经膀胱经腧穴透刺关节突关节温针灸治疗腰椎关节突关节源性腰痛的临床研究  

A clinical study of acupuncture at zygapophysial joint with warmed needle that reaches there by penetrating acupoint of bladder meridian for treatment of low back pain originated from lumbar zygapophysial joints

作　　者：王雷生[1] 杨勇[2] WANG Leisheng;YANG Yong(The Affiliated Hospital of Henan Academy of Traditional Chinese Medicine , Zhengzhou 450004 , Henan , China;The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450008, Henan, China)

机构地区：[1]河南省中医药研究院附属医院,河南郑州450004 [2]河南中医药大学第三附属医院,河南郑州450008

出　　处：《中医正骨》2018年第5期6-9,19,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：河南省中医药科学研究专项课题(2015ZY02070)

摘　　要：目的:观察经膀胱经腧穴透刺关节突关节温针灸治疗腰椎关节突关节源性腰痛的临床疗效和安全性。方法:将72例符合要求的腰椎关节突关节源性腰痛患者随机分为2组,每组36例。直刺组在患者L4、L5、S1椎体双侧上关节突与相应横突根部的交界点实施温针灸治疗,透刺组采用经双侧气海俞、大肠俞、关元俞向L4、L5、S1椎体同侧上关节突与相应横突根部交界点透刺温针灸治疗。2组的温针灸治疗均每天1次,10次为1个疗程,间隔7 d后进行下一疗程治疗,共治疗2个疗程。采用视觉模拟量表(visual analogue scale,VAS)评定患者的腰部疼痛情况,采用BCS-400背力计测定患者的腰背伸力,采用Oswestry功能障碍指数(Oswestry disability index,ODI)问卷表评定腰痛对患者日常生活的影响,同时观察患者试验期间的不良反应发生情况。结果:2组患者均完成试验,试验过程中均未出现不良反应。治疗前2组患者的腰痛VAS评分比较,差异无统计学意义(t=0.081,P=0.936);治疗结束后2组患者的腰痛VAS评分均较治疗前降低[(6.62±1.50)分,(3.18±1.09)分,t=7.635,P=0.000;(6.71±1.59)分,(2.10±1.13)分,t=12.875,P=0.001];治疗结束后直刺组的评分高于透刺组(t=5.473,P=0.008)。治疗前2组患者的腰背伸力比较,差异无统计学意义(t=0.253,P=0.880);治疗结束后2组患者的腰背伸力均较治疗前增大[(58.02±3.67)N,(64.64±5.23)N,t=11.771,P=0.000;(57.89±5.77)N,(67.17±4.46)N,t=8.005,P=0.000];治疗结束后直刺组的腰背伸力低于透刺组(t=-3.751,P=0.000)。治疗前2组患者的ODI比较,差异无统计学意义(t=1.240,P=0.287);治疗结束后2组患者的ODI均较治疗前降低[(68.45±13.67)%,(17.64±11.23)%,t=15.332,P=0.000;(69.19±12.77)%,(13.17±10.46)%,t=17.653,P=0.000];治疗结束后直刺组的ODI高于透刺组(t=-4.369,P=0.001)。结论:经膀胱经腧穴透刺关节突关节温针灸治疗和关节突关节温针灸治疗均能有效缓解腰椎关节突关节源�Objective：To observe the clinical curative effects and safety of acupuncture at zygapophysial joint with warmed needle that reaches there by penetrating acupoint of bladder meridian for treatment of low back pain originated from lumbar zygapophysial joints.Methods：Seventy-two patients with low back pain originated from lumbar zygapophysial joints enrolled in the study were randomly divided into straight acupuncture group and penetrating acupuncture group,36 cases in each group.The patients in straight acupuncture group were treated with acupuncture with warmed needles at the junction points of bilateral superior articular processes of L_4-S_1and corresponding roots of transverse processes,while the patients in penetrating acupuncture group were treated with acupuncture at the junction points of ipsilateral superior articular processes of L_4-S_1and corresponding roots of transverse processes with warmed needles that reached there by penetrating bilateral acupoints of Qihaishu（BL24）,Dachangshu（BL25）and Guanyuanshu（BL26）.The needle warming therapy was performed on patients once a day for 2 courses of treatment,10 times for each course with a 7-day rest-insertion between courses.The low back pain,the low back tensility and the effect of low back pain on daily living were evaluated by using visual analogue scale（VAS）,BCS-400 back strength dynamometer and Oswestry disability index（ODI）questionnaires respectively,meanwhile,the adverse reactions were observed.Results：The clinical trial was finished successfully in all patients,and no adverse reactions were found in the 2 groups during the clinical trial.There was no statistical difference in the low back pain VAS scores between the 2 groups before the treatment（t=0.081,P=0.936）.The low back pain VAS scores decreased after the end of the treatment compared to pretreatment in the 2 groups（6.62＋/-1.50 vs 3.18＋/-1.09 points,t=7.635,P=0.000;6.71＋/-1.59 vs 2.10＋/-1.13 points,t=12.875,P=0.001）.The low back pain VAS scores were higher i

关 键 词：腰痛 椎关节突关节 温针疗法 膀胱经 透针 临床试验 

分 类 号：R246.9[医药卫生—针灸推拿学]