(1) Eliminating the cause: Because lumbar muscle strain generally has a long-term and repeated injury cause, the primary problem in treating lumbar muscle strain is to eliminate the cause, such as improving working posture and posture and avoiding bending too long. For occupations where the waist must maintain a certain posture, the waist posture should conform to biomechanics as much as possible, pay attention to the frequent movement of the waist, and don't keep the waist in the same posture for too long.
(2) Drug therapy: Indomethacin, prednisone, Riplin and other drugs can be taken orally; Or choose traditional Chinese medicine, such as Duhuo Jisheng decoction, Bushen Zhuangjin decoction and so on. , can relax muscles and promote blood circulation, warm meridians and dispel cold, dispel wind and dredge collaterals; You can also choose Jinwenluotong Ointment and Musk Tiger Bone Ointment for external application.
(3) Manual therapy: On the basis of relaxing muscles by pressing and kneading, press the tender points hard, and push, knead and roll along the sacrospinous muscles from top to bottom. For adhesion or muscle tension, plucking can also be used.
(4) Lumbar muscle exercise: Generally speaking, it is mainly for muscle exercise to increase the strength of sacrospinous muscles. Waist muscle exercise can not only increase muscle strength to compensate pathological tissue function, but also promote patients' early recovery.
(5) Others: For lumbar muscle strain, physical therapy methods such as infrared ray, ultrashort wave, wax therapy, cupping and magnetic therapy can also be used, and acupuncture or local blocking can also be selected.
Dietotherapy for lumbar muscle strain
(1) Lycium barbarum lamb kidney porridge: fresh Lycium barbarum leaves 500g, washed lamb kidney 1 pair, washed and chopped, rice 250g, added with appropriate amount of water, and simmered with low fire to make porridge, which can be eaten in different periods. Add onion and ginger to taste before eating. Regular consumption can tonify the kidney, and is suitable for treating diseases such as kidney deficiency, waist and knee pain and heel pain in the elderly.
(2) L pairs of pig kidneys, 30g of Eucommia ulmoides Oliv. , a little salt, stew soup to drink, daily 1 time, 7 days in a row.
(3) Wash 30g of leek or leek root, add 500ml of water, boil to 250ml with low fire, add 30g of rock sugar, and drink after warming. Avoid spicy and warm food, such as pepper, cinnamon, ginger and mutton.
Lumbar muscle strain is a chronic accumulation of lumbar lesions, which is related to people's physique and occupation. This kind of low back pain is light or heavy, so it should be treated and cared in time. People with lumbar muscle strain should do manual work according to their abilities, not bluffing, and have correct posture; It is best for office workers to relax their waist muscles with armchairs; Bend over to work, you have to change your single posture. You'd better sleep on a hard bed at night. At the same time, it is necessary to properly control sexual life.
One of the precautions of lumbar muscle strain: correct bad posture and habits. Standing posture, sitting posture, good posture are the foundation of health, and bad posture is the starting point of illness. For example, to lift heavy objects, you should have skills, don't bend over, and bend your hips and knees; The muscles of thigh and calf exert force at the same time to disperse the strength of waist, thus preventing and treating waist injury. Patients with lumbar muscle strain should also avoid taking heavy objects from high places.
Precautions for lumbar muscle strain 2: Do not sit for a long time. Office workers and car drivers. People who work in a sitting position for a long time are prone to low back pain. This is because the waist load is too long when sitting, so you should stand up and exercise, or change your posture to relax the muscles and ligaments that have been in a state of tension for a long time and avoid low back pain caused by strain. In addition, for sitting workers, we should also choose comfortable and flexible seats. The ideal height is that when you sit down, your knees are slightly higher than your hips, your feet can rest on the ground completely, and the muscles in front of your hips are relaxed. Its ideal depth is slightly shorter than the thigh length, so the waist can lean on the back of the chair when sitting down, so that the waist muscles are not easy to fatigue.
Precautions for lumbar muscle strain 3: Change the standing posture frequently. Factory workers, surgeons and other workers who stand for a long time should avoid standing in one posture for a long time and change their standing posture from time to time. If you stand for too long, you can take a few steps to relax the highly tense intermuscular ligament.
The fourth note of lumbar muscle strain: it is advisable to lie on your side in sleeping position, so that your hips and knees are in a proper flexion position; If the mattress is too soft, a hard board should be placed under the cushion; Note that the mattress should not be too thin to prevent the waist from catching cold.
