经颅重复针刺激足运感区治疗腰椎间盘突出型坐骨神经痛临床研究  

Clinical Study on rTAS of Foot Motor Sensory Area in Treating Sciatica Caused by LDH

作　　者：蒋汶汐 蒋希成[2] 孙远征[1] JIANG Wenxi;JIANG Xicheng;SUN Yuanzheng(The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150001, China;Heilongjiang University of Chinese Medicine, Harbin 150040, China)

机构地区：[1]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001 [2]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《针灸临床杂志》2021年第8期20-24,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目,编号:国中医药人教发[2014]20号。

摘　　要：目的:观察经颅重复针刺激(rTAS)足运感区治疗腰椎间盘突出型坐骨神经痛的临床疗效,为经颅重复针刺激法的临床应用提供理论依据。方法:将90例患者按随机数字表随机分为对照组、头针组和经颅重复针刺激法(rTAS)组,每组各30例。对照组予常规针刺治疗,选取“十三五”规划教材《针灸治疗学》中坐骨神经痛主穴;头针组在对照组基础上加双侧头部足运感区;rTAS组在头针基础上头针施加经颅重复针刺激法。3组均治疗1次/d,6次/周,共治疗4周。治疗后对比3组治疗前后的NRS评分、M-JOA评分、直腿抬高试验角度以及治疗总有效率。结果:治疗后,3组患者NRS评分、M-JOA评分较治疗前均下降,直腿抬高试验角度较治疗前增大(P<0.05);与对照组比较,头针组的各项指标改善情况更具优势(P<0.05);与头针组比较,rTAS组的各项指标改善情况更显著(P<0.05)。3组总有效率分别为对照组50.0%(15/30)、头针组83.3%(25/30)和rTAS组90.0%(27/30)。结论:经颅重复针刺激足运感区治疗腰椎间盘突出型坐骨神经痛疗效显著,能够明显改善临床症状及体征,优于常规针刺。Objective:To observe the clinical efficacy of repeated transcranial acupuncture stimulation(rTAS)in the treatment of sciatica caused by lumbar disc herniation(LDH),and to provide theoretical basis for the clinical application of rTAS.Methods:90 patients met the inclusion criteria were randomly divided into the control group(n=30),the scalp acupuncture group(n=30)and the rTAS group(n=30).The control group was treated with conventional needling main acupoints for sciatica;on which basis,the scalp acupuncture group was also treated with needling foot sensory areas;the rTAS group received rTAS on the treatment basis of the scalp acupuncture group.After four weeks of the treatment,the grade of numerical rating scale(NRS),the scores of modified Japanese Orthopaedic Association(M-JOA),the angles of straight leg elevation test and the total effective rate were compared among the three groups.Results:The grade of NRS and the scores of M-JOA were significantly decreased and the angles of straight leg elevation test were greatly increased after the treatment compared to those before the treatment in the three groups(P<0.05).Compared to those in the control group,the improvements of various indicators in the scalp acupuncture group were more significant(P<0.05).Compared to those in the scalp acupuncture group,the improvements of various indicators in the rTAS group were more significant(P<0.05).In terms of the effective rate,it was 50.0%(15/30)in the control group,83.3%(25/30)in the scalp acupuncture group and 90.0%(27/30)in the rTAS group.Conclusion:rTAS is effective in treating sciatica caused by LDH,it can obviously improve the clinical symptoms and physical signs,which is superior to conventional acupuncture.

关 键 词：经颅重复针刺激法 足运感区 腰椎间盘突出 坐骨神经痛 

分 类 号：R246.6[医药卫生—针灸推拿学]