坐骨神经痛
Alias坐骨神经病变
Traditional Chinese Medicine Definition
Bilateral Sciatica, also known as "Bi Syndrome" in traditional Chinese medicine, falls under the category of "limb meridian diseases." According to the classical text "Internal Medicine of Traditional Chinese Medicine," bilateral sciatica is often attributed to deficiencies in the liver and kidney, malnutrition of the sinews and bones, or invasion by pathogenic cold and dampness, leading to obstructed circulation of Qi and blood, blockage of the meridians, and pain due to obstruction. The primary manifestation is pain along the path of the sciatic nerve, often accompanied by numbness and a feeling of沉重 in the lower limbs.
In clinical practice of traditional Chinese medicine, the core pathogenesis of bilateral sciatica is attributed to deficiencies in the liver and kidney, malnutrition of the sinews and bones, or invasion by pathogenic cold and dampness, qi stagnation, and blood stasis. Common triggers include prolonged sitting, fatigue, exposure to cold, and traumatic injuries. During diagnosis, it is crucial to differentiate between cold and heat, deficiency and excess. For instance, the Bi Syndrome with cold and dampness obstruction often presents with pain along the path of the sciatic nerve, which worsens in cold conditions; while qi stagnation and blood stasis manifest as sharp, fixed pain that is worse at night and improves during the day, with limitations in flexion and extension. The overall approach to treatment suggests focusing on warming the meridians to dispel cold, removing dampness to unblock the meridians, promoting blood circulation to resolve stasis, regulating qi to alleviate pain, and harmonizing Qi and blood to achieve the goal of pain relief and functional recovery. During the treatment process, it is essential to combine the specific constitution and condition of the patient with flexible application of traditional Chinese medicine treatments such as herbal medicine, acupuncture, and massage.
Common Syndrome Types and Key Points of Differentiation
寒湿阻络证
Main Manifestations：沿坐骨神经走行部位疼痛，遇寒加重
Management Approach：温经散寒，除湿通络
气滞血瘀证
Main Manifestations：刺痛固定，日轻夜重，屈伸不利
Management Approach：活血化瘀，理气止痛
The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.
Physician's Clinical Insights
The pain in patients with bilateral sciatica is often due to invasion by pathogenic cold and dampness, and treatment requires warming the meridians to dispel cold and unblocking the meridians to alleviate pain.
— 陈燕 中医执业医师
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This page is for the popular science of traditional Chinese medicine knowledge and does not constitute medical advice. Specific diagnosis should be completed by a licensed traditional Chinese medicine practitioner in person.
参考文献：《中医内科学》（十三五规划教材）、《中医病证诊断疗效标准》(ZY/T001.1-94)、《中医病证分类与代码》(GB/T 15657-2021)