腕踝针对腰痛止痛作用的针刺点特异性随机对照临床研究

Needling point specificity for analgesic effect of wrist-ankle acupuncture on low-back pain:a randomized controlled trial

目的研究腕踝针的"针刺点"与"身体分区"的对应关系是否具有特异性,即腕踝针针刺点作用的特异性。方法采用随机对照临床试验,将90例急性腰痛患者随机分为三组,每组30例。三组受试者均采用腕踝针治疗1次,留针30 min。特异针刺点组根据腕踝针"按身体分区选择针刺点"的理论针刺下6或下5针刺点;非特异针刺点1组和2组分别针刺下2和上5针刺点。治疗前3 min和治疗过程第5、10、15和第30 min,分别用简式Mc Gill疼痛问卷(SF-MPQ)评价受试者活动腰部时疼痛情况,用重复改良的Schober试验(MMS)观察腰椎活动度,用预期和治疗信任度问卷(ETCS)评价三组患者治疗前后预期的变化。结果三组治疗前SFMPQ、MMS和ETCS各项差异均无统计学意义(P>0.05)。三组SF-MPQ评分在第5、10、15和30 min与治疗前相比均降低(P<0.05)。在第5、10和15 min,特异针刺点组的SF-MPQ多项评分(除PPI外)与治疗前的差值高于非特异针刺点1组和2组(P<0.05)。治疗30 min后,特异针刺点组的SF-MPQ所有项目评分与治疗前的差值均高于非特异针刺点1组和2组(P<0.05)。三组MMS治疗后均高于治疗前(P<0.05),特异针刺点组MMS治疗后与治疗前差值高于非特异针刺点1组和2组(P<0.05)。特异针刺点组的ETCS所有项目评分在治疗后与治疗前相比均升高(P<0.05)。非特异针刺点1组和2组的ETCS所有项目评分在治疗后与治疗前相比,差异无统计学意义(P>0.05)。结论腕踝针针刺点对急性腰痛具有止痛和改善腰椎前屈活动度作用,具有一定的特异性。

Objective To study whether the corresponding relationship between ＂needling point＂ and＂ body partition＂ is specific, that is, the specificity of the needling point in wrist-ankle acupuncture. Methods A randomized controlled trial was designed. Ninety patients with acute low-beck pain （ALBP） were randomly divided into the specific needling point group and No. 1 and 2 non-specific needling point groups, 30 cases in each group. All the subjects were treated with wrist-ankle acupuncture for one time with a retaining needle time of 30 minutes. The specific needling point group was treated with acupuncture at the needling points of lower 5 or 6 region according to the theory of ＂selecting needling point based on the body partition＂, and No. 1 and 2 non-speeific needling point groups were treated with acupuncture at the needling points of lower 2 and uppers region,respectively. At the timepoints af3 minutes before treatment andS, 10, 15, 30 minutes in the treatment course, the short form McGiil pain questionnaire （SF-MPQ） was used to evaluate the waist pain when the subjects exercised, the modified- modified Schober test （MMS） was used to observe the lumbar activity,the expected changes in the three groups before and afler the treatment were analyzed by expectation and treatment credibility scale （ETCS）. Results Before the treatment, there were no statistically significant differences on the scores of all items in SF-MPQ, MMS and ETCS among the three groups （ P 〉 0. 05 ）. Compared with the treatment before, the scores of all items in SF-MPQ in the three gToups were all decreased at the timepoints of 5, 10, 15 and 30 minutes in the treatment course（ P 〈0.05 ）. For the comparison of treatment before and after,at the timepoint of 5, 10, 15 minutes, the differences on the scores of all items in SF-MPQ （ except PPI） in the specific needling point group were all greater than those in No. 1 and 2 non-specific needling point groups （P 〈 0.05 ） ; at the timepoint of 30 minutes, the differences on the scores of all items in SF-MPQ in the specific needling point group were all greater than those in No. 1 and 2 non-specific needling point groups（P 〈 0. 05 ）. Compared with the treatment before, the scores of MMS in the three groups were all increased after treatment（ P 〈 0.05 ）. For the comparison of treatment before and after, the differences on the score of MMS in the specific needling point group were all greater than those in No. 1 and 2 non-specific needling point greups（P 〈0.05）. Compared with the treatment before,the scores of all items in ETCS in the specific needling point group were all increased after treatment （ P 〈 0.05 ）. For the comparison of treatment before and after, there were no statistically significant differences on the scores of all items in ETCS in No. 1 and 2 non-speeific needling point groups（ P 〉 0. 05 ）. Conclusion The wrist-ankle acupuncture shows the analgesic effect on low-back pain and improves the lumbar flexion activity,which has certain specificity.