经筋刺法治疗非特异性腰痛的多中心随机对照研究

Multi-center randomized controlled trials of non-specific low back pain treatment of tendons acupuncture therapy

目的:采用多中心随机对照试验方案观察针刺传统经穴与结筋病灶点治疗非特异性腰痛(NLBP)的疗效差异。方法:将180例NLBP患者按1∶3的比例随机分为对照组(45例)和试验组(135例)。对照组选择大肠俞、委中、腰眼等辨证取穴进行针刺。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;隔日治疗1次,5次为1个疗程,疗程之间休息2d,共治疗4个疗程。记录治疗前、治疗中(治疗2个疗程)、治疗后两组患者VAS、RMBQ评分以及腹、背肌等长耐力测试。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。治疗中和治疗后,两组VAS评分、RMDQ评分,腹肌和背肌耐力测试均较治疗前显著改善(P<0.01),其中试验组治疗后指标均优于治疗中(P<0.01)。试验组在治疗中及治疗后,各指标均较对照组显著改善(P<0.01)。结论:经筋刺法与传统刺法均能明显改善NLBP的临床症状与肌肉耐力,且前者作用更优。

Objective:To observe the difference in the efficacy of acupuncturing tendon focal points and traditional meridian points for the treatment of non-specific low back pain(NLBP)through a multi-center randomized controlled trial.Methods:A total of 180 patients with NLBP were randomly divided into a control group(45 cases)and a test group(135 cases)at a ratio of 1:3.Patients in the control group were treated by acupuncturing traditional meridian points which conclude Dachangshu(BL 25),Weizhong(BL 40),Yaoyan(EX-B6)etc..Patients in the test group were firstly subjected to palpation of tendon focal points,and then followed the acupuncture procedure based on the tendon focal points.Treatment was performed once every other day,and 5 times was a course of treatment,There was a 2 d rest between courses,and a total of 4 courses were treated.The VAS,RMBQ scores and abdominal and dorsum muscle endurance tests were recorded before treatment,amidst treatment(2 courses),and after treatment.Results:A total of 12 cases of shedding were retained in the original group and statistical analysis was performed using pre-intervention data.Amidst and after treatment,the VAS score,RMDQ score,and abdominal and dorsum muscle endurance tests of the two groups were improved compared with those before treatment(P<0.01),and the evaluation indicators of the test group were better than those during treatment(P<0.01).In the test group,the indexes were significantly improved compared with the control group at the amidst and after treatment(P<0.01).Conclusion:Both the tendon and traditional acupuncture can significantly improve the clinical symptoms and muscle endurance of NBLP,and the former is better.