针刺治疗腰椎间盘突出症的临床正交设计观察  

Acupuncture in the Treatment of Lumbar Disc Herniation:An Analysis Based on Orthogonal Design

作　　者：刘欢 宋洪堰 朱中书 岳艳芳 孟令章 柴一峰 LIU Huan;SONG Hong-yan;ZHU Zhong-shu;YUE Yan-fang;MENG Ling-zhang;CHAI Yi-feng(School of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Shandong Ji'nan 250355, China;Department of Acupuncture and Moxibustion, Zaozhuang Municipal Hospital of Traditional Chinese Medicine, Shandong Zaozhuang 277000, China;First Department of Acupuncture and Moxibustion, Linyi Municipal Hospital of Traditional Chinese Medicine, Shandong Linyi 276000, China)

机构地区：[1]山东中医药大学针灸推拿学院,山东济南250355 [2]山东省枣庄市中医医院针灸科,山东枣庄277000 [3]山东省临沂市中医医院针灸一科,山东临沂276000

出　　处：《安徽中医药大学学报》2020年第5期42-47,共6页Journal of Anhui University of Chinese Medicine

摘　　要：目的对腰椎间盘突出症的针刺治疗方案进行初步优选。方法以48例腰椎间盘突出症患者为观察对象,以视觉模拟评分法(visual analogue scale,VAS)、日本骨科协会(Japanese orthopaedic association,JOA)评分系统为评价指标,以针刺腰夹脊穴为主要治疗方法,采用四因素二水平正交设计方案,对加强局部选穴、循经远端取穴、电针频率、针刺间隔时间的组合方案进行优选。结果加强局部取穴、循经远端取穴、电针频率3个因素两水平间的VAS及JOA评分差异具有统计学意义(P<0.05);针刺时间间隔两水平之间VAS及JOA评分差异无统计学意义(P>0.05);交互作用中,加强局部取穴与电针频率4 Hz、循经远端取穴与电针频率4 Hz的交互作用最为显著。结论腰椎间盘突出症宜针刺夹脊穴,配合加强局部取穴和循经远端取穴,电针频率4 Hz,隔日治疗1次。Objective To optimize the treatment regimen of acupuncture in the treatment of lumbar disc herniation.Methods A total of 48 patients with lumbar disc herniation were enrolled as subjects.With Visual Analogue Scale(VAS)and the Japanese Orthopaedic Association(JOA)scoring system as the evaluation indices and acupuncture at waist Jiaji points as the main treatment method,the four-factor two-level orthogonal design was used to optimize the combined regimen of enhanced local acupoint selection,distal acupoint selection along the meridians,electroacupuncture frequency,and acupuncture interval.Results There were significant differences in VAS and JOA scores between the two levels of enhanced local acupoint selection,distal acupoint selection along the meridians,and electroacupuncture frequency(P<0.05),while there were no significant differences in VAS and JOA scores between the two levels of acupuncture interval(P>0.05).The interaction analysis showed the strongest interaction between enhanced local acupoint selection and an electroacupuncture frequency of 4 Hz,as well as between distal acupoint selection along the meridians and an electroacupuncture frequency of 4 Hz.Conclusion The best acupuncture treatment regimen for lumbar disc herniation is acupuncture at Jiaji points,combined with enhanced local acupoint selection,distal acupoint selection along the meridians,and an electroacupuncture frequency of 4 Hz,every other day.

关 键 词：腰椎间盘突出症 针刺 正交设计 电针频率 取穴方法 电针时间间隔 

分 类 号：R681.5[医药卫生—骨科学] R246.2[医药卫生—外科学]