针刺联合雷火灸治疗寒湿型腰痛:随机对照试验  

Acupuncture combined with thunder-fire moxibustion for low back pain with cold-damp:a randomized controlled trial

作　　者：朱涛 蒋石琳 张玉甲 张天生 高珍 苗晋玲 ZHU Tao;JIANG Shilin;ZHANG Yujid;ZHANG Tiansheng;GAO Zhen;MIAO Jinling(School of Acupuncture-Moxibustion and Tuina,Chengdu University of TCM,Chengdu 611137,Sichuan Province,China;Second Clinical College,Shanxi University of CM;Fourth Department of Acupuncture-Moxibustion,Shanxi Provincial Hospital of Acupuncture and Moxibustion,Taiyuan 030006)

机构地区：[1]成都中医药大学针灸推拿学院,四川成都611137 [2]山西中医药大学第二临床学院 [3]山西省针灸医院针灸四科,太原030006

出　　处：《中国针灸》2025年第3期312-316,共5页Chinese Acupuncture & Moxibustion

基　　金：山西省教育厅科技创新项目:2022L340。

摘　　要：目的:观察针刺联合雷火灸治疗寒湿型腰痛的临床疗效。方法:将72例寒湿型腰痛患者随机分为观察组(36例,剔除1例)和对照组(36例,脱落1例)。对照组予针刺治疗,穴取脊中、腰阳关、阿是穴及双侧肾俞、大肠俞、委中,每次30 min,每天1次;观察组在对照组基础上予雷火灸治疗,取穴同对照组,每天1次。两组患者均连续治疗6d后休息1d,共治疗4周。观察两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、日本骨科学会(JOA)评分、当前疼痛强度(PPI)评分及血清β-内啡肽(β-EP)、5-羟色胺(5-HT)、P物质(SP)含量,并比较两组患者临床疗效。结果:治疗后,两组患者VAS、ODI、PPI评分及血清5-HT、SP含量较治疗前降低(P<0.01),JOA评分、血清β-EP含量较治疗前升高(P<0.01);观察组患者VAS、ODI、PPI评分及血清5-HT、SP含量低于对照组(P<0.05),JOA评分、血清β-EP含量高于对照组(P<0.05)。观察组总有效率为94.3%(33/35),高于对照组的82.9%(29/35,P<0.05)。结论:针刺联合雷火灸治疗可有效改善寒湿型腰痛患者的疼痛症状及腰部功能,可能与调控β-EP、5-HT、SP水平有关。Objective To observe the clinical efficacy of acupuncture combined with thunder-fire moxibustion in treating low back pain with cold-damp.Methods Seventy-two patients of low back pain with cold-damp were randomly divided into an observation group(36 cases,1 case was eliminated)and a control group(36 cases,1 case dropped out).The control group received acupuncture at Jizhong(GV6),Yaoyangguan(GV3),ashi points,bilateral Shenshu(BL23),Dachangshu(BL25),and Weizhong(BL40)for 30 min daily.The observation group was treated with thunder-fire moxibustion in addition to the same acupuncture regimen as the control group,once daily.Both groups were treated for 6 consecutive days followed by one rest day,for a total duration of 4 weeks.The visual analog scale(VAS)score,Oswestry disability index(ODI)score,Japanese Orthopedic Association(JOA)score,present pain intensity(PPI)score,and serum levels ofβ-endorphin(β-EP),5-hydroxytryp tamin(5-HT),and substance P(SP)were compared before and after treatment,and the clinical efficacy was also compared between the two groups.Results Compared before treatment,the VAS scores,ODI scores,PPI scores,and serum levels of 5-HT and SP were decreased(P<0.01),while JOA scores and serum levels ofβ-EP were increased(P<0.01)in both groups after treatment.The observation group showed lower VAS,ODI,and PPI scores and serum levels of 5-HT and SP than those in the control group(P<0.05),as well as higher JOA score and serum level ofβ-EP(P<0.05).The total effective rate in the observation group was 94.3%(33/35),higher than 82.9%(29/35)in the control group(P<0.05).Conclusion Acupuncture combined with thunder-fire moxibustion could effectively alleviate pain and improve lumbar function in patients of low back pain with cold-damp,possibly by regulatingβ-EP,5-HT,and SP levels.

关 键 词：寒湿型腰痛 针刺 雷火灸 疼痛 随机对照试验 

分 类 号：R246.9[医药卫生—针灸推拿学]