针刺坐骨神经干治疗腰椎间盘突出症所致坐骨神经痛的疗效观察

A Randomized Controlled Clinical Trial of Treatment of Lumbar Disc Herniation-induced Sciatica by Acupuncture Stimulation of Sciatic Nerve Trunk

目的:观察以针刺坐骨神经干为主治疗腰椎间盘突出症所致坐骨神经痛的疗效,并与常规针刺组进行比较,探讨腰椎间盘突出症所致坐骨神经痛的更佳治疗方案。方法:将腰椎间盘突出症所致坐骨神经痛患者随机分为神经干刺激组和常规针刺组,每组30例。常规针刺组选取阿是穴、腰夹脊、大肠俞穴,并结合辨证取穴针刺;神经干刺激组采用坐骨神经干刺激法,针刺环跳、环中,并配合常规针刺的方法进行治疗。两组均每天治疗1次,5次为1个疗程,每个疗程间休息2d,共治疗4个疗程。采用简化McGill疼痛量表(SFMPQ)进行临床疗效评价。结果:神经干刺激组愈显率为83.3%(25/30),明显优于常规针刺组的60.0%(18/30,P<0.05)。治疗后两组疼痛分级指数、视觉疼痛模拟评分、现有疼痛强度评分较治疗前均明显降低(P<0.01),神经干刺激组较常规针刺组改善更为明显(P<0.01)。结论:在治疗腰椎间盘突出症所致坐骨神经痛方面,针刺坐骨神经干与常规针刺方法均安全有效,在改善患者疼痛方面,针刺坐骨神经干治疗优于常规针刺。

Objective To observe the efficacy of acupuncture stimulation of the sciatic nerve trunk in the treatment of patients suffering from sciatica induced by lumbar disc herniation（LDH）.Methods A total of 60 LDH sciatica patients met the inclusion criteria were randomly divided into treatment group and control group,with 30 cases in each.Patients of the treatment group were treated by directly needling the sciatic nerve and routine acupuncture of Ashi-points,Lumbar Jiaji（EX-B 2）,Dachangshu（BL 28）,etc.,and those of the control group treated by simple routine acupuncture.The treatment was conducted once a day,5times a week,4weeks altogether.The clinical effect was evaluated according to the＂Standards for Diagnosis and Therapeutic Effect Evaluation of Syndromes of Chinese Medicine＂and the pain intensity was assessed by using simplified Short-Form McGill Pain Questionnaire（SF-MPQ）containing pain rating index（PRI）,visual analogue scale（VAS）and present pain intensity（PPI）.Results After the treatment,of the two 30 cases of LDH sciatica patients in the control and treatment groups,11 and 18were cured,7and 7experienced marked improvement,10 and 4were effective,2and 1was invalid,with the effective rate being 93.3% and 96.7%,respectively.The cured＋markedly effective rate of the treatment group was significantly higher than that of the control group（P0.05,83.3% vs 60.0%）.Compared with pre-treatment,the scores of PRI,VAS and PPI were evidently lowered in both groups（P0.01）,and the effect of the treatment group was notably better than that of the control group（P0.01）.Conclusion Acupuncture stimulation of the sciatic nerve trunk is effective in relieving sciatica in LDH patients,and is superior to simple routine acupuncture in the clinical efficacy.