圆利针伞形刺结合长蛇灸治疗慢性非特异性下腰痛的灸时-灸效相关性研究  

A Study on Moxibustion Time-Moxibustion Effect Correlation of Round-Sharp Needle Umbrella-Shaped Needling Combined with Long-Snake Moxibustion in Treatment of CNLBP

作　　者：张慧杰 张明明[3] 丁戊坤 栾仲秋 盛紫阳[1,2] 毕述鹏 宋立群[1,2] 吴建丽 ZHANG Huijie;ZHANG Mingming;DING Wukun;LUAN Zhongqiu;SHENG Ziyang;BI Shupeng;SONG Liqun;WU Jianli(The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang University of Chinese Medicine,Harbin 150040,China;The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学,黑龙江哈尔滨150040 [3]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150001

出　　处：《针灸临床杂志》2023年第8期33-37,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家自然科学基金青年项目,编号:82105030;黑龙江省中医药管理局项目,编号:ZHY18-001;黑龙江中医药大学教育教学研究课题,编号:XJJY2018007;宋立群全国名老中医专家传承工作室建设项目,编号:国中医药人教涵[2022]75号。

摘　　要：目的:探讨圆利针伞形刺结合不同灸时长蛇灸治疗慢性非特异性下腰痛的时效关系,为长蛇灸治疗慢性非特异性下腰痛最佳施灸时间的筛选提供临床依据。方法:选取本院收治的慢性非特异性下腰痛患者105例,按照灸时不同随机分为A组、B组和C组,每组各35例。圆利针伞形刺,隔天1次,10 d为1个疗程,共治疗2个疗程,疗程之间间隔7 d。于大椎穴至腰俞穴区施行长蛇灸1次,施灸时长分别为30 min、45 min和60 min,每周1次,共治疗4周。分别观察3组患者治疗前、后视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分、指地距离(FFD)、腰背肌耐力、血清P物质和炎症因子水平的疗效。结果:3组患者治疗后VAS、ODI评分、FFD、P物质、炎症因子CRP和IL-6均低于治疗前,静、动态肌耐力均高于治疗前,差异均具有统计学意义(P<0.05);治疗后,B组和C组的VAS、ODI评分、FFD、P物质、炎症因子CRP和IL-6均低于A组,静、动态肌耐力均高于A组,C组与A组比较,差异具有统计学意义(P<0.05);治疗后C组的总有效率为91.43%(32/35),高于B组85.71%(30/35)和A组77.14%(27/35),C组与A组比较,差异具有统计学意义(P<0.05)。结论:圆利针伞形刺结合60 min长蛇灸治疗慢性非特异性下腰痛疗效最佳。Objective:To explore the time-effect relationship of round-sharp needle umbrella-shaped needling combined with different times of long-snake moxibustion in treatment of chronic non-specific low back pain(CNSLBP),and to provide clinical basis for screening the optimal moxibustion time for long-snake moxibustion in treatment of CNSLBP.Methods:A total of 105 patients with CNSLBP were randomly divided into group A,group B and group C according to the time of moxibustion,with 35 cases in each group.Umbrella-shaped acupuncture with round-sharp needle once every other day for 2 courses of treatment,10 days were taken as a course of treatment,with an interval of 7 days between courses.Long-snake moxibustion was performed once a week from Dazhui(DU14)to Yaoshu(DU2),and the moxibustion duration was 30 minutes,45 minutes and 60 minutes respectively,once a week for 4 weeks.The visual analog scale(VAS)score,Oswestry disability index(ODI)score,finger-to-floor distance(FFD),lower back muscle endurance,as well as serum levels of substance P and inflammatory factors were observed before and after the treatment in the three groups.Results:The scores of VAS and ODI,FFD,substance P,inflammatory factors of CRP and IL-6 were lower,and the static and dynamic muscular endurance were higher after the treatment than those before the treatment in the three groups(P<0.05);the scores of VAS and ODI,FFD,substance P,inflammatory factors of CRP and IL-6 were lower,and the static and dynamic muscular endurance were higher in group B and group C than those in group A after the treatment(P<0.05).The total effective rate of group C was 91.43%(32/35),which was higher than 85.71%(30/35)of group B and 77.14%(27/35)of group A;there was a statistical difference in the total effective rate between group C and group A(P<0.05).Conclusion:The round-sharp needle umbrella-shaped needling combined with 60min long-snake moxibustion has the best effect in treatment of CNSLBP.

关 键 词：非特异性下腰痛 长蛇灸 圆利针伞形刺 灸时 灸效 

分 类 号：R246.6[医药卫生—针灸推拿学]