng chan (henh nhan khong the di kieng chan dtfdc, mat phan xa gan got).
Thtfdng ton nhieu re (L5, S i..): cac roi loan van dong phoi hdp vdi cac roi loan cam giac va dinh dudng.
d. Dau day than kinh hong hai ben:
Doi khi dau ttf ben nay lan sang ben kia.
4. Nguyen nhan
- Dau day than kinh hong do thoat vi dia dem Dau day than kinh hong khong do thoat vi dia dem: + Hep ong song that ltfng.
+ Rong oiig song that ltfng.
+ Di dang cua tui ctfng mang ctfng, nang (kyste), hoac tui thtfa (diverticule) mang nhen, di dang bao cua cac re than kinh, cac re than kinh duoi ngtfa to va dai.
+ U than kinh (neurinome) duoi ngtfa. + U chen ep re than kinh.
+ Lao cot song that ltfng.
+ Tai bien do tiem vao than kinh hong: thtfdng do tiem mong bang Quinin.
- Dau than kinh hong hai ben thtfdng do:
+ Ung thtf cot song hay chau hong nho, di can ung thtf tien liet tuyen hoac ung thtf vu, ung thtf sinh due ntf.
+ Chan thtfdng cot song ltfng - that ltfng: chi thay trong cac chan thtfdng nang.
+ Thoat vi dia dem mtfc do nang d L4 - L5, doi khi kem hoi chung duoi ngtfa.
5. Dieu tri
a. Dieu tri nguyen nhan: b. Dieu tri trieu chiing:
Giai doan cap:
+ Nam nghi tren gitfdng co van cung.
+ Thuoc giam dau (aspirin, falixylat, phenacetin, Phenylbutazon, indomethacin, prednisolon... chu y chong chi dinh khi co loet da day ta trang).
+ Vitamin B,, BG, B 12 lieu cao.
+ Thuoc gian cd va an than nhe: Diazepam
(seduxen, valium, cercin).
+ Tiem ngoai mang cung bang novocain,
hydrocortison.
Giai doan ban cap va man tinh:
+ Ly lieu: song ngan, nhiet dien, dong dien nhip, ion dien phan vdi natri salisylat.
+ Xoa bop, bam nan.
+ Lieu phap van dong: luc dau tap thu dong, sau do (khi dau da giam) chuyen sang tap chu dong. Cac bai tap nh&m tang ctfdng he cd bung, cd ltfng va on dinh cot song.
+ Keo gian cot song that ltfng tren mat phang nghieng hoac tren gitfdng keo (neu nguyen nhan la do dia dem).
c. Dieu tri theo y hoc co truyen::
Dau than kinh hong dtfdc mo ta trong pham vi cua chtfng thap ty: phtfdng phap chtfa benh theo v hoc co truyen tuy thuoc vao nguyen nhan gay ra chtfng dau day than kinh hong.
Dau day than kinh hong do lanh: trung phong han d kinh lac, co them trieu chtfng toan than: sd lanh, reu ltfdi trang, mach phu. Phtfdng phap chtfa. Khu phong tan han, hanh khi hoat huyet (hoat lac).
Bai thuoc:
B d i 1:
Re la lot 12g
Thien nien kien 12g Cau ti'ch Ngai ctfu Que chi 16g 8g 8g Chi xac 8g T r in bi 8g Ngtfu tat 12g Xuyen khung 12g B d i 2:
Doc hoat 12g Que chi 8g
Phong phong 8g Chi xac 8g
Uy linh tien 12g Tran bi 8g
Dan sam 12g Ngtfu tat 12g
Tang ky sinh 12g Xuyen khung 12g
Cham ctiu cac huyet Dai trUdng du, Trat bien, Hoan khieu, ThUa phu, uy chung, ThUa sdn, DUdng lang tuyen, Giai khe, Con Ion.
Thuy cham: vitamin B12 vao cac huyet tren. Nhi tram: vung day toa.
Dau day than kinh hong do thoai hoa cot song: y hoc co truyen goi la phong han thap ty. Co them trieu chUng toan than: an kem, ngu it, mach nhu hoan tram nhUdc... PhUdng phap chUa: khu phong, tan han, trU thap, boat huyet, bo can than.
Neu teo cd phai bo khi huyet.
Bai thuoc:
Thuc dia 12g Hoai sdn 12g
Cau ti'ch 12g Y d i 12g
Tuc doan 12g Bach truat 12g
Tang ky sinh 16g Ty giai 12g
NgUu tat 12g Ha thu o 12g
Dang sam 12g
■: Doc hoat ky sinh thang gia giam
Doc hoat 12g Dang sam 12g
Tang ky sinh 12g Phuc linh 12g
Phong phong 8g Cam thao 8g
Te tan 6g Bach thUdc 12g
Que chi 6g Dudng quy 12g
Ngtfu tat 12g Thuc dia
Do trong Mg Dai tao
B a i 3: Y di nh anthang
12g 12g
Y di 16g Gtfng
Thtfdng truat 8g Cam thao
Doc hoat 8g Dai tao 12g
Khtfdng hoat 8g Do trong 8g
Que chi 8g Phu tii che 8g
f; Bo than thang gia giam
Thuc dia 12g Pha co chi 8g
Do trong 12g Tho ty tii 8g
Tang ky sinh 16g Tuc doan 12g
Cau tich 16g Khtfdng hoat 8g
Phong ky 12g Thtfdng truat 8g
Ky tii 12g
B a i 5:
La lot 12g Day dau xtfdng
(sao vang) 12g
Thien men kien lOg Voi voi 16g
Que chi 8g Sai dat 16g
Tho phuc linh 12g Caiu ti'ch 16g
Re co xtfdc 12g Do trong 16g
Ngai ctfu 8g Y di 20g
Gia giam: the han: tang que chi, giam Sai dat, Voi voi. The nhiet: ngtfdc lai the han.
The thap: tang Tho phuc linh. co xtfdc.
Sac uong ngay 1 thang. Khi het dau: ngam rtfdu 2 lit 1 thang, ngay uong 40ml, chia lam 2 lan uong, thdi gian tu 3 - 6 thang.