超声引导下输刺夹脊穴治疗腰椎间盘突出症的随机对照试验  

A randomized controlled trial of acupuncture at Jiaji points for treatment of lumbar disc herniation under ultrasonic guidance

作　　者：朱曦 陶宇洪 黄鹏[3] 李丹 Zhu Xi;Tao Yuhong;Huang Peng;Li Dan(Department of Acupuncture,Third Affiliated Hospital,Beijing University of Chinese Medicine,Beijing 100029,China;Chinese PLA Medical School,Beijing 100853,China;Department of Orthopedics,Fourth Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]北京中医药大学第三附属医院针灸科,北京市100029 [2]解放军医学院,北京市100853 [3]解放军总医院第四医学中心骨科医学部,北京市100853

出　　处：《中国组织工程研究》2024年第36期5852-5857,共6页Chinese Journal of Tissue Engineering Research

基　　金：陆军后勤科研项目(BLJ19J010),项目负责人:黄鹏。

摘　　要：背景:在腰椎间盘突出症的研究中大多数针刺治疗由CT引导或非引导,对位点的精准控制及针刺有效部位不够明确。目的:观察超声引导下输刺夹脊穴治疗腰椎间盘突出症的临床疗效。方法:选择于解放军总医院及北京中医药大学第三附属医院就诊的腰椎间盘突出症患者70例,男36例,女34例,年龄18-65岁,采用随机数表法分成试验组与对照组,每组35例。对照组患者予输刺夹脊穴治疗,试验组患者在超声引导下予输刺夹脊穴治疗,于就诊当天及就诊后4,7 d各治疗1次。治疗前后进行目测类比评分、Oswestry功能障碍指数、日本骨科协会(JOA)评分及健康调查简表(SF-36)评估。结果与结论:①与治疗前相比,两组患者治疗后的目测类比评分均降低(P<0.01);与对照组比较,试验组患者治疗第2,3,6,7天及治疗结束后1,2周的目测类比评分降低(P<0.05,P<0.01)。②与治疗前相比,两组患者治疗后的Oswestry功能障碍指数均降低(P<0.01);与对照组相比,试验组患者治疗第1-7天及治疗结束后1,2周的Oswestry功能障碍指数降低(P<0.01)。③与治疗前相比,两组患者治疗后的JOA评分均升高(P<0.01);与对照组相比,试验组患者治疗等3,7天及治疗结束后1,2周的JOA评分升高(P<0.05,P<0.01)。④与治疗前相比,两组患者治疗后的SF-36评分均升高(P<0.01);两组间治疗后的SF-36评分比较差异无显著性意义(P>0.05)。⑤结果表明,输刺夹脊穴对腰椎间盘突出症具有疗效,并且超声引导能够提升输刺夹脊穴治疗腰椎间盘突出症的疗效。BACKGROUND:In the research on acupuncture treatment for lumbar disc herniation,most acupuncture treatments are performed under CT guidance or without guidance.The precise control of the target site and the effective acupuncture location are not clear.OBJECTIVE:To observe the clinical effects of acupuncture at Jiaji points under ultrasonic guidance in treating lumbar disc herniation.METHODS:A total of 70 cases of lumbar disc herniation,36 males and 34 females aged 18-65 years old,were selected from Chinese PLA General Hospital and Third Affiliated Hospital of Beijing University of Chinese Medicine.They were divided into trial group and control group by random number table method,with 35 cases in each group.The control group received acupuncture at Jiaji points.The trial group received acupuncture at Jiaji points under ultrasonic guidance.The patients were treated once on the day of treatment and 4,7 days after treatment.Visual analog scale score,Oswestry disability index,Japanese Orthopaedic Association score,and MOS 36-Item Short-Form Health Survey(SF-36)were evaluated before and after treatment.RESULTS AND CONCLUSION:(1)Compared with before treatment,the visual analog scale scores of both groups were decreased after treatment(P<0.01).Compared with the control group,the visual analog scale scores of the trial group were decreased on days 2,3,6,7 of treatment and 1,2 weeks after the end of treatment(P<0.05,P<0.01).(2)Compared with before treatment,Oswestry disability index after treatment was decreased in both groups(P<0.01).Compared with the control group,Oswestry disability index of the trial group was decreased from days 1 to 7 of treatment and 1,2 weeks after treatment(P<0.01).(3)Compared with before treatment,the Japanese Orthopaedic Association scores of both groups were increased after treatment(P<0.01).Compared with the control group,the Japanese Orthopaedic Association scores of the trial group were increased on days 3,7 of treatment and 1,2 weeks after treatment(P<0.05,P<0.01).(4)Compared with before tre

关 键 词：腰椎间盘突出症 超声引导 针刺 夹脊穴 临床观察 针灸治疗 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学] R245