杵针治疗腰椎间盘突出症的多中心随机对照研究

Effect of pestle needle in treating lumber disc herniation: a multicenter randomized controlled trial

目的比较杵针和电针治疗血瘀型腰椎间盘突出症的临床疗效差异。方法将233例血瘀型腰椎间盘突出症患者随机分成治疗组117例和对照组116例。治疗组采用杵针治疗,穴取腰阳关八阵穴、河车路命门至长强段、环跳、阳陵泉,隔天治疗1次,20 min/次,每周3次,12次为1个疗程,共观察治疗1个疗程;对照组穴取腰阳关、十七椎、环跳、阳陵泉,治疗时间和周期与治疗组相同。观察两组的临床疗效,并记录两组患者治疗前后及治疗后1个月随访时下腰痛评分(JOA评分)。结果两组腰椎间盘突出症患者治疗后,治疗组总有效率86.32%,对照组总有效率90.52%,两组比较差异无统计学意义(P>0.05),说明两组临床疗效相当。两组腰椎间盘突出症患者治疗后及1个月后随访时的JOA评分与治疗前比较均有显著性提高(P<0.01),而各时间点组间差异均无统计学意义(P>0.05)。结论杵针与电针治疗血瘀型腰椎间盘突出症临床疗效相当,但杵针无创伤、无痛苦、操作方便,患者易于接受,值得临床推广应用。

Objective To compare the effect of pestle acupuncture(PA)and electroacupuncture(EA)in treating lumbar disc herniation(LDH)differentiated by blood stasis syndrome.Methods A total of 233 LDH patients differentiated by blood stasis syndrome were randomized into the observation group(117)and the control group(116).The observation group was treated by PA on eight tactical arrays of GV 3(Yaoyangguan),heche line from GV 4(Mingmen)to GV 1(Changqiang),GB 30(Huantiao),GB 34(Yanglingquan),for 20 minutes each time,once every two days,three times a week,12 times as one course.The control group was treated by electroacupuncture on the points of GV 3(Yaoyangguan),EX-B 8(Shiqizhui),GB 30(Huantiao),and GB 34(Yanglingquan),and treatment frequency and duration were the same as the observation group.Clinical effect was observed and the Japanese Orthopedics Association(JOA)score was recorded before treatment,after treatment and in 1-month follow-up visit in the two groups.Results The total effective rate was 86.32%in the observation group,and 90.52%in the control group respectively,without significant differences between the groups(P>0.05),indicating a similar clinical effect.Compared with those before treatment,JOA scores were all improved after treatment and in follow-up visit in the two groups(P<0.01),without statistical significance at each time point between the two groups(P>0.05).Conclusion The pestle needle has a similar effect as the electroacupuncture in treating LDH differentiated by blood stasis syndrome.However,PA is noninvasive,painless,convenient and easily to accept by patients,which is worthy of application.