电针为主治疗腰椎间盘突出所致坐骨神经痛:多中心随机对照试验

Electro-Acupuncture-Based Therapy for Sciatica Caused by Prolapsed Lumbar Disc: A Multi-Center Randomized Controlled Trial

目的：筛选以电针为主治疗腰椎间盘突出所致坐骨神经痛的简便优效方案。方法：开展多中心随机对照试验,将198例腰椎间盘突出所致坐骨神经痛患者随机分成电针治疗组（A组）66例、电针联合牵引治疗组（B组）67例、电针联合牵引治疗组（C组）65例。3组均第1-2 w,5次/w,第3-4 w每周治疗3次,第5-6 w每周治疗2次,第12 w随访。比较各组治疗前后腿痛VAS视觉模拟评分（Vas LP）、改良罗兰功能问卷（Roland）、Likert总体恢复自我评价量表的改变。结果：治疗6 w后,3组Vas LP评分、Roland评分均显著降低（均P〈0.01）,Likert总体恢复评分逐渐增高,且在治疗后第12 w疗效更加显著。3组Vas LP评分、Roland评分、Likert总体恢复组间差异均无统计学意义（均P〉0.05）。结论：三种治疗方案对腰椎间盘突出所致坐骨神经痛均有减轻患腿疼痛、增强患腿运动功能、促进总体恢复的疗效,且三者疗效相当,并未随着疗法的增加出现明显的疗效叠加效应。

Objective： To screen a simple and effective electro-acupuncture-based therapy for sciatica caused by prolapsed lumbar disc. Methods： 198 patients with sciatica were randomly divided into group A for 66, group B for 67 and group C for 65 persons. Electro-acupuncture therapy was given to group A, a combination of electro-acupuncture and traction therapy to group B, and a combination of electro-acupuncture, traction and western medicine therapy to group C. In the lS＇ and 2nd week, patients received 5 times treatments per week; in the 3rd and 4th week, 3 times per week; and in the 5th and 6th week, twice per week; the follow-up was performed in the 12th week. For each group, the change of scores of Visual Analog Scale of Leg Pain （VasLP）, Improved Roland Functional Questionnaire （Roland） and Likert＇ s Overall Recovery Self Evaluating Scale before and after the therapy were compared. Results： After the therapy for 6 weeks, for all the 3 groups, the scores of VasLP and Roland significantly decreased （ all P 〈0.01 ）, and the scores of Likert＇ s Overall Recovery Self Evaluating Scale gradually increased. Moreover, a more pronounced effect was observed after the therapy for 12 weeks. All the differences between the groups for the scores of VasLP, Roland and Lekert＇ s Over- all Recovery Self Evaluating Scale had no statistical significance （ all P 〉 0. 05） . Conclusion- All of the three kinds of therapies can treat sciatica due to prolapsed lumbar disc in reducing leg pain, improving motor function of the affected leg, and in promoting overall recovery almost equally. No additive effects have been observed with the increase of therapy.