针刺远端取穴在治疗腰椎间盘突出症中的临床应用  

Clinical Application of Acupuncture at Distal Acupoints in Treating Protrusion of Lumbar Disc Herniation

作　　者：陈春 莫靖煊 林海 时福东 靳蛟 吴冠男[1] 张世民[1] Chen Chun;Mo Jingxuan;Lin Hai;Shi Fudong;Jin Jiao;Wu Guannan;Zhang Shimin(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100020,China)

机构地区：[1]中国中医科学院望京医院,北京100020

出　　处：《中国中医急症》2023年第5期866-869,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：中国中医科学院科技创新工程重大攻关项目(CI2021A02006)。

摘　　要：目的 观察针刺远端取穴治疗腰椎间盘突出症的临床疗效并探讨其作用机制。方法 67例患者随机分为针刺组33例与药物牵引组34例。药物牵引组予口服塞来昔布胶囊联合腰椎牵引。针刺组在其基础上予针灸远端取穴治疗(先牵引后针刺)。两组均以7 d为1个疗程,共治疗2个疗程。观察对比治疗前、第1次治疗后即刻、治疗2周及治疗后1个月两组的情况,采用日本骨科协会评估治疗分数(JOA)评估神经功能改善情况,采用疼痛视觉模拟表(VAS)评分和Oswestry功能障碍指数(ODI)评价患者疼痛和功能改善情况,采用改良MacNab标准评价治疗后1个月随访时临床疗效。结果 67例患者均顺利完成治疗并获随访,随访时间超过1个月,平均(33.62±2.23)d,治疗期间未出现明显不良反应。治疗2周及治疗后1个月与治疗前比较,两组VAS评分和ODI评分均降低,JOA评分升高,且针刺组评分改善均优于药物牵引组(均P <0.05)。针刺组优良率高于药物牵引组,但差异无统计学意义(P> 0.05)。结论 针刺远端取穴治疗腰椎间盘突出症起效迅速、疗效理想。Objective:To observe the clinical efficacy of acupuncture at distal acupoints for lumbar disc herniation.Methods:A total of 67 patients with lumbar disc herniation who were admitted randomly divided into an acupuncture group and a drug traction group.The drug traction group was used the oral celecoxib capsules(200 mg/time,2 times/d)combined with lumbar traction.The acupuncture group was treated with acupuncture and moxibustion on the basis of remote acupoint selection(traction first,then acupuncture).Both groups took 7 days as a course of treatment for a total of 2 courses of treatment.The two groups were compared before treatment,immediately after the first treatment,2 weeks after treatment,and 1 month after treatment.Japanese Orthopedic Association(JOA)scores were used to evaluate the improvement of neurological function after treatment.Visual Analog Scale(VAS)score and Oswestry Disability Index(ODI)were used to evaluate the improvement of pain and function of patients,and the modified MacNab standard was used to evaluate the clinical efficacy at 1-month after treatment.Results:All 67 patients successfully completed the treatment and were followed.At immediately after the first treatment,2 weeks after treatment and 1 month after treatment,in terms of VAS score and ODI index,the two groups both have decreased compared with those before treatment(P<0.05).However,the JOA score both increased in two groups afer treatment.The acupuncture group was better than the drug traction group(P<0.05).Conclusion:Acupuncture at distal acupoints is effective in the treatment of lumbar disc herniation with rapid onset and has satisfactory curative effect,which is worthy of popularization.

关 键 词：腰椎间盘突出症 远端取穴 针灸 临床应用 

分 类 号：R681.53[医药卫生—骨科学]