环跳穴针刺深度对气滞血瘀型腰椎间盘突出症疗效的影响

Effect of needling depth at Huantiao(GB30)on the efficacy for lumbar intervertebral disc herniation of blood stasis due to Qi stagnation

目的观察环跳穴不同针刺深度对气滞血瘀型腰椎间盘突出症临床疗效的影响。方法招募150例气滞血瘀型腰椎间盘突出症患者,用随机数字表法分为深刺组(75例)和浅刺组(75例)。深刺组采用芒针深刺环跳穴治疗,浅刺组采用毫针针刺环跳穴治疗。分别在治疗前、治疗1个疗程后、治疗后和随访时,观察两组疼痛视觉模拟量表(visual analog scale,VAS)评分、日本骨科协会(Japanese Orthopaedic Association,JOA)腰椎评分、肌力评分和患侧膝踝反射评分的变化。比较两组临床疗效。结果深刺组治愈率高于浅刺组(P<0.05)。两组各时间点VAS评分、JOA腰椎评分、肌力评分和患侧膝踝反射评分比较,差异有统计学意义(P<0.05)。治疗后和随访时,深刺组VAS评分均低于浅刺组(P<0.05);治疗1个疗程后、治疗后和随访时,深刺组JOA腰椎评分和肌力评分均优于对照组(P<0.05)。结论环跳穴深刺治疗气滞血瘀型腰椎间盘突出症的临床疗效优于浅刺,可更有效地缓解疼痛,改善症状,提高肌力。

Objective To observe the effects of different needling depths at Huantiao(GB30)on the clinical efficacy for lumbar intervertebral disc herniation of blood stasis due to Qi stagnation.Method One hundred and fifty patients with lumbar intervertebral disc herniation of blood stasis due to Qi stagnation were enrolled and randomized to a deep needling group(75 cases)and a superficial needling group(75 cases)using the random number table method.The deep needling group was treated by the deep insertion of an elongated needle at Huantiao and the superficial needling group treated by the insertion of a filiform needle at Huantiao.The visual analog scale(VAS)score,Japanese Orthopaedic Association(JOA)lumbar vertebra score,myodynamia score and the affected-side knee and ankle reflex score were recorded in the two groups before treatment,after 1-course treatment and the whole treatment,and at the follow-up.The clinical therapeutic effects were compared between the two groups.Result The cure rate was higher in the deep needling group than in the superficial needling group(P<0.05).There were statistically significant differences in VAS score,JOA lumbar vertebra score,myodynamia score and affected-side knee and ankle reflex score at various time points between the two groups(P<0.05).The VAS score was lower in the deep needling group than in the superficial needling group after the completion of treatment and at the follow-up(P<0.05).The JOA lumbar vertebra score,myodynamia score and affected-side knee and ankle reflex score were better in the deep needling group than in the superficial needling group after 1-course treatment and the completion of treatment and at the follow-up(P<0.05).Conclusion Deep needling at Huantiao is clinically more effective than superficial needling in treating lumbar intervertebral disc herniation of blood stasis due to Qi stagnation. It can more effectively alleviate pain, relieve the symptoms and improve myodynamia.