腰段夹脊穴不同针刺方向对慢性非特异性腰痛疗效研究

Study on the therapeutic effect of different acupuncture directions of waist Jiaji points on chronic non-specific low back pain

目的探究腰段夹脊穴不同针刺方向对慢性非特异性腰痛的临床疗效。方法选取90例慢性非特异性腰痛患者,按随机数表法分为分成3组,A组予华佗夹脊穴直刺深刺(与矢状面平行0°进针),B组予华佗夹脊穴斜刺深刺(与矢状面30°角),C组予华佗夹脊穴直刺浅刺,各30例,A、B、C组穴位取腰1-腰5华佗夹脊穴,深刺组针刺2寸,浅刺组针刺1寸。比较3组患者的临床疗效,针刺前及治疗当天,90 d的功能障碍指数(ODI)、视觉模拟评分法(VAS)、腰椎功能评分(JOA),不良反应发生率。结果治疗后当天和90 d后,A组和B组临床疗效总有效率均高于C组(P<0.05);治疗后当天,A组和B组ODI评分明显低于C组(P<0.05);治疗后当天,B组VAS评分明显低于A组和C组(P<0.05);治疗期间,3组的不良反应发生情况差异无统计学意义(P>0.05)。结论不同角度和深度针刺华佗夹脊穴对治疗慢性非特异性腰痛均具有效果,可有效改善患者的功能障碍,缓解疼痛,但深刺对短期内改善患者的症状和体征效果更明显。

Objective To explore the clinical efficacy of different acupuncture directions at Jiaji points in the treatment of chronic non-specific low back pain.Methods 90 patients with chronic non-specific low back pain were selected and divided into group A,group B and group C according to the random number table method,with 30 cases in each group.Group A received direct needling and deep needling at Huatuo Jiaji acupoint(0°parallel to the sagittal plane),group B received oblique needling and deep needling at Huatuo Jiaji acupoint(30°angle to the sagittal plane),and group C received direct needling and shallow needling at Huatuo Jiaji acupoint.Group A,group B and group C selected Huatuo Jiaji acupoints from L1 to L5,and the group receiving deep needling received 2 inches of acupuncture,while the group receiving shallow needling received 1 inch of acupuncture.The clinical efficacy,and the Oswestry Disability Index(ODI),Visual Analog Scale(VAS)and Japanese Orthopaedic Association(JOA)score before acupuncture,on the day of treatment and 90 days after treatment,and incidence of adverse reactions of the three groups were compared.Results On the day after treatment and 90 days after treatment,the total clinical effective rates of Group A and Group B were higher than those of Group C(P<0.05).On the day after treatment,the ODI scores of Group A and Group B were significantly lower than those of Group C(P<0.05).On the day after treatment,the VAS score of Group B was significantly lower than that of Group A and Group C(P<0.05).During the treatment,there was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Acupuncture at Huatuo Jiaji acupoints from different angles and depths has effective effects in the treatment of chronic non-specific low back pain,which can effectively improve patients’dysfunction,and alleviate pain.However,deep needling has the more significant effect on improving patients'symptoms and signs in the short term.