The fifth note of lumbar muscle strain: moderate diet, sometimes living. Daily life is sometimes the guarantee of human health. Normal people should get enough sleep, go to bed early and get up early. Reasonable diet and regular life are helpful to prevent lumbar muscle strain.
Lumbar muscle strain exercise
Chronic lumbar muscle strain is often caused by many factors. For example, long-term physical labor or exercise will lead to fatigue or injury of lumbar muscles due to excessive waist load. Fat people who lack physical exercise for a long time, when standing, move their center of gravity forward, which is also easy to cause strain on waist ligaments and muscles. Long-term cold invasion of the waist can also cause chronic low back stiffness and pain. Falling, twisting and bumping in daily life can also cause different degrees of damage to waist muscles and ligaments. Improper or incomplete treatment of acute injury can also turn into chronic lumbar muscle strain. Chronic lumbar muscle strain is characterized by light and heavy, aggravated in the morning, relieved after a little exercise and aggravated after fatigue.
Simple rehabilitation exercises for lumbar muscle strain are as follows:
1. Waist flexion and extension: Stand with your feet shoulder width apart, hands akimbo, and prepare for posture. Then make the waist bend forward fully, stretch backward four times steadily, and relax the waist muscles as much as possible during exercise.
2, waist swing: the posture is the same as before. The waist rotates clockwise and counterclockwise 1 time, and then rotates from slow to fast, from small to large, clockwise and counterclockwise for 8 times.
3. "Arch Bridge Style": Lie on your back, bend your legs, and lift your hips with your feet, elbows and back of your head as fulcrums, such as arch bridge style. With the progress of exercise, you can put your arms on your chest and practice with your feet and the back of your head as fulcrums. Exercise repeatedly for 20- 40 times.
4. "Flying Swallow": On the prone bed, put your arms on your sides, straighten your legs, and then lift your head, upper limbs and lower limbs. Don't bend your elbows and knees, always keep straight, such as flying swallows, and exercise repeatedly for 20- 40 times. Do the above methods once before going to bed and once in the morning.
Drug name
Generic name: aspirin enteric-coated tablets
English name: aspirin enteric-coated tablets
Chinese Pinyin: Aspirin Chang Rong Tablets.
Dosage form: tablet (enteric coating)
Ingredients aspirin.
Chemical name: 2- (acetoxy) benzoic acid.
Molecular formula: C9H8O4
Molecular weight: 180. 16
Properties This product is an enteric-coated tablet, which is white after coating is removed.
Pharmacology, toxicology and pharmacology: 1. Analgesic effect: Peripheral analgesic effect is mainly produced by inhibiting the synthesis of prostaglandin and other substances that can make pain sensitive to mechanical or chemical stimuli (such as bradykinin and histamine). However, the possibility of central analgesia (which may act on hypothalamus) cannot be ruled out. 2. Anti-inflammatory effect: The exact mechanism is not clear, which may be due to the anti-inflammatory effect of this product by inhibiting the synthesis of prostaglandin or other substances that can cause inflammatory reaction (such as histamine). Inhibition of lysosomal enzyme release and leukocyte chemotaxis may also be related to it. 3. antipyretic effect; It may act on the thermoregulatory center of hypothalamus to dilate peripheral blood vessels, increase skin blood flow and sweat, thus increasing heat dissipation and playing an antipyretic role. This central effect may be related to the inhibition of prostaglandin synthesis in hypothalamus. 4. Anti-rheumatic effect: The anti-rheumatic mechanism of this product is mainly anti-inflammatory besides antipyretic and analgesic effects. (5) Inhibition of platelet aggregation: It plays a role by inhibiting cyclooxygenase of platelets and reducing the production of prostaglandin.
