燔针劫刺针法对椎间盘源性坐骨神经痛疗效的影响:随机对照试验  

Therapeutic effect of Fanzhen Jieci needling on discogenic sciatica: a randomized controlled trial

作　　者：潘昊天 李璟[1,3] 冯晨晨 裴丽娟 奚紫琦 侯文光[1,3] 王珂 PAN Hao-tian;LI Jing;FENG Chen-chen;PEI Li-juan;XI Zi-qi;HOU Wen-guang;WANG Ke(Acupuncture Anesthesia Clinical Research Institute;Yueyang Clinical Medical College,Shanghai University of TCM,Shanghai 201203;Department of Acupuncture and Moxibustion,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of TCM,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院针麻临床研究室,上海201203 [2]上海中医药大学岳阳临床医学院,上海201203 [3]上海中医药大学附属岳阳中西医结合医院针灸科,上海201203

出　　处：《中国针灸》2022年第3期261-266,共6页Chinese Acupuncture & Moxibustion

基　　金：上海市科委医学引导项目:18401904900;国家自然科学基金项目:81973940、81673756;上海市卫生系统优秀人才培养计划项目:2018BR24;上海市针灸临床医学研究中心项目:20MC1920500;上海市临床重点专科项目:shslczdzk04701;上海市进一步加快中医药事业发展三年行动计划项目:ZY(2018-2020)-CCCX-2004-04。

摘　　要：目的:比较燔针劫刺联合常规针刺与单纯常规针刺治疗椎间盘源性坐骨神经痛的临床疗效。方法:将76例椎间盘源性坐骨神经痛患者随机分为燔针劫刺组和常规针刺组,每组38例。常规针刺组于肾俞、大肠俞、L_(1)~L_(5)夹脊穴、患侧环跳穴等进行常规针刺;在常规针刺组基础上,燔针劫刺组于L_(1)~L_(5)夹脊穴和患侧环跳穴行燔针劫刺针法,即L_(1)~L_(5)夹脊穴行温针灸,患侧环跳快速进针40~60 mm,使患者产生触电样感并放射至下肢,然后快速出针。两组均隔日1次,每周3次,共治疗3周。比较两组患者治疗前后腿痛与腰痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分、健康调查简表(SF-36)评分。结果:两组患者治疗后腿痛与腰痛VAS评分、ODI评分均较治疗前降低(P<0.001),燔针劫刺组腿痛、腰痛VAS评分降幅大于常规针刺组(P<0.05)。治疗后,除情感职能、健康变化评分外,燔针劫刺组患者SF-36各维度评分均较治疗前升高(P<0.01);除生理职能、情感职能、健康变化评分外,常规针刺组患者SF-36各维度评分均较治疗前升高(P<0.01)。治疗后,燔针劫刺组患者生理功能、生理职能、身体疼痛、精神健康及总体健康维度SF-36评分高于常规针刺组(P<0.05)。结论:燔针劫刺联合常规针刺可有效缓解椎间盘源性坐骨神经痛患者疼痛症状,改善精神状态,疗效优于单纯常规针刺。Objective To compare the therapeutic effect between Fanzhen Jieci(warming acupuncture plus fast needling)combined with conventional acupuncture and simple conventional acupuncture on discogenic sciatica.Methods A total of 76 patients with discogenic sciatica were randomized into a Fanzhen Jieci group and a conventional acupuncture group,38 cases in each one.Conventional acupuncture was applied at Shenshu(BL 23),Dachangshu(BL 25),L_(1)~L_(5) Jiaji(EX-B 2)and Huantiao(GB 30)on the affected side,etc.in the conventional acupuncture group.On the basis of the treatment in the conventional acupuncture group,Fanzhen Jieci was applied at L_(1)~L_(5) Jiaji(EX-B 2)and Huantiao(GB 30)on the affected side in the Fanzhen Jieci group,i.e.warming acupuncture was applied at L_(1)~L_(5) Jiaji(EX-B 2),and fast needling was applied at Huantiao(GB 30)on the affected side for a depth of 40-60 mm,so as to introduce a sensation of electric shock transmitting to lower limb,and then the needle was immediately withdrawn.The treatment was given once every other day,3 times a week for 3 weeks in both groups.The visual analogue scale(VAS)score of leg and low back pain,the Oswestry disability index(ODI)score and the 36-item short form health survey(SF-36)score before and after treatment were compared between the two groups.Results Compared before treatment,the VAS scores of leg and low back pain and the ODI scores after treatment were decreased in both groups(P<0.001),the changes of the VAS scores of leg and low back pain in the Fanzhen Jieci group were larger than those in the conventional acupuncture group(P<0.05).After treatment,except for the role emotional and health transition scores,the various scores of SF-36 were increased compared before treatment in the Fanzhen Jieci group(P<0.01);except for the role physical,role emotional and health transition scores,the various scores of SF-36 were increased compared before treatment in the conventional acupuncture group(P<0.01).After treatment,the physical functioning,role physical,bodily pain,m

关 键 词：坐骨神经痛 腰椎间盘突出症 针灸 燔针劫刺 

分 类 号：R246.2[医药卫生—针灸推拿学]