经筋刺法治疗下腰痛的随机对照研究

A randomized controlled study on the treatment of low back pain with meridian sinew acupuncture

目的比较针刺结筋病灶点与传统经穴治疗下腰痛的疗效差异。方法将2018年5月—2020年1月就诊于大连市中心医院的180例下腰痛患者按1∶1比例随机分为试验组90例和对照组90例。试验组患者先进行经筋触诊,确定结筋病灶点部位后按照针刺流程操作,常见结筋病灶点有环跳次、志室次、肓门次、腰椎横突等;对照组选择大肠俞、委中、腰眼等辨证取穴进行针刺。2组均隔日治疗1次,5次为1个疗程,疗程之间休息2 d,共治疗4个疗程。记录治疗前、治疗2个疗程后、治疗4个疗程后2组患者视觉模拟疼痛评分(VAS)、Roland-Morris功能障碍调查表(RMDQ)评分以及腹、背肌等长耐力。结果共脱落12例,均保留在原组并使用干预前数据进行统计分析。治疗2个疗程后、治疗4个疗程后2组VAS评分、RMDQ评分均明显低于治疗前(P均<0.05),且试验组均明显低于同期对照组(P均<0.05);2组腹、腰肌耐力均明显提高(P均<0.05),且试验组均明显高于同期对照组(P均<0.05)。结论经筋刺法与传统刺法均能明显改善下腰痛的临床症状与肌肉耐力,且前者改善程度更优。

Objective It is to observe the difference in the efficacy between acupuncture at sinew lesion and traditional meridian points in the treatment of low back pain(LBP).Methods A total of 180 patients with low back pain treated in Dalian Central Hospital from May 2018 to January 2020 were randomly divided into a test group of 90 cases and a control group of 90 cases according to a 1∶1 ratio.The patients in the test group were first to undergo meridian sinew palpation to determine the location of the musculoskeletal lesions and follow the acupuncture procedures,the common meridian sinew lesions were Huantiao,Zhishi,Huangmen,lumbar transverse process,etc.;the control group was treated with acupuncture at the acupoints such as Dachangshu,Weizhong,Yaoyan after syndrome differentiation.Both groups were treated once every other day,5 times as a course of treatment,2 days of rest between treatment courses,a total of 4 courses of treatment.The scores of visual analogue scale(VAS),Roland-Morris dysfunction questionnaire(RMDQ)and the endurance of abdominal and back muscles were recorded before treatment,and after 2 and 4 treatment courses.Results A total of 12 cases of shedding were retained in the original group and statistical analysis was performed using pre-intervention data.After 2 and 4 treatment courses,the VAS scores and RMDQ scores of the two groups were significantly lower than those before treatment,and the test group was significantly lower than the control group during the same period;the endurance of the abdominal and psoas muscles of the two groups were significantly improved(P<0.05),and the test group was significantly higher than the control group during the same period(P<0.05).Conclusion Both meridian sinew acupuncture and traditional acupuncture can significantly improve the clinical symptoms and muscle endurance of low back pain,and the former is more effective.