三才组合针法治疗盘源性坐骨神经痛的效果观察

Observation on the therapeutic effect of Sancai combined acupuncture on discogenic sciatica

目的 观察三才组合针法治疗盘源性坐骨神经痛的临床疗效。方法 选择2021年2月至2022年12月于康复医学科收治的盘源性坐骨神经痛患者162例,采用随机数字表法分为对照组、常规针刺组、三才针刺组。对照组采用非甾体抗炎药口服止痛,常规针刺组采用常规针刺法,三才针刺组采用基于三才理论的组合针法,即天部采用传统头针配合山元氏新头针,地部采用毫火针劫刺根穴,人部采用揿针埋入后的运动针法。3组均干预4周。3组分别于干预前、干预4周以及干预结束后2周和4周进行疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)的评估,并在干预前后采集血清P物质(SP)、趋化因子配体10(CXCL10)、降钙素相关基因肽(CGRP)水平,测定腓肠神经的运动传导速度(MCV)和感觉传导速度(SCV)。结果 治疗方法与时间对VAS和ODI存在交互作用(P <0.05),治疗方法及时间对VAS和ODI主效应显著(P <0.05)。3组在干预4周、干预结束2周和4周的VAS和ODI结果均优于治疗前,差异有统计学意义(P <0.05)。三才针刺组在干预结束2周和4周的VAS评分以及在干预4周、干预结束2周和4周的的ODI评分均低于其余两组,差异有统计学意义(P <0.05);而在实验室指标和神经传导速度,治疗4周后,除对照组CXCL10、MCV、SCV三项指标外,各组在SP、CXCL10、CGRP水平均低于干预前,在MCV和SCV均高于干预前,差异有统计学意义(P <0.05)。组间比较,三才针刺组在CXCL10、CGRP水平均低于其余两组(P <0.05),在SP三才针刺组低于对照组(P <0.05),与常规针刺组差异无统计学意义(P> 0.05),在MCV和SCV,三才针刺组均高于其余两组(P <0.05)。结论 三才组合针法能有效干预患者的疼痛和功能障碍,改善多项实验室指标,提高神经传导速度,值得进一步研究。

Objective To observe the clinical effect of Sancai combined acupuncture on discogenic sciatica.Methods 162 patients with discogenic sciatica admitted to the Department of Rehabilitation Medicine of our hospital from February 2021 to December 2022 were randomly divided into control group,conventional acupuncture group and Sancai acupuncture group.The control group was treated with non-steroidal anti-inflammatory drugs for oral analgesia,the conventional acupuncture group was treated with conventional acupuncture,and the Sancai acupuncture group was treated with combined acupuncture based on Sancai theory,that is,the traditional scalp acupuncture combined with Shanyuan's new scalp acupuncture was used in the sky,the fire needle was used in the ground to rob the root point,and the human body was treated with the movement acupuncture after the press needle was buried.All three groups were intervened for 4 weeks.The pain visual analogue score(VAS) and Oswestry dysfunction index(ODI) were evaluated before,4 weeks after and 2 and 4 weeks after the intervention in the three groups,and the levels of serum substance P(SP),chemokine ligand 10(CXCL10),calcitonin related gene peptide(CGRP) were collected before and after the intervention,and the motor conduction velocity(MCV) and sensory conduction velocity(SCV) of the sural nerve were measured.Results There was an interaction between treatment method and time on VAS and ODI(P<0.05),and the main effect of treatment method and time on VAS and ODI was significant(P<0.05).The VAS and ODI results of the three groups at 4 weeks,2 weeks and 4 weeks after treatment were better than those before treatment,and the difference was statistically significant(P<0.05).The VAS score and ODI score of Sancai acupuncture group at the end of 2 and 4 weeks of treatment were lower than those of the other two groups,with significant difference(P<0.05);However,after 4 weeks of treatment,the levels of SP,CXCL10 and CGRP in the three groups were lower than those before treatment,and the levels of MCV and SCV were higher than those before treatment,except for CXCL10,MCV and SCV in the control group(P<0.05).In comparison between groups,the levels of CXCL10 and CGRP in Sancai acupuncture group were lower than those in the other two groups(P<0.05),lower in SP Sancai acupuncture group than those in the control group(P<0.05),and there was no difference between the two groups(P>0.05).In MCV and SCV,Sancai acupuncture group was higher than those in the other two groups(P<0.05).Conclusion Sancai combined acupuncture can effectively intervene the pain and dysfunction of patients,improve many laboratory indicators,and increase nerve conduction velocity,which is worthy of further study.