Pharmacokinetics this product can absorb most of it in the upper part of small intestine. However, the absorption of enteric-coated tablets is slow. The protein binding rate of aspirin is low, while the protein binding rate after salicylate hydrolysis is 65% ~ 90%. When the blood concentration is high, the binding rate decreases accordingly. The combination rate of renal insufficiency and pregnancy is also low. T 1/2 is 15 ~ 20 minutes; The length of salicylate t 1/2 depends on the dose and urine pH value, and it takes about 2 ~ 3 hours when taking a small dose at a time. Large dose can last for more than 20 hours, and repeated use can last for 5 ~ 18 hours. Most of this product is rapidly hydrolyzed into salicylate in gastrointestinal tract, liver and blood, and then metabolized in liver. The main metabolites are salicyluric acid and glucuronic acid, and a small part is oxidized to gentisic acid. After one dose, the peak plasma concentration was 1 ~ 2 hours. The blood concentration of analgesic and antipyretic drugs is 25 ~ 50g/ml；; 150 ~ 300 g/ml anti-rheumatic and anti-inflammatory. The time required for the blood drug concentration to reach a stable state increases with the increase of daily dose. In the case of large dose of drugs (such as anti-rheumatism), it usually takes 7 days, but it takes 2 ~ 3 weeks or more to achieve the best curative effect. For patients who take large doses of drugs for a long time, because the main metabolic pathways of drugs are saturated, the increase of small doses can lead to great changes in blood drug concentration. This product is excreted from the kidney in the form of bound metabolites and free salicylic acid. When the dose is large, the excretion of unmetabolized salicylic acid increases. There will be great discrimination between individuals. Urine pH has an effect on excretion rate. In alkaline urine, the excretion rate is accelerated and the amount of free salicylic acid is increased, while in acidic urine, the opposite is true.
Indications This product is a non-steroidal anti-inflammatory drug. Clinically, it can be used in the following situations.
1. Analgesia and antipyretic: it can relieve mild or moderate pain, such as headache, toothache, neuralgia, muscle pain, menstrual pain, etc., and can also be used for fever such as cold and flu. This product can only relieve symptoms, but cannot treat the causes of pain and fever, so other drugs should be used to treat the causes at the same time.
2. Anti-inflammatory and anti-rheumatism: it is a commonly used drug to treat rheumatic fever. After taking it, it can relieve fever, improve joint symptoms and reduce ESR, but it can't eliminate the basic pathological changes of rheumatic fever, nor can it treat and prevent complications such as heart damage.
3. Arthritis: In addition to rheumatoid arthritis, this product is also used to treat rheumatoid arthritis, which can improve symptoms, but it must be treated at the same time. In addition, this product can also be used for skeletal muscle pain with non-rheumatic inflammation such as osteoarthritis, ankylosing spondylitis and juvenile arthritis, and can also relieve symptoms. But in recent years, this product has been rarely used for these diseases.
4. Anti-thrombosis: This product can inhibit platelet aggregation and prevent thrombosis. Clinically, it is used to prevent thrombosis after transient ischemic attack, myocardial infarction, atrial fibrillation, artificial heart valve, arteriovenous fistula or other operations. It can also be used to treat unstable angina pectoris.
5. Pediatrics is used to treat cutaneous mucosal lymph node syndrome (Kawasaki disease).
Usage and dosage: 1. Adults generally take it orally. (1) antipyretic and analgesic, 0.3~0.6g once, three times a day, every 4 hours 1 time if necessary; ② Anti-rheumatism, 3 ~ 6g per day, taken orally for 4 times; ③ Small dosage should be used to inhibit platelet aggregation, such as 80 mg ~ 300 mg per day 1 time; ④ Treatment of biliary ascariasis, 1g once, 2 ~ 3 times a day for 2 ~ 3 days; Paroxysmal strangulation was stopped after 24 hours, and then treated with insect repellent. 2. Children usually take it orally. (1) antipyretic and analgesic, taken orally according to body surface area 1.5g/m2, 4-6 times a day, or 5- 10mg/kg each time, or 60mg every year, and every 4-6 hours 1 time if necessary; ② Anti-rheumatism: Take it at a weight of 80- 100 mg/kg, 3-4 times a day. If there is no curative effect after 1-2 weeks, the dosage can be adjusted according to the blood concentration. Some cases need to be increased to 130mg/kg/ day. For children with cutaneous mucosal lymph node syndrome (Kawasaki disease), 80 ~ 100 mg/kg daily, divided into 3 ~ 4 times; After 2 ~ 3 days of fever, take 30mg/kg daily, divided into 3 ~ 4 times, and take it continuously for more than 2 months. During the period of platelet elevation and hypercoagulability, take 5 ~ 10 mg/kg, 1 time every day.
