傍针刺治疗坐骨神经痛随机对照研究

Randomized controlled study on proximal needling for sciatica

目的:比较傍针刺与常规针刺治疗坐骨神经痛的疗效差异。方法:将60例坐骨神经痛患者随机分为傍针刺组和常规针刺组,每组30例。傍针刺组采用傍针刺环跳穴,常规针刺组穴取环跳、殷门、委中、阳陵泉等,行常规针刺。观察两组治疗1个疗程后及结束治疗3个月后随访的数字疼痛评分(NPRS)、改良日本骨科学会下腰痛评分(JOA)。结果:两组随访时总有效率均为100.0%(30/30),两组疗效相当;傍针刺组治疗后JOA评价分级总改善率为100.0%(30/30),优于常规针刺组的80.0%(24/30);两组患者治疗后、随访时NPRS疼痛评分、JOA评分均较治疗前明显改善(均P<0.01),治疗后傍针刺组2项评分较常规针刺组改善更明显(均P<0.05)。结论:傍针刺环跳穴较常规针刺治疗坐骨神经痛近期疗效显著。

Objective To compare the effect of proximal needling and routine acupuncture for sciatica. Methods Sixty patients with sciatica were randomly divided into a proximal needling group and a routine acupuncture group, 30 cases in each group. The proximal needling group was treated by proximal needling at Huantiao （GB 30）. The routine acupuncture group was treated by acupuncture at Huantiao （GB 30）, Yinmen （BL 37）, Weizhong （BL 40）, Yanglingquan （GB 34） etc. with routine acupuncture method. The Numerical Pain Rating Scales （NPRS） the Japanese Orthopaedic Association Scores （JOA） were all observed before, after treatment and in following up. Results The total effective rates were 100.0% （30/30） in both groups, with no significant difference between the two groups （P〉0. 05） in 3 month follow up. After 5 treatments, the total improvement rate of 100.0% （30/30） in the proximal needling group was super to that of 80.0% （24/30） in the routine acupuncture group. The NPRS and JOA scores were all improved significantly after 5 treatment and in following up compared with those before treatment in two groups （all P〈0. 01）. After treatments, the improvement of the NPRS and JOA scores in the proximal needling group was greater than those in the routine acupuncture group （both P〈0. 05）. Conclusion The proximal needling treatment has rapid and obvious therapeutic effect and analgesia on sciatica.