刺骨针法改善退行性腰椎管狭窄症疼痛及功能的临床研究  

Clinical study on the effectiveness of bone acupuncture for alleviating pain and improving function in patients with degenerative lumbar spinal stenosis

作　　者：韩昶晓 冯敏山[1,2] 高景华 尹逊路[1,2] 刘广伟 温海宝 李静 彭博辰 朱立国 HAN Chang-xiao;FENG Min-shan;GAO Jing-hua;YIN Xun-lu;LIU Guang-wei;WEN Hai-bao;LI Jing;PENG Bo-chen;ZHU Li-guo(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing Key Laboratory of Traditional Chinese Orthopaedics,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]中医正骨技术北京市重点实验室,北京100102

出　　处：《中国骨伤》2025年第2期152-156,共5页China Journal of Orthopaedics and Traumatology

基　　金：北京市中医药科技发展项目(编号:JJ-2020-72);中国中医科学院望京医院高水平中医医院建设项目“名老医药专家学术经验传承”专项(编号:WJCC-202302)。

摘　　要：目的:评估刺骨针法对退行性腰椎管狭窄症患者疼痛与功能障碍的改善情况,并与常规夹脊针法进行对比。方法:2023年1月至2023年12月采用针刺治疗的腰椎管狭窄患者80例,根据针刺方法不同分为骨针组与夹脊针组。骨针组40例,男15例,女25例;年龄(60.60±6.98)岁。夹脊针组40例,男16例,女24例;年龄(61.48±9.55)岁。观察比较两组治疗前及治疗后2、4、12周的Roland Morris残疾问卷(Roland Morris disability questionnaire,RMDQ)、行走距离、视觉模拟疼痛评分(visual analogue scale,VAS)以及生活质量简表(the MOS item short from health survey,SF-36),评估功能障碍、疼痛及生活质量改善情况。结果:80例患者获得随访,时间3~5(3.62±0.59)个月。两组患者一般资料与各评分在治疗前差异均无统计学意义(P>0.05)。两组的RMDQ评分在治疗后2、4、12周均较治疗前显著降低(P<0.05);在治疗后各时间点,骨针组较夹脊针组降低更为显著(P<0.05)。两组的腰部与腿部VAS在治疗后2、4、12周均较治疗前显著降低(P<0.05);在治疗后各时间点,骨针组腰部VAS均较夹脊针组降低更为显著(P<0.05);两组腿部VAS在治疗后2、12周比较差异均无统计学意义(P>0.05),在治疗后4周骨针组较夹脊针组改善更为显著(P<0.05)。两组的SF-36评分在治疗后2、4、12周均较治疗前显著升高(P<0.05),在治疗后各时间点,骨针组较夹脊针组的SF-36评分均升高更为显著(P<0.05)。在治疗后2周,两组的行走距离结果比较差异无统计学意义(P>0.05),治疗后4、12周骨针组较夹脊针组的行走距离提升更为显著(P<0.05)。结论:刺骨针法能一定程度改善退行性腰椎管狭窄症患者的功能障碍、疼痛与生活质量,疗效优于常规夹脊针治疗。Objective To assess the effectiveness of bone acupuncture in improving pain and function in degenerative lumbar spinal stenosis(DLSS)and compare it with Jiaji acupuncture.Methods From January to December 2023,80 DLSS patients were treated with acupuncture and divided into bone acupuncture and Jiaji acupuncture groups.Among them,40 patients in the bone acupuncture group included 15 males and 25 females,with a mean age of(60.60±6.98)years old;anthor 40 patients in the Jiaji acupuncture group included 16 males and 24 females,with a mean age of(61.48±9.55)years old.The Roland Morris disability questionnaire(RMDQ),walking distance,visual analogue scale(VAS),and the MOS item short from health survey(SF-36)of two groups at baseline,2 weeks,4 weeks,and 12 weeks post-treatment were compared.Results Eighty patients were followed up for 3 to 5 months with an average of(3.62±0.59)months.There was no significant differences in general data and the scores before treatment between two groups(P>0.05).The RMDQ scores in both groups decreased significantly at 2,4 and 12 weeks after treatment compared with before treatment(P<0.05),at each time point after treatment,the decrease was more significant in the bone acupuncture group than in the Jiaji acupuncture group(P<0.05).The VAS of waist and leg in both groups was significantly lower at 2,4 and 12 weeks after treatment that before treatment(P<0.05).At all time points after treatment,the waist VAS in the bone acupuncture group was reduced more significant than in the Jiaji acupuncture group(P<0.05);there was no significant difference in leg VAS at 2 and 12 weeks after treatment between two groups(P>0.05),the improvement was more significant in the bone acupuncture group in the 4 weeks after treatment than in the Jiaji acupuncture group.The SF-36 scores in both groups were significantly higher at 2,4,and 12 weeks after treatment than before treatment(P<0.05);the SF-36 score raised more significant in the bone acupuncture group than in the Jiaji acupunture group(P<0.05).No signific

关 键 词：刺骨针法 夹脊针 退行性腰椎管狭窄症 疼痛 功能障碍 

分 类 号：R853.617[医药卫生—航空、航天与航海医学]