Adverse reactions The dosage usually used to relieve fever and pain rarely causes adverse reactions. Long-term large-scale use of drugs (such as treating rheumatic fever), especially when the blood concentration of drugs is greater than 200 g/ml, is prone to adverse reactions. The higher the blood concentration, the more obvious the adverse reactions. 1. The common gastrointestinal reactions (3% ~ 9%) are nausea, vomiting, epigastric discomfort or pain (caused by direct stimulation of gastric mucosa by this product), which can disappear after stopping taking the drug. Long-term or high-dose administration may lead to gastrointestinal bleeding or ulcer. 2. Central nervous system: after taking a certain course of treatment, reversible tinnitus and hearing loss usually occur, and the blood drug concentration reaches 200 ~ 300 g/L. 3. Allergic reaction: 0.2% of patients have asthma, urticaria, angioneurotic edema or shock. Most of them are susceptible, and dyspnea occurs quickly after taking the medicine, which can lead to death in severe cases, which is called aspirin asthma. Some are allergic to aspirin, asthma and nasal polyps, which are often related to genetic and environmental factors. 4. The damage of liver and kidney function is dose-related, especially when the blood concentration reaches 250g/ml. This damage is reversible and can be recovered after drug withdrawal. However, there are reports of renal papillary necrosis.
Taboo 1. Those who are allergic to this product are prohibited; 2. The following conditions should be prohibited: ① Active ulcer or gastrointestinal bleeding caused by other reasons; ② Hemophilia or thrombocytopenia; ③ People with allergic history to aspirin or other non-steroidal anti-inflammatory drugs, especially those with asthma, neurovascular edema or shock.
Precautions 1. Allergic reaction to fork. If you are allergic to this product, you may also be allergic to another salicylic acid drug or another non-salicylic acid non-steroidal anti-inflammatory drug. But not absolutely. We must be alert to the possibility of cross-allergy. 2. Interference with diagnosis: ① When the daily dose of copper sulfate exceeds 2.4g for a long time, the urine glucose test of copper sulfate may be false positive. Glucose enzyme urine glucose test can appear false negative; ② It can interfere with urine ketone body test; ③ When the blood concentration exceeds 1.30 g/ml, a false high value can be obtained by colorimetric method, but the uricase rule is not affected; ④ This product can interfere with the fluorometric determination of 5- hydroxyindoleacetic acid (5-HIAA) in urine; ⑤ The determination of urine vanillin almond acid (VMA) may be high or low due to different methods; ⑥ Because this product inhibits platelet aggregation, it can prolong bleeding time. As small as 40mg/ day can also affect platelet function, but there is no report of bleeding caused by small dose (< <150 mg/day) in clinic. ⑦ Liver function test showed that alanine aminotransferase, aspartate aminotransferase and serum alkaline phosphatase changed abnormally when the blood concentration was more than 250 g/ml, and returned to normal after reducing the dose; ⑧ Large dose application can prolong the prothrombin time, especially when the plasma concentration is greater than 300 g/ml; Pet-name ruby serum cholesterol is low when the daily dosage exceeds 5g; Attending because this product acts on renal tubules, potassium excretion increases, which can lead to decreased blood potassium; The results of serum thyroxine (T4) and triiodothyroxine (T3) determined by radioimmunoassay may decrease when using this product in large doses. Because this product and phenol red are excreted competitively in renal tubules, the excretion of phenol red is reduced (PSP excretion test). 3. Use with caution in the following situations: ① When allergic reactions such as asthma occur; ② Glucose -6- phosphate dehydrogenase deficiency (this product occasionally causes hemolytic anemia); (3) gout (this product can affect the action of other uric acid excretion drugs, and a small dose may cause uric acid retention); ④ Liver toxicity and bleeding tendency can be aggravated when liver function declines, and patients with liver insufficiency and cirrhosis are prone to renal adverse reactions; ⑤ Cardiac insufficiency or hypertension may cause heart failure or pulmonary edema when a large amount of drugs are used; ⑥ Renal insufficiency may aggravate nephrotoxicity; ⑦ thrombocytopenia. 4. The hematocrit, liver function and serum salicylic acid content should be checked regularly when a large number of drugs are used for a long time.
