① Qi Stagnation and Blood Stasis Pattern: Severe, stabbing pain; marked tenderness at the painful site; ecchymosis on the skin; dark-red tongue with stasis-obstructed sublingual collaterals; thin white coating; wiry-tight pulse.
② Liver-Kidney Yin Deficiency Pattern: Flushed complexion; dry throat and mouth; soreness and weakness in the lower back and legs; forgetfulness and tinnitus; dizziness and blurred vision; general fatigue and weakness; insomnia with vivid dreams; constipation; red tongue with scanty coating; wiry-rapid pulse.
③ Spleen-Kidney Yang Deficiency with Blood Stasis Pattern: Fixed-location pain; marked soreness and weakness in the lumbar spine; blurred vision, loosening teeth, and hair loss; poor appetite and loose stools; anorexia; rough or dry skin; purplish-dark lips; pale or dark tongue, possibly with petechiae or ecchymosis; deep-fine-weak or choppy pulse.
④ Spleen-Kidney Yang Deficiency Pattern: Dull, lingering pain in the injured limb; cold pain in the lumbar region and back; flaccid and weak lower limbs; withered, atrophied muscles; lassitude and fatigue; pale complexion; shortness of breath and reluctance to speak; dizziness and blurred vision; spontaneous sweating; palpitations and insomnia; dark-red tongue with thin white coating; fine or weak pulse.
⑤ Kidney Deficiency with Blood Stasis Pattern: Fixed-location pain; marked tenderness at the painful site; soreness and weakness in the lower back and knees; generalized pain; muscle spasm and contraction; tinnitus and deafness; hair loss and loosening teeth; forgetfulness; delayed motor responses; history of trauma or chronic disease; purplish-dark tongue with petechiae or ecchymosis; choppy or wiry pulse.
Standard Classification of TCM Syndromes for Lumbar Disc Herniation
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Qi Stagnation and Blood Stasis Syndrome: Sharp, stabbing low back and leg pain localized to a fixed site; milder during the day but worse at night; stiffness and rigidity in the lumbar region; restricted flexion, extension, and rotation; tenderness upon palpation at the painful site. The tongue appears dark-purple or exhibits ecchymotic spots; the pulse is wiry-tight or choppy.
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Cold-Damp Syndrome: Cold, heavy, and achy pain in the low back and legs; difficulty turning or shifting position; no relief from pain while lying still; exacerbation by cold exposure or rainy weather; coolness in the limbs. The tongue is pale with a white or greasy coating; the pulse is deep-tight or soft-slow.
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Damp-Heat Syndrome: Low back pain accompanied by weakness and heaviness in the legs; a sensation of heat at the painful site; aggravation by heat or rainy weather; alleviation after physical activity; aversion to heat, thirst, and scanty, dark-yellow urine. The tongue coating is yellow-greasy; the pulse is soft-rapid or wiry-rapid.
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Liver-Kidney Deficiency Syndrome: Dull, aching low back pain; fatigue and weakness in the legs and knees; worsening with exertion and improvement when lying down.
- In cases of Yang deficiency: pallor, cold hands and feet, shortness of breath, lethargy, cold sensation in the low back and legs, impotence or premature ejaculation (in men), or clear, thin vaginal discharge (in women); pale tongue; deep-fine pulse.
- In cases of Yin deficiency: dry throat and thirst, flushed complexion, fatigue and lassitude, irritability, insomnia, frequent dreams, or nocturnal emissions (in men), or yellow, foul-smelling vaginal discharge (in women); red tongue with little coating; wiry-fine-rapid pulse.
References
Lumbar Disc Herniation: TCM Evidence-Based Practice Guidelines (Draft).pdf