摘要
目的:腰椎间盘突出症(Lumbar Disc Herniation,LDH)是引发腰腿疼的常见原因,寒湿证为其常见中医证型。本研究以影响针刺效果的针刺刺激量(针刺方式、留针时间、针刺频率及针刺疗程)作为筛选因素,采用正交设计法优选LDH寒湿证的最佳针刺搭配方案,为临床选择LDH寒湿证的最优治疗方案提供思路。方法:纳入180例LDH寒湿证患者,采用L_(9)(3^(4))正交设计方案,探究针刺方式(电针、温针、无刺激)、留针时间(10分钟、20分钟、30分钟)、针刺频率(1日2次、1日1次、2日1次)和针刺疗程(1周、2周、3周)对LDH寒湿证治疗效果的影响,观察各组治疗前后Roland–Morris功能障碍调查表(Roland–Morris Disability Questionnaire,RMDQ)、椎体Oswestry功能障碍指数(Oswestry Disability Index,ODI)、视觉模拟评分法(Visual Analogue Scale,VAS)和日本骨科协会评估治疗分数(Japanese Orthopaedic Association,JOA)评分的改善情况,分析各因子主效应和边际平均值结果,优选LDH寒湿证的最佳针刺搭配方案。结果:①与治疗前比较,各组治疗后RMDQ、ODI、VAS和JOA评分均显著改善,差异具有统计学意义(P<0.05),说明各组治疗方案均可改善LDH寒湿证患者的临床症状;②基于各因子主效应和边际平均值分析,温针、留针30分钟、2日1次、治疗2周的治疗方案具有治疗前后的最大RMDQ差值、ODI差值、VAS差值和JOA差值,说明温针、留针30分钟、2日1次、治疗2周治疗效果最佳。结论:本研究预测针刺治疗寒湿型LDH的最佳治疗方案是针刺方式为温针,留针时间30分钟,针刺频率2日1次,针刺疗程为2周。
Objective:Lumbar disc herniation(LDH)is a common cause of low back and leg pain,and cold dampness syndrome is its common TCM syndrome type.In this study,the amount of acupuncture stimulation(acupuncture method,needle retention time,acupuncture frequency and acupuncture course)that affects the acupuncture effect will be selected as the screening scheme,and the orthogonal design method will be used to determine the optimal acupuncture combination scheme,providing ideas for the clinical approach of LDH cold dampness syndrome.Method:180 patients with LDH cold dampness syndrome were included,and an L_(9)(3^(4))orthogonal design was used to investigate the effects of acupuncture methods(electroacupuncture,warm needle,no stimulation),needle retention time(10 minutes,20 minutes,30 minutes),acupuncture frequency(twice a day,once a day,once every 2 days),and acupuncture duration(1 week,2 weeks,3 weeks)on the treatment effect of LDH cold dampness syndrome.The improvement of RMDQ,ODI,VAS,and JOA scores before and after treatment in each group was observed,and the main effects and marginal mean values of each factor were analyzed to select the optimal acupuncture combination for LDH cold dampness syndrome.Result:①Compared with before treatment,RMDQ,ODI,VAS,and JOA scores in all groups improved significantly after treatment,and the differences were statistically significant(P<0.05),indicating that all treatments can improve the clinical symptoms of LDH cold dampness syndrome patients.②Based on the main effects and marginal mean analysis of various factors,the treatment plan of warm needle,needle retention for 30 minutes,once every 2 days,and treatment for 2 weeks has the maximum RMDQ difference,ODI difference,VAS difference,and JOA difference before and after treatment,indicating that warm needle,needle retention for 30 minutes,once every 2 days,and treatment for 2 weeks have the best effect.Conclusion:This study predicts that the optimal treatment plan for acupuncture in the treatment of LDH cold dampness syndrome is warm needling,needle retention time of 30 minutes,acupuncture frequency of once every 2 days,and acupuncture course of 2 weeks.
出处
《中医临床研究》
2025年第28期86-93,共8页
Clinical Journal Of Chinese Medicine
基金
山东省中医药科技项目(Q–2022036)。
关键词
腰椎间盘突出
寒湿证
正交设计
针刺方式
留针时间
Lumbar disc herniation
Cold dampness syndrom
Orthogonal design
Acupuncture method
Needle retention time