Pregnant women and lactating women can easily pass through the placenta when using this product. Animal experiments show that the application of this product in early pregnancy can cause teratomas, such as spina bifida, cranial fissure, facial fissure, leg deformity, central nervous system, organ and bone hypoplasia, etc. There are also reports of human fetal defects after using this product. In addition, long-term and large-scale use of this product in the third month of pregnancy can prolong pregnancy and increase the risk of overdue delivery syndrome and prenatal bleeding. Use in the last two weeks of pregnancy will increase the risk of fetal bleeding or neonatal bleeding. Long-term medication in the third trimester of pregnancy may also cause fetal arterial catheter contraction or early atresia, leading to persistent pulmonary hypertension and heart failure in newborns. It is reported that excessive use or abuse of this product in the third trimester of pregnancy will increase the incidence of stillbirth or neonatal death (possibly due to arterial catheter atresia, prenatal bleeding or low weight). However, the above adverse reactions were not found by using general therapeutic doses. This product can be excreted through milk sweat, and the drug concentration in milk can reach 173 ~ 483 g/ml 5 ~ 8 hours after oral administration of 650mg by lactating women. Therefore, infants taking large doses of drugs for a long time may have adverse reactions.
Pediatric patients, especially those with fever and dehydration, are prone to toxic reactions. The use of this product in children with acute febrile diseases, especially influenza and chickenpox, may be related to the occurrence of Wright syndrome, which is rare in China.
Due to the decline of renal function, elderly patients are prone to toxic reactions when taking this product.
drug interaction
1. When combined with other non-steroidal anti-inflammatory and analgesic drugs, the efficacy is not enhanced, because this product can reduce the bioavailability of other non-steroidal anti-inflammatory drugs. In addition, gastrointestinal side effects (including ulcers and bleeding) have increased; In addition, due to the enhanced inhibition of platelet aggregation, it can also increase the risk of bleeding in other parts. Long-term and large-scale use of this product and acetaminophen may lead to kidney diseases, including renal papillary necrosis, renal cancer or bladder cancer.
2. When it is combined with any drug that can cause hypoproteinemia, thrombocytopenia, decreased platelet aggregation function or gastrointestinal ulcer bleeding, it may aggravate coagulation disorder and cause bleeding.
3. Combined with anticoagulant (dicoumarin, heparin, etc.). ) and thrombolytic agents (streptokinase, urokinase) will increase the risk of bleeding.
4. Urine alkalizing drugs (sodium bicarbonate, etc. ) and antacids (long-term large-scale application) can increase the excretion of this product from urine and reduce the blood drug concentration. However, when the blood drug concentration of this product reaches a stable state and the alkaline drugs are stopped, the blood drug concentration of this product can rise to a toxic level. Carbonic anhydrase inhibitor can alkalize urine, but it can cause metabolic acidosis, which can not only reduce the blood drug concentration, but also increase the amount of the product penetrating into brain tissue, thus aggravating the toxic reaction.
5. Uric acid drugs can reduce the excretion of this product and increase its blood concentration. Patients whose blood concentration of this product has reached a stable state may increase the blood concentration of this product and increase the toxic reaction after adding uric acid drugs.
6. Glucocorticoid (hormone for short) can increase the excretion of salicylate. In order to maintain the blood concentration of this product, the dosage of this product should be increased when necessary. This product is used with hormones for a long time. Especially when used in large quantities, it may increase the risk of gastrointestinal ulcer and bleeding. Therefore, it is not recommended to use these two drugs at the same time in clinic at present.
7. The hypoglycemic effect of insulin or oral hypoglycemic agents can be strengthened and accelerated by combining with this product.
8. When combined with methotrexate (MTX), it can reduce the combination of methotrexate and protein, reduce its excretion from the kidney, increase the blood drug concentration and increase the toxic reaction.
9. At the same time, the application of this product can reduce the uric acid excretion of probenecid or sulpirone; When the blood concentration of salicylate is greater than 50g/ml, it will obviously decrease, especially when it is greater than 100 ~ 150g/ml. In addition, probenecid can reduce the clearance rate of salicylate from kidney, thus increasing the plasma concentration of salicylate.
Symptoms of drug overdose: ① mild salicylic acid reaction, which is more common in rheumatic patients treated with this product, including headache, dizziness, tinnitus, deafness, nausea, vomiting, diarrhea, drowsiness, mental disorder, hyperhidrosis, deep breathing, polydipsia, involuntary movement of hands and feet (more common in the elderly) and visual impairment; ② Severe symptoms, including hematuria, convulsion, hallucination, severe mental disorder, dyspnea and nameless fever; Children with mental and respiratory disorders are more obvious.
Specification (1) 0.3g (2) 25mg (3) 50mg (4) 75mg
Keep away from light and seal in a dry place.
Each bottle 100 tablets, packed in plastic bottles; 12 tablets per box, aluminum-plastic blister packaging.
Validity 12